Tuberculosis-associated Immune Thrombocytopenia: A Case Report.

Area of Science:

• Internal Medicine
• Infectious Diseases
• Hematology

Background:

• Tuberculosis (TB) presents with diverse hematological issues, yet its link to immune thrombocytopenia (ITP) is infrequent and often overlooked.
• Prompt diagnosis and management of TB are crucial, as delayed recognition can lead to severe complications.

Observation:

• A 39-year-old male with epistaxis and hematuria presented with diffuse lymphadenopathy.
• Initial diagnosis was ITP, but TB was suspected late due to patient's refusal of biopsy and the uncommon association.
• Steroid treatment for ITP without concurrent anti-TB therapy potentially triggered TB reactivation and dissemination.

Findings:

• The patient was later diagnosed with active pulmonary TB (acid-fast bacilli in sputum).
• Despite treatment, he developed sepsis and multiorgan failure, leading to death.
• This case underscores the rare co-occurrence of TB and ITP.

Implications:

• Clinicians should suspect TB as a potential cause of ITP, particularly in patients with lymphadenopathy.
• Increased awareness of this rare association can improve diagnostic timelines and patient outcomes.
• Early integration of anti-TB treatment is vital for patients with coexisting TB and ITP.