Immune thrombocytopenia associated with lymph node tuberculosis: a case report.

Area of Science:

• Internal Medicine
• Infectious Diseases
• Hematology

Background:

• Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by low platelet counts.
• Tuberculosis (TB), a serious infectious disease, can manifest in various forms, including extrapulmonary disease.
• The co-occurrence of ITP and tuberculosis is exceptionally rare, particularly when TB affects both pulmonary and lymph node sites.

Observation:

• A 29-year-old male presented with severe thrombocytopenia (platelet count of 4,000/µL).
• Diagnostic imaging revealed mediastinal adenomegaly, aortic lymph node clusters, and left upper lung lobe consolidation.
• Histopathological examination of lung tissue confirmed active tuberculosis.

Findings:

• The patient received intravenous immunoglobulin and methylprednisolone, followed by a standard four-drug anti-tuberculosis regimen (rifampicin, isoniazid, pyrazinamide, ethambutol).
• Corticosteroid therapy was gradually withdrawn.
• Platelet counts normalized following successful treatment of tuberculosis.

Implications:

• This case suggests a potential causal association between tuberculosis infection and the development of immune thrombocytopenia.
• Early diagnosis and treatment of tuberculosis may lead to the resolution of associated ITP.
• Further research is warranted to elucidate the immunological mechanisms underlying this rare association.