title: Immune thrombocytopenic purpura associated with rheumatoid arthritis: case report.
abstract: A 54-year-old Japanese woman was diagnosed with rheumatoid arthritis (RA) in 1995 on the basis of symmetric effusive polyarthritis, morning stiffness, and strongly positive rheumatoid factor. She had received low-dose prednisolone, indomethacin, methotrexate (MTX), and cyclophosphamide (CPA), at least, over 4 years before the current admission and showed partial improvement of polyarthralgia. In November 2002, she suddenly developed thrombocytopenia (platelet count was 0.3 x 10(4) mm(-3)) with purpura and was diagnosed with immune thrombocytopenic purpura (ITP). As she had refractory ITP, the administration of pulsed high-dose dexamethasone (DEX) therapy was started, resulting in the complete remission of ITP. The present paper reports that pulsed high-dose DEX therapy was useful for the treatment of refractory ITP associated with RA.
authors.affiliation: Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kohasu, Okoh-cho, Nankoku, Japan. horinot@med.kochi-u.ac.jp
authors.forename: Taro
authors.initials: T
authors.lastname: Horino
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sasaoka
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Takao
authors.forename: Takafumi
authors.initials: T
authors.lastname: Taguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maruyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.forename: Shigeki
authors.initials: S
authors.lastname: Takemoto
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Taguchi
authors.forename: Kozo
authors.initials: K
authors.lastname: Hashimoto
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D020551:Pulse Therapy, Drug; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D012074:Remission Induction
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone