Immune thrombocytopenic purpura associated with rheumatoid arthritis: case report.
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.
Horino
Taro
T
Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kohasu, Okoh-cho, Nankoku, Japan. horinot@med.kochi-u.ac.jp
Sasaoka
Atsushi
A
Takao
Toshihiro
T
Taguchi
Takafumi
T
Maruyama
Hiroshi
H
Ito
Hiroyuki
H
Takemoto
Shigeki
S
Taguchi
Hirokuni
H
Hashimoto
Kozo
K
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
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone