title: Recovery from idiopathic thrombocytopenic purpura (ITP) following right hemicolectomy for mucocele of appendix.
abstract: A 61-year-old woman with a 2-year medication-free history of idiopathic thrombocytopenic purpura was referred to our hospital complaining of right lower abdominal pain. The platelet count was about 3-4x10(4)/mm3. This patient was diagnosed with mucocele of the appendix on computed tomography and colonoscopy. We performed only right hemicolectomy without splenectomy. The pathological diagnosis was mucinous cystadenoma of the appendix. The platelet count increased to 18.1x10(4)/mm3 on postoperative-day 7, and remained stable, at 20-24x10(4)/mm3, for 14 months after the operation. Platelet-associated immunoglobulin G decreased remarkably after the operation, to 30.2 ng/10(7) cells, from 240 ng/10(7) cells preoperatively. We describe the first case of recovery from idiopathic thrombocytopenic purpura following right hemicolectomy performed for mucocele of the appendix. Considering our patients clinical course, it is possible that mucinous cystadenoma of the appendix may have influenced the thrombocytopenia. Findings in this patient suggest that mucocele of the appendix may be associated with a new diagnosis and idiopathic thrombocytopenic purpura treatment.
authors.affiliation: Department of Surgery, Iida Hospital, Nagano, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kitamura
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakase
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Toshiya
authors.initials: T
authors.lastname: Osawa
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Tsuchiya
mesh_terms: D001062:Appendectomy / Q000379:methods; D001065:Appendix; D001707:Biopsy, Needle; D002429:Cecal Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D003113:Colonoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009078:Mucocele / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome