title: Gastric bleeding in a patient with rheumatoid arthritis complicated by immune thrombocytopenic purpura.
abstract: Rheumatoid arthritis, in common with other systemic autoimmune diseases, can involve several other organs presenting with complex immunological manifestations. Immune thrombocytopenic purpura caused by an autoimmune reaction against platelets is an infrequent haematological complications. A female patient with rheumatoid arthritis rapidly developed extremely severe immune thrombocytopenic purpura upon suspending oral corticosteroid therapy. Besides the involvement of the mucosa of the coecum, ascending colon and the gastric antrum, the situation was further complicated by bleeding of a gastric polyp, at the nadir of the thrombocytopenic crisis. The bleeding was managed by endoscopic intervention and platelet count recovered upon high dose corticosteroid treatment within a couple of days.
authors.affiliation: 2nd Department of Internal Medicine, Kenézy Gyula Teaching Hospital, Bartók B. u. 2-26, H-4043 Debrecen, Hungary. derekstr@gmail.com
authors.forename: István
authors.initials: I
authors.lastname: Gál
authors.forename: Lajos
authors.initials: L
authors.lastname: Tóth
authors.forename: László
authors.initials: L
authors.lastname: Szegedi
authors.forename: Gyula G
authors.initials: GG
authors.lastname: Kiss
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D011127:Polyps / Q000150:complications; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications*; D013272:Stomach Diseases / Q000150:complications