Coincidence of immune thrombocytopenia, intracranial hemorrhage and graft-versus-host disease in an 11-year-old girl.
Primary immune thrombocytopenia (ITP) in children is usually self-limiting and harmless but can, rarely, result in life-threatening complications. The case of an 11-year-old girl with ITP is presented who developed recurrent intracranial hemorrhages followed by cerebral infarctions. The clinical course was complicated by a graft-versus-host disease involving several organs. Treatment was performed according to the current international consensus report of 2010 with glucocorticoids, immunoglobulin G, anti-D-immunoglobulin and additionally embolisation of the splenic artery. The girl survived. Reliable predictors, preventive measures for life-threatening complications in ITP and more information about the effectiveness and side-effects of the recommended treatment are urgently needed.
Landgraf
M
M
Zentrum für Frauen- und Kindermedizin, Universität Leipzig, Liebigstrasse 20a, Leipzig, Germany. mirjam.landgraf@medizin.uni-leipzig.de
Siekmeyer
M
M
Fischer
L
L
Bierbach
U
U
Siekmeyer
W
W
Meixensberger
J
J
Hirsch
W
W
Kiess
W
W
D002544:Cerebral Infarction / Q000150:complications / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy; D003399:Craniotomy; D004621:Embolization, Therapeutic; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000150:complications* / Q000628:therapy; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007262:Infusions, Intravenous; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000628:therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D017713:Platelet Transfusion / Q000009:adverse effects; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000628:therapy; D012008:Recurrence; D018029:Rho(D) Immune Globulin / Q000627:therapeutic use; D013154:Spleen / Q000098:blood supply; D014057:Tomography, X-Ray Computed
D005938:Glucocorticoids; D007074:Immunoglobulin G; D018029:Rho(D) Immune Globulin; D008775:Methylprednisolone