title: Immune Thrombocytopenic Purpura and Gastritis by H. pylori Associated With Type 1 Diabetes Mellitus.
abstract: We present the 15th case reported worldwide and 3rd case reported in Latin America of immune thrombocytopenic purpura associated with Type 1 diabetes mellitus in Scopus, MEDLINE, and SciELO. An 11-year-old male patient of mixed ethnicity with immune thrombocytopenic purpura, Type 1 diabetes mellitus, and gastritis due to H. pylori presented to the emergency room with petechiae, ecchymosis, and gingival and conjunctival bleeding that had been worsening for the past three months. The patient had a body mass index of 18.85 kg/m(2) (P75). A biochemical analysis showed 1×10(9) platelets/L, increased prothrombin time, increased partial thromboplastin time, and an HbA1C of 7.84% on admission. He was prescribed a single dose of intravenous methylprednisolone 750 mg in 100 mL of NaCl and daily oral 50 mg prednisolone, with intravenous 250 mg tranexamic acid every eight hours. The patient's glycemic control was continued with the administration of insulin glargine (30 units every 24 hours) and prandial insulin glulisine (five to eight units per meal). Before admission, the patient was on a prescribed treatment of sitagliptin 50 mg and metformin 850 mg, but this was suspended in the emergency room. For the eradication of H. pylori he was prescribed amoxicillin 500 mg every eight hours, oral clarithromycin 335 mg every 12 hours, and IV omeprazole 40 mg. After 15 days, he showed disease resolution and he was discharged to his home with orders to follow-up with pediatrics, hematology, and endocrinology services. The first-line treatment for immune thrombocytopenic purpura patients with active bleeding and a platelet count < 30,000 platelets/μl is the administration of corticosteroids and inmunoglobulin.
authors.affiliation: Facultad de Ciencias de la Salud, Universidad Nacional de Piura, Piura, Perú
authors.forename: Carlos
authors.initials: C
authors.lastname: Culquichicón-Sánchez
authors.affiliation: NICHD, National Institute of Health.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Correa
authors.affiliation: Facultad de Ciencias de la Salud, Universidad Nacional de Piura, Piura, Perú
authors.forename: Igor
authors.initials: I
authors.lastname: Flores-Guevara
authors.affiliation: Servicio de Diabetes, Instituto Cardiovascular Lezica.
authors.forename: Frank
authors.initials: F
authors.lastname: Espinoza Morales
authors.affiliation: Escuela de Medicina Humana, Universidad Continental, Huancayo, Peru.
authors.forename: Christian R
authors.initials: CR
authors.lastname: Mejia
keywords: idiophatic thrombocytopenic purpura; inmune thrombocytopenic purpura; latin america; peru; type 1 diabetes mellitus