title: An idiopathic thrombocytopenic purpura with polyneuropathy.
abstract: Concurrent association of idiopathic thrombocytopenic purpura (ITP) and peripheral neuropathy is a rare condition. There are only few case reports published concerning peripheral neuropathy with ITP. One of the etiopathogenetic mechanisms proposed is intraneural hemorrhage, but the pathogenesis is not fully understood. Autoimmune nature with common antibodies to the platelets and the nerve´s myelin sheath should also be considered. Here we describe a 47-year-old woman, with a family history of autoimmune diseases. She was diagnosed 2 years ago with ITP and later developed a chronic combined inflammatory demyelinating polyneuropathy. Treatment with high-dose steroids was initiated with a poor response. The patient showed a clear improvement in platelet count and in the peripheral neuropathy symptoms when treatment with intravenous immunoglobulin was administered. Common etiologic mechanism of the two diseases should be considered, both, because of the simultaneous time of development and a similar response to intravenous immunoglobulin treatment.
authors.affiliation: Departamento de Medicina Interna, Hospital La Paz, Madrid, Spain.|Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel.
authors.forename: Valeria
authors.initials: V
authors.lastname: Katchan
authors.affiliation: Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.|Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel.
authors.forename: Paula
authors.initials: P
authors.lastname: David
authors.affiliation: Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel. shoenfel@post.tau.ac.il.|Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. shoenfel@post.tau.ac.il.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008875:Middle Aged; D011115:Polyneuropathies / Q000188:drug therapy*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*
chemical_list: D016756:Immunoglobulins, Intravenous
keywords: Autoantibodies; Autoimmunity; Idiopathic thrombotic purpura; Intravenous immunoglobulin; Peripheral neuropathy