Immune Thrombocytopenic Purpura and Ganglionic Tuberculosis: An Unlikely Link

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 6; p. e62074
• Main Authors: Atalaia Barbacena, Henrique, Esperança-Martins, Miguel, Matias Lopes, Inês, Branquinho, Leonor, Howell Monteiro, Patrícia
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 10.06.2024; Cureus
• Subjects: Anemia; Antibodies; Anticoagulants; Antigens; Blood platelets; Bone marrow; Cytomegalovirus; Dehydrogenases; Drug dosages; Epistaxis; Glycoproteins; Hematology; Hemoglobin; Hepatitis; Immune system; Immunoglobulins; Infectious Disease; Internal Medicine; Lupus; Purpura; Serology; Skin; Steroids; Thrombocytopenia; Tuberculosis; lymphatic tuberculosis; ganglionic tuberculosis; thrombocytopenia; immune mediated thrombocytopenic purpura (itp); extrapulmonary tuberculosis (eptb)
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.62074

Tuberculosis (TB) is one of the leading infectious causes of morbidity and mortality worldwide. Either in its pulmonary (PTB) or extrapulmonary forms (EPTB), TB has a wide variety of manifestations, including hematological ones like thrombocytosis (especially in PTB) and thrombocytopenia (mainly with disseminated or miliary TB). Hematological manifestations are infrequently presenting features of TB, and within them, immune thrombocytopenic purpura (ITP)-associated TB is one of the rarest presenting features. We report a case of a 22-year-old woman with a diagnosis of ganglionic tuberculosis (GTB) presenting with ITP. The therapeutic approach was challenging and included the use, originally, of intravenous immunoglobulin 30 mg/day for five days and, posteriorly, of high-dose corticosteroids (dexamethasone 40 mg/day) and anti-tubercular therapy with satisfactory outcomes.