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Immune thrombocytopenia associated with sarcoidosis

면역성혈소판감소증을 동반한 사르코이드증

  • Jeong, Da Eun (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Kim, Min Kyoung (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Koh, Sung Ae (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Lee, Kyoung Hee (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Choi, Joon Hyuk (Department of Pathology, Yeungnam University College of Medicine) ;
  • Hong, Young Hoon (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Cho, Jae Ho (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Goo, Eun Ju (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Hyun, Myung Soo (Department of Internal Medicine, Yeungnam University College of Medicine)
  • 정다은 (영남대학교 의과대학 내과학교실) ;
  • 김민경 (영남대학교 의과대학 내과학교실) ;
  • 고성애 (영남대학교 의과대학 내과학교실) ;
  • 이경희 (영남대학교 의과대학 내과학교실) ;
  • 최준혁 (영남대학교 의과대학 병리학교실) ;
  • 홍영훈 (영남대학교 의과대학 내과학교실) ;
  • 조재호 (영남대학교 의과대학 내과학교실) ;
  • 구은주 (영남대학교 의과대학 내과학교실) ;
  • 현명수 (영남대학교 의과대학 내과학교실)
  • Received : 2014.03.27
  • Accepted : 2014.05.23
  • Published : 2015.06.30

Abstract

Sarcoidosis is a systemic disease of unknown cause involving multiple organs and is characterized by noncaseating granuloma. Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased peripheral platelet destruction due to the presence of an antibody to the platelet and abnormal platelet production. There is no known pathogenesis that occurs concurrently with ITP and sarcoidosis. However, considering together of 2 known pathogenesis, abnormal immune response triggers either ITP or sarcoidosis. The disease that develops first stimulates secondary disease. After development of secondary disease, they stimulate each other. A few cases of ITP associated with sarcoidosis are well documented in English; however, the disease has rarely been reported in Korea. Here, we report on a case of ITP with sarcoidosis in a 29-year-old man. He suffered from easy bruising. The chest X-ray and the contrast-enhanced computed tomography scan showed bihilar lymphadenopathy and reticulonodular infiltrates. Bone marrow study and fluoroscopy-guided percutaneous needle biopsy were performed and the patient was diagnosed with sarcoidosis and ITP. He was put on 400 mg/kg of intravenous immunoglobulin for 5 days and administered oral steroids and further follow-up will be carried out. He has shown a good response without significant bleeding event. However, administration of more oral steroid and additional follow-up is required than for single disease, whether sarcoidosis or ITP.

Keywords