A Case of Immune Thrombocytopenic Purpura Developing after Treatment for Non-Hodgkin's Lymphoma

Hui-Young Lee; Dae Joon Jeong; Dong-Gyu Lee; Kwangjin Chun; Sook Won Ryu; Seo-Young Song

doi:10.5045/kjh.2009.44.2.113

Journal List > Korean J Hematol > v.44(2) > 1032816

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee, Jeong, Lee, Chun, Ryu, and Song: A Case of Immune Thrombocytopenic Purpura Developing after Treatment for Non-Hodgkin's Lymphoma

Case Report

Korean J Hematol 2009;44(2):113-116.

Published online: 20 June 2009

DOI: https://doi.org/10.5045/kjh.2009.44.2.113

A Case of Immune Thrombocytopenic Purpura Developing after Treatment for Non-Hodgkin's Lymphoma

Hui-Young Lee, M.D.¹, Dae Joon Jeong, M.D.¹, Dong-Gyu Lee, M.D.¹, Kwangjin Chun, M.D.¹, Sook Won Ryu, M.D.², Seo-Young Song, M.D.^1,

¹Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea

²Department of Laboratory Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea

Correspondence to：Seo-Young Song, M.D. Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine 17-1, Hyoja-dong, Chuncheon 200-947, Korea Tel: ＋82-33-258-2406, Fax: ＋82-33-258-2160 E-mail: sysong@kangwon.ac.kr

Received 7 January 2009 Revised 13 May 2009 Accepted 16 May 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Immune thrombocytopenic purpura (ITP) can be classified as primary or secondary according to the presence of an underlying non-malignant or malignant disorder, including lymphoproliferative disorders. The estimated prevalence of ITP in patients with Hodgkin's lymphoma is about 1%, and its clinical course has been reported in approximately 50 patients. ITP is an unusual and poorly documented complication in patients with non-Hodgkin's lymphoma. Some cases have been described in patients who have undergone high-dose chemotherapy and autologous bone marrow/peripheral blood stem cell transplantation. Rare cases appear to be coincidental. Here, we report on a rare case of a 61-year-old man who had ITP after being in a state of complete remission of non-Hodgkin's lymphoma for about 15 months.

Keywords: Idiopathic thrombocytopenic purpura, Non-Hodgkin's lymphoma, Splenectomy

References

1. Hauswirth AW, Skrabs C, Schützinger C, et al. Autoimmune thrombocytopenia in non-Hodgkin's lymphomas. Hematologica. 2008; 93:447–50.

2. Liebman H. Other immune thrombocytopenias. Semin Hematol. 2007; 44:S24–S34.

3. Kirshner JJ, Zamkoff KW, Gottlieb AJ. Idiopathic thrombocytopenia purpura and Hodgkin's disease: report of two cases and a review of the literature. Am J Med Sci. 1980; 280:21–8.

4. Cohen JR. Idiopathic thrombocytopenic purpura in Hodgkin's disease: a rare occurrence of no prognostic significance. Cancer. 1978; 41:743–6.

5. Jones SE. Autoimmune disorders and malignant lymphoma. Cancer. 1973; 31:1092–8.

6. Kaden BR, Rosse WF, Hauch TW. Immune thrombocytopenia in lymphoproliferative disease. Blood. 1979; 53:545–51.

7. Gang MS, Kim SW, Kim JS, et al. Immune thrombocytopenic purpura. Cha YJ, Goo HH, Gwon SW, editors. Hematology. 1st ed.Seoul, Korea: Epublic Press;2006. p. 497–503.

8. Hamblin TJ, Oscier DG, Young BJ. Autoimmunity in chronic lymphocytic leukaemia. J Clin Pathol. 1986; 39:713–6.

9. Váróczy L, Gergely L, Zeher M, Szegedi G, Illés A. Malignant lymphoma-associated autoimmune diseases-a descriptive epidemiological study. Rheumatol Int. 2002; 22:233–7.

10. Dührsen U, Augener W, Zwingers T, Brittinger G. Spectrum and frequency of autoimmune derangements in lymphoproliferative disorders: analysis of 637 cases and comparison with myeloproliferative diseases. Br J Haematol. 1987; 67:235–9.

11. Gr⊘nbaek K, D'Amore F, Schmidt K. Autoimmune phenomena in non-Hodgkin's lymphoma. Leuk Lymphoma. 1995; 18:311–6.

12. Diehl LF, Ketchum LH. Autoimmune disease and chronic lymphocytic leukemia: autoimmune hemolytic anemia, pure red cell aplasia, and autoimmune thrombocytopenia. Semin Oncol. 1998; 25:80–97.

13. Cooper N, Bussel J. The pathogenesis of immune thrombocytopaenic purpura. Br J Haematol. 2006; 133:364–74.

Fig. 1.

Peripheral blood shows marked thrombocytopenia (Wright-Giemsa stain, ×200).

Fig. 2.

Computed tomography (CT) scan demonstrates multiple enlarged lymph nodes at lymphoma diagnosis (A). Follow-up CT scan shows no evidence of newly developed lesions (B).

Fig. 3.

PET-CT scan shows no abnormal focal FDG uptake.

Fig. 4.

Bone marrow finding showing adequate number and normal morphology of magakaryocytes. There are no aggregates or infiltrates of large lymphoid cells in the marrow space (H&E stain, ×200).

TOOLS

Similar articles