Abstract
We describe here the case a patient with advanced cervix carcinoma and who developed idiopathic thrombocytopenic purpura (ITP). A 63-year-old woman with stage IV squamous cell carcinoma of the uterine cervix and that was complicated by hydronephrosis was treated palliatively with 45Gy of external beam radiation to the pelvis. About 3 years later, she developed hematochezia and severe thrombocytopenia. The laboratory examinations showed no evidence of thrombotic thrombocytopenic purpura or disseminated intravascular coagulopathy, and she was positive for serum anti-platelet antibodies. On the bone marrow examination, there was a normal number and morphology of megakaryocytes with no evidence of malignant cell infiltration. We made the clinical diagnosis of ITP, and the intravenous immunoglobulin and steroid therapy was successful. This case suggests the possibility that ITP can occur in association with advanced cervix carcinoma.
References
2. Chehal A, Taher A, Seoud M, Shamseddine A. Idiopathic thrombocytopenic purpura and ovarian cancer. Eur J Gynaecol Oncol. 2003; 24:539–40.
3. Kim HD, Boggs DR. A syndrome resembling idiopathic thrombocytopenic purpura in 10 patients with diverse forms of cancer. Am J Med. 1979; 67:371–7.
4. Schwartz KA, Slichter SJ, Harker LA. Immune-mediated platelet destruction and thrombocytopenia in patients with solid tumours. Br J Haematol. 1982; 51:17–24.
5. DiFino SM, Lachant NA, Kirshner JJ, Gottlieb AJ. Adult idiopathic thrombocytopenic purpura. Clinical findings and response to therapy. Am J Med. 1980; 69:430–42.
6. Bir A, Bshara W, George M, Fakih MG. Idiopathic thrombocytopenic purpura in a newly diagnosed pancreatic adenocarcinoma. JOP. 2006; 7:647–50.
7. Demirer T, Celebi H, Arat M, et al. Autoimmune thrombocytopenia in a patient with small cell lung cancer developing after chemotherapy and resolving following autologous peripheral blood stem cell transplantation. Bone Marrow Transplant. 1999; 24:335–7.
8. Porrata LF, Alberts S, Hook C, Hanson CA. Idiopathic thrombocytopenic purpura associated with breast cancer: a case report and review of the current literature. Am J Clin Oncol. 1999; 22:411–3.