Improvement of idiopathic thrombocytopenic purpura by antithyroid therapy

Abstract

Here we report a case of idiopathic thrombocytopenic purpura accompanied by Graves' disease. Improvement in thyroid function with methimazole led to the spontaneous recovery of the platelet count from 8 x 10(9)/L to 84 x 10(9)/L. Furthermore, the second fall and recovery of the platelet count well coincided with the recurrence of hyperthyroidism after the discontinuation of methimazole and its normalization by resumption of the drug, respectively. These parallel fluctuations of platelet and thyrotropin because of the cessation and resumption of antithyroid therapy suggests that correction of hyperthyroidism may be beneficial to the control of an imbalance in the immune system which impairs not only thyroid but also the platelet.

Prevalence and Clinical Significance of Antithyroid Antibodies in Children with Immune Thrombocytopenic Purpura

“…ITP may present itself earlier or at a significantly different time to the diagnosis of thyroid disorders. Timing between the diagnosis of ITP and thyroid disease can vary from months to years [18,19]. In our study, no thyroid dysfunction such as hypo or hyperthyroidism was detected in the patients whose thyroid autoantibodies were positive.…”

Thyroid-associated autoimmune coagulation disorders

“…Interestingly, the control of hyperthyroidism and the restoration of a euthyroid state by antithyroid drug therapy resulted in the complete and lasting remission of the coagulation disorder [23]. This beneficial effect on platelet count of antithyroid agents, probably due to their immunomodulatory activity [39], has also been observed by other authors [32]. In addition, Bowles et al [38] documented the case of a 52-year-old woman with chronic severe thrombocytopenia refractory to steroids, immunosuppression, immunoglobulin, and splenectomy successfully treated with thyroxine.…”

Thyroid storm complicated by bicytopenia and disseminated intravascular coagulation

“…Graves’ disease is an autoimmune disorder characterized by hyperthyroidism, ophthalmopathy, and dermopathy, which can be complicated by various autoimmune blood disorders, including hemolytic anemia [4], idiopathic thrombocytopenic purpura [5], and iron deficiency anemia [6]. …”