Toshikuni N, Yamato R, Kobashi H, Nishino K, Inada N, Sakanoue R, Suehiro M, Fujimura Y, Yamada G. Association of primary biliary cirrhosis with idiopathic thrombocytopenic purpura. World J Gastroenterol 2008; 14(15): 2451-2453 [PMID: 18416479 DOI: 10.3748/wjg.14.2451]
Corresponding Author of This Article
Nobuyuki Toshikuni, Dr, Department of Internal Medicine, Center for Liver Diseases, Kawasaki Hospital, Kawasaki Medical School, 2-1-80 Nakasange, Okayama 7008505, Japan. n.toshikuni@gmail.com
Article-Type of This Article
Case Report
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Nobuyuki Toshikuni, Ryumei Yamato, Ken Nishino, Nobu Inada, Ritsuko Sakanoue, Mitsuhiko Suehiro, Yoshinori Fujimura, Gotaro Yamada, Department of Internal Medicine, Center for Liver Diseases, Kawasaki Hospital, Kawasaki Medical School, Okayama 7008505, Japan
Haruhiko Kobashi, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 7008558, Japan
Author contributions: Toshikuni N wrote the paper; Toshikuni N, Yamato R and Kobashi H treated the present patient; Nishino K, Inada N, Sakanoue R, Suehiro M, Fujimura Y and Yamada G gave helpful comments on the present case.
Correspondence to: Nobuyuki Toshikuni, Dr, Department of Internal Medicine, Center for Liver Diseases, Kawasaki Hospital, Kawasaki Medical School, 2-1-80 Nakasange, Okayama 7008505, Japan. n.toshikuni@gmail.com
Telephone: +81-86-2252111
Fax: +81-86-2328343
Received: December 15, 2007 Revised: February 15, 2008 Published online: April 21, 2008
Abstract
Although both primary biliary cirrhosis (PBC) and idiopathic thrombocytopenic purpura (ITP) are autoimmune diseases, the association of the 2 diseases is rare. Here, we report a case of ITP that developed during the follow-up of PBC in a 74-year-old man. The patient had been diagnosed with PBC 12 years previously, and had received treatment with ursodeoxycholic acid. The platelet count decreased from approximately 60 × 109/L to 8 × 109/L, and the association of decompensated liver cirrhosis (PBC) with ITP was diagnosed. Steroid and immune gamma globulin therapy were successful in increasing the platelet count. Interestingly, human leukocyte antigen genotyping detected the alleles DQB1*0601 and DRB1*0803, which are related to both PBC and ITP in Japanese patients. This case suggests common immunogenetic factors might be involved in the development of PBC and ITP.
