The dilemma in a case of immune thrombocytopenia in a patient with human immunodeficiency virus on antituberculosis treatment for miliary pulmonary tuberculosis.
Oxf Med Case Reports
; 2019(11): 486-489, 2019 Nov.
Article
em En
| MEDLINE
| ID: mdl-31844534
ABSTRACT
The multifactorial mechanisms of immune thrombocytopenia (ITP) in patients with human immunodeficiency virus (HIV) and tuberculosis (TB) could be caused by HIV, TB or anti-TB drugs. No patients with HIV and opportunistic infection of miliary pulmonary TB who developed thrombocytopenia after treatment with anti-TB drugs have been reported. A 47-year-old woman with HIV/acquired immunodeficiency syndrome and miliary TB with normal platelet count (229 000/µL) started anti-TB drugs (rifampicin, isoniazid, pyrazinamide and ethambutol). After 10 days of treatment, her platelet count was low (17 000/µL). As rifampicin and isoniazid were stopped and intravenous methylprednisolone was given, her platelet count began to increase. After more than a month, her platelet count was normal (192 000/µL) and she started antiretrovirals. This improved platelet count after high-dose methylprednisolone is suggestive of ITP; however, the dilemma is whether it was rifampicin alone that caused ITP or did HIV and disseminated TB infection also play a role?
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1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Oxf Med Case Reports
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Indonésia