The Importance of Treating Subclinical Hypothyroidism in Patients With Immune Thrombocytopenia: A Case Report

Abstract

The leading cause of isolated thrombocytopenia in asymptomatic individuals is immune thrombocytopenia (ITP). It is an autoimmune disease characterized by decreased platelet counts caused by the immune system's destruction of platelets. Sometimes, autoimmune thyroid diseases and ITP can coexist, which could cause an aggravated immune system response. When thyroid autoimmune diseases are present, treating ITP may become challenging. Treatment of the underlying thyroid disease in such individuals results in a significant improvement in platelet count, along with remission of the disease. It enhances the response to traditional ITP therapy. In this case report, we present a case of a 40-year-old female who was treated for ITP along with hypothyroidism, resulting in a considerable improvement in platelet count and a remission of the condition.

Keywords: auto-antibody; eltrombopag; hashimoto's hypothyroidism; immune thrombocytopenia (itp); sub clinical hypothyroidism.

Figure 1. This figure shows a puffy face with a coarse skin texture of the patient.

Figure 2. Figures A and B show the echymotic patches over the arm and thigh, respectively (highlighted by red arrow).

Figure 3. Figures A and B show a bone marrow biopsy with abnormal giant megakaryocytes at 100× and 20×, respectively (highlighted by red arrow).

The image shows an electron microscope picture of bone marrow biopsy in oil emulsion and a normal microscope, respectively