Coincidence of immune thrombocytopenia, intracranial hemorrhage and graft-versus-host disease in an 11-year-old girl

Klin Padiatr. 2010 Nov;222(6):378-82. doi: 10.1055/s-0030-1263152. Epub 2010 Sep 9.

Abstract

Primary immune thrombocytopenia (ITP) in children is usually self-limiting and harmless but can, rarely, result in life-threatening complications. The case of an 11-year-old girl with ITP is presented who developed recurrent intracranial hemorrhages followed by cerebral infarctions. The clinical course was complicated by a graft-versus-host disease involving several organs. Treatment was performed according to the current international consensus report of 2010 with glucocorticoids, immunoglobulin G, anti-D-immunoglobulin and additionally embolisation of the splenic artery. The girl survived. Reliable predictors, preventive measures for life-threatening complications in ITP and more information about the effectiveness and side-effects of the recommended treatment are urgently needed.

Publication types

  • Case Reports

MeSH terms

  • Cerebral Infarction / complications
  • Cerebral Infarction / therapy
  • Child
  • Combined Modality Therapy
  • Craniotomy
  • Embolization, Therapeutic
  • Female
  • Glucocorticoids / therapeutic use
  • Graft vs Host Disease / complications*
  • Graft vs Host Disease / therapy
  • Humans
  • Immunoglobulin G / therapeutic use
  • Infusions, Intravenous
  • Intracranial Hemorrhages / complications*
  • Intracranial Hemorrhages / therapy
  • Methylprednisolone / therapeutic use
  • Platelet Transfusion / adverse effects
  • Purpura, Thrombocytopenic, Idiopathic / complications*
  • Purpura, Thrombocytopenic, Idiopathic / therapy
  • Recurrence
  • Rho(D) Immune Globulin / therapeutic use
  • Spleen / blood supply
  • Tomography, X-Ray Computed

Substances

  • Glucocorticoids
  • Immunoglobulin G
  • Rho(D) Immune Globulin
  • Methylprednisolone