Year :
2024
| Month :
July
| Volume :
18
| Issue :
7
| Page :
OD01 - OD04
Full Version
Bridging Immune Realms: A Striking Case Report on Autoimmune Thyroiditis Co-existing with Immune Thrombocytopenic Purpura
Published: July 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/67860.19573
Kashish Khurana, Satish Mahajan, Sourya Acharya, Nikhil Pantbalekundri
1. Junior Resident, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India.
2. Professor and Vice Dean, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India.
3. Professor and Head, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India.
4. Junior Resident, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India.
Correspondence Address :
Dr. Kashish Khurana,
Junior Resident, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra-442004, India.
E-mail: kashish.khurana.295@gmail.com
Abstract
Immune Thrombocytopenic Purpura (ITP), an autoimmune disease, is characterised by isolated thrombocytopenia, with or without bleeding. Thyroid autoimmune illness can coexist with ITP. The specific clinical characteristics are still unknown. The length of ITP or the patients’ response to treatment is not related to their thyroid condition. In patients with ITP, thyroid impairment is more common. In the present case report, a 60-year-old female patient, a known case of asthma, presented to the hospital with complaints of swelling in the neck along with transient episodes of breathlessness for 3-4 years. On local examination, a butterfly-shaped mass was seen in the neck, which moved upwards on deglutination but did not move on protrusion of the tongue. Pemberton’s sign was also positive. On palpation, the thyroid measured around 8×6 cm in size, thyroid lobes were bosselated, consistency was firm, and no bruit was heard on auscultation. Based on routine laboratory findings, she was found to have refractory thrombocytopenia with a normal thyroid profile. Further investigations revealed that the patient had positive antithyroid stimulating hormone antibodies, and Fine Needle Aspiration Cytology (FNAC) showed colloid nodular goitre with haemorrhagic cystic changes. A bone marrow biopsy was performed in view of refractory thrombocytopenia, which was suggestive of ITP. The patient was advised to take tablet eltrombopag, after which the platelet counts improved drastically. Subsequently, the patient was advised to undergo thyroidectomy, but this could not be done due to haemodynamic instability.
Keywords
Bleeding, Colloid nodular goitre, Eltrombopag, Euthyroid, Refractory thrombocytopenia, Thyroid enlargement
DOI: 10.7860/JCDR/2024/67860.19573
Date of Submission: Oct 04, 2023
Date of Peer Review: Dec 20, 2023
Date of Acceptance: Jan 30, 2024
Date of Publishing: Jul 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 06, 2023
• Manual Googling: Dec 25, 2023
• iThenticate Software: Jan 29, 2024 (7%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
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