10 October 2021>: Articles
Treatment-Refractory, Primary Immune Thrombocytopenic Purpura in a Patient with Celiac Disease
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology
Beka Aroshidze A* , Sos Nalghranyan A , Gregory Gotlieb C , Burak Erdinc A , Alok Aggarwal A , Cherif El Younis A , Boris Avezbakiyev ADOI: 10.12659/AJCR.931877
Am J Case Rep 2021; 22:e931877
Figure 2. Bone marrow biopsy (40×) revealed slightly hypercellular marrow (70%) with trilineage hematopoiesis. The myeloid-to-erythroid ratio (M: E) was within normal range; increased number of megakaryocytes were present, consistent with immune thrombocytopenic purpura (ITP), no evidence of lymphoma or leukemia was seen, no stainable storage iron was noted, and no marrow fibrosis or granulomatous inflammation/necrosis identified. Given the past medical history of TB, the possibility of disseminated TB with bone marrow involvement was ruled out by negative AFB stain and culture for AFB.