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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 A

DOI: 10.12659/AJCR.931877

Am J Case Rep 2021; 22:e931877

Table 1. Timeline showing therapeutic intervention, along with respective platelet counts and celiac disease-specific antibody panel.

TimelineTreatmentPlatelet countCeliac antibody panel Ref. range tTG-IgA: <4 U/mL Endomysial IgA: Negative (<1: 5)
1/15/20Treatment naïve4×10/uL
1/17/20Steroid, IVIG, platelet transfusion15×10/uL
2/21/20Steroid, rituximab, IVIG3×10/uLtTG-IgA: >100 U/mL Endomysial IgA: Positive (1: 80)
5/5/20Eltrombopag4×10/uL
5/27/20Azathioprine & eltrombopag7×10/uL
6/10/20Plasmapheresis & maintenance treatment with eltrombopag7×10/uLtTG-IgA: 36 U/mL Endomysial IgA: Positive (1: 10)
7/1/20Splenectomy141×10/uL
11/30/20Status post splenectomy followed by fostamatinib maintenance29×10/uLtTG-IgA: 36 U/mL Endomysial IgA: Positive (1: 10)

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923