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Inicio Gastroenterología y Hepatología Colitis ulcerosa asociada a púrpura trombocitopénica idiopática
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Vol. 26. Núm. 9.
Páginas 545-548 (Enero 2003)
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Vol. 26. Núm. 9.
Páginas 545-548 (Enero 2003)
DOI: 10.1016/S0210-5705(03)70410-5
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Colitis ulcerosa asociada a púrpura trombocitopénica idiopática
Ulcerative colitis associated with idiopathic thrombocytopenic purpura
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A. Puebla Maestu
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aidapuebla@hotmail.com

Correspondencia: Dra. A. Puebla Maestu. Venerables, 4, 2.o A. 09005 Burgos. España.
, J.L. Martín-Lorente, A. López-Morante, S. García-Morán, L. Yuguero del Moral, A. Arauzo González
Sección de Aparato Digestivo. Hospital General Yagüe. Burgos. España
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Resumen

Se han descrito múltiples anomalías hematológicas asociadas a la enfermedad inflamatoria intestinal crónica. La púrpura trombocitopénica idiopática es una enfermedad de etiología autoinmune que se caracteriza por la presencia de trombopenia aislada con un número normal o aumentado de megacariocitos en la médula ósea y la ausencia de esplenomegalia. Existen en la bibliografía varios casos clínicos en los que la púrpura trombocitopénica idiopática se asocia con una enfermedad inflamatoria intestinal crónica, la mayoría de las veces con colitis ulcerosa. Se desconoce el mecanismo patogénico por el que ambas entidades se asocian. Se han utilizado varios tratamientos, que van desde cursos cortos de esteroides hasta el uso de inmunodepresores y la esplenectomía, en función de la gravedad del cuadro.

Describimos el caso de una paciente con colitis ulcerosa y púrpura trombocitopénica idiopática, en la que esta última se manifestó cuando la enferma se encontraba en tratamiento con corticoides y ciclosporina, una de las posibles opciones para el control de la púrpura trombocitopénica. La plaquetopenia persistió a pesar del tratamiento con azatioprina y la realización de una colectomía, también descrita como posible tratamiento curativo.

Multiple hematological anomalies have been described in association with chronic inflammatory bowel disease. Idiopathic thrombocytopenic purpura is an autoimmune disease characterized by the presence of isolated thrombopenia with a normal or increased number of megakaryocytes in bone marrow and absence of splenomegaly. Several case reports of idiopathic thrombocytopenic purpura associated with chronic inflammatory bowel disease, mostly ulcerative colitis,have been published in the literature. The pathogenic mechanism through which these entities are associated is unknown. Several treatments have been used, varying from short courses of steroids to the use of immunosuppressive agents and splenectomy, depending on the severity of the symptoms.

We describe the case of a woman with ulcerative colitis and idiopathic thrombocytopenic purpura, in which the latter first presented when the patient was undergoing treatment with corticosteroids and cyclosporin, one of the therapeutic options for controlling thrombopenic purpura. Platelet deficiency persisted despite treatment with azathioprine and colectomy, also described as a possible curative treatment.

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Copyright © 2003. Elsevier España, S.L.. Todos los derechos reservados
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