Abstract
A 35-year-old woman was admitted to the hospital because of gum bleeding and purpura on extremities. She was well until one month before entry, when she aborted. After she aborted, the bleeding tendency was appeared. The physical examination revealed the purpura on the both of shoulders and legs. Many dental caries and goiter were found, but other examination was negative. The hematocrit was 34.1%, the white cell count was 5,300 with a normal differentiation. The platelet count was 3,000. Examination of bone marrow revaled normal cellurality and the number of megakarytes was seen within normal range with a few platelet production. The bleeding time was 15 minutes, but other coagulation tests were normal. Anti-platelet antibody was detected, and ANA and anti-DNA antibody were also positive. Thyroid function was normal. Prednisolone (40mg/day) was administered under the diagnosis of ITP. The platelet count rose to over 100,000, and the symptoms and the laboratory datas were markedly improved after treatment. As the prednisolone reudced, she complaind of dryness of mouth and eyes. A diagnosis of Sjogren's syndrome was made by sialography and schirmer test. Thyroid biopsy was performed because of anti-microsome antibody and anti-thyroglobulin antibody were detected. Typical findings of Hashimoto's disease was observed histologically.
Overlapping of other autoimmune diseases is characteristic of Sjogren's syndrome. The overlapping case with Sjogren's syndrome, ITP and Hashimoto's disease was discussed.
