Abstract
A 28-year-old female was admitted to our hospital because of bleeding tendency on December 1, 1978. On admission, nasal and oral bleeding, petechiae and purpurae over the body and moderately enlarged goiter were noted, but exophthalmus or hepato-splenomegaly were not detected. Thrombocytopenia of 8,000/cmm and marked increase of immature megakaryocytes in the bone marrow were consistent with idiopathic thrombocytopenic purpura, though antiplatelet antibody was not detected. Laboratory findings such as T3 uptake, 54.7%; T4 level 21.4 μg/dl and 131I uptake 71.8% confirmed the association of hyperthyroidism. Prednisolone and azathioprine did not provide lasting improvement of the thrombocytopenia, while thyrotoxicosis was controlled by methimazole. On March 28, 1979, splenectomy was performed, when she was in euthyroid state. Soon after the operation, marked thrombocytosis occurred and maintained over 200,000/cmm without additional use of prednisolone or azathioprine.
It was suggested from the experience of this case that splenectomy should be recommendable for idiopathic thrombocytopenic purpura in spite of the assocation of hyperthyroidism.
