Coincidence of Immune Thrombocytopenia, Intracranial Hemorrhage and Graft-versus-Host Disease in an 11-Year-Old Girl

Abstract

Primary immune thrombocytopenia (ITP) in children is usually self-limiting and harmless but rarely can result in life-threatening complications. The case of an 11-year-old girl with ITP is presented who developed recurrent intracranial hemorrhages followed by cerebral infarctions. The clinical course was complicated by a graft-versus-host disease involving several organs. Treatment was performed according to the current international consensus report of 2010 with glucocorticoids, immunoglobulin G, anti-D-immunoglobulin and additionally embolisation of the splenic artery. The girl survived. Reliable predictors, preventive measures for life-threatening complications in ITP and more information about the effectiveness and side-effects of the recommended treatment are urgently needed.

Zusammenfassung

Die primäre Immunthrombozytopenie (ITP) bei Kindern ist normalerweise selbstlimitierend und harmlos, kann aber selten zu lebensbedrohlichen Komplikationen führen. Der Fall eines 11-jährigen Mädchens, das im Rahmen einer ITP rezidivierende intrakranielle Blutungen, gefolgt von Infarkten, entwickelte, wird vorgestellt. Der klinische Verlauf wurde kompliziert durch eine Graft-versus-Host-Erkrankung, die mehrere Organe betraf. Die Therapie der ITP wurde beim Kind gemäß International Consensus Report von 2010 mit Glukokortikoiden, Immunglobulin G, Anti-D-Immunglobulin und zusätzlicher Embolisation der Milzarterie durchgeführt. Das Mädchen überlebte. Zuverlässige Prädiktoren und präventive Massnahmen für lebensbedrohliche Komplikationen bei ITP und genauere Informationen über Effektivität und Nebenwirkungen der empfohlenen Therapie sind dringend notwendig.

Key words

children - immune thrombocytopenia - ITP - intracranial hemorrhage - graft-versus-host disease

Schlüsselwörter

Kinder - Immunthrombozytopenie - ITP - intrakranielle Blutung - Graft-versus-Host-Erkrankung

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