Complete Remission of Immune Thrombocytopenic Purpura After Dermoid Cystectomy

Abstract

Abstract

Background:

Immune thrombocytopenic purpura (ITP) is characterized by a low platelet count with severe bleeding risks. ITP has a complex pathogenesis of platelet destruction due to autoantibodies binding on platelet antigens and sometimes to their precursors. In adults, ITP is mostly a chronic disease. This report describes the recovery of a patient with ITP after cystectomy of a dermoid cyst.

Case:

A 21-year-old woman complained of progressive petechia and minor bleeding. Laboratory evaluation showed isolated deep thrombocytopenia. She was diagnosed with primary ITP and treated with prednisone and later with intravenous immunoglobulins (IVIgs). There was a good response to the IVIgs and her platelet count increased, but, in between two courses of IVIg, her platelets decreased again. Meanwhile, because of dyspepsia, an abdominal ultrasound was performed, on which an ovarian cyst was seen. Cystectomy was performed on the cyst.

Results:

After the cystectomy, the thrombocytopenia resolved spontaneously, and treatment with IVIg was discontinued. A literature search on ITP (and all synonyms) combined with dermoid cyst (and all synonyms) revealed no results. A search for other hematologic disorders and dermoid cysts showed multiple case reports on autoimmune hemolytic anemia and dermoid cysts but no literature on the relationship between ITP and dermoid cysts.

Conclusions:

Complete spontaneous remission of ITP after dermoid cystectomy has not been described before. Diagnostic imaging and treatment of dermoid cysts can be considered in patients with chronic ITP.