doi:10.1111/jog.12731
J. Obstet. Gynaecol. Res. Vol. 41, No. 9: 1495–1498, September 2015
Immune thrombocytopenia associated with solid cancer Takako Shimada1, Toshiaki Saito1, Ilseung Choi2, Shinichiro Yamaguchi1, Kumi Shimamoto1, Kazuya Ariyoshi1 and Masao Okadome1 1
Gynecology Service and 2Division of Hematology, National Kyushu Cancer Center, Fukuoka, Japan
Abstract We describe a case of immune thrombocytopenia (ITP) associated with ovarian cancer. At the patient’s first visit to hospital, high platelet-associated IgG and low platelet count (74 × 109/L) were noted on blood test. She was diagnosed as having ITP complicated by ovarian cancer. Four days after surgery, the platelet count had increased to within the normal range. This is the first report of a patient with ITP complicated by ovarian cancer in which the platelet count reverted to normal soon after surgery for the ovarian cancer. We also investigated the characteristics of similar solid cancers with ITP at National Kyushu Cancer Center, Fukuoka, Japan. Key words: gastrointestinal cancer, Helicobacter pylori infection, immune thrombocytopenia, ovarian cancer, platelet count.
Introduction Immune thrombocytopenia (ITP), a rare autoimmune disorder, is also known as primary immune thrombocytopenic purpura. There are two types of ITP: acute ITP, which is commonly associated with viral infection; and chronic ITP, which is associated with the presence of antibodies to platelets.1 Recently, some cases of ITP associated with solid cancers have been reported,2,3 but there are few such reports and the underlying mechanisms are unclear. We report a patient with ITP complicated by ovarian cancer whose platelet count improved within days after surgery for the ovarian cancer. We also investigated the prevalence of solid cancers in patients with ITP and the clinical characteristics of such cases. Approval was obtained from Institutional Review Board review.
Case Report A 49-year-old woman, gravida 1, para 1, was admitted to the National Kyushu Cancer Center after detection of a pelvic tumor on ultrasonography. Her mother and sister had died of ovarian cancer, BRCA1 mutation
having been identified in her mother’s case. Two years prior to the current patient’s presentation, she had had normal pap smear and gynecologic examination, including trans-vaginal ultrasonography. Low platelet count (50 × 109/L and abdominal total hysterectomy, bilateral oophorectomy, lymphadenectomy, para-aortic lymph node biopsy, and appendectomy were performed. By the third postoperative day, platelet count had increased to 94 × 109/L; it was within the normal range by the fourth postoperative day, and stayed normal during the following 11 months (Fig. 1). On the sixth day postoperative day, urea breath test (20.7/mL; normal range,
J. Obstet. Gynaecol. Res. Vol. 41, No. 9: 1495–1498, September 2015
Immune thrombocytopenia associated with solid cancer Takako Shimada1, Toshiaki Saito1, Ilseung Choi2, Shinichiro Yamaguchi1, Kumi Shimamoto1, Kazuya Ariyoshi1 and Masao Okadome1 1
Gynecology Service and 2Division of Hematology, National Kyushu Cancer Center, Fukuoka, Japan
Abstract We describe a case of immune thrombocytopenia (ITP) associated with ovarian cancer. At the patient’s first visit to hospital, high platelet-associated IgG and low platelet count (74 × 109/L) were noted on blood test. She was diagnosed as having ITP complicated by ovarian cancer. Four days after surgery, the platelet count had increased to within the normal range. This is the first report of a patient with ITP complicated by ovarian cancer in which the platelet count reverted to normal soon after surgery for the ovarian cancer. We also investigated the characteristics of similar solid cancers with ITP at National Kyushu Cancer Center, Fukuoka, Japan. Key words: gastrointestinal cancer, Helicobacter pylori infection, immune thrombocytopenia, ovarian cancer, platelet count.
Introduction Immune thrombocytopenia (ITP), a rare autoimmune disorder, is also known as primary immune thrombocytopenic purpura. There are two types of ITP: acute ITP, which is commonly associated with viral infection; and chronic ITP, which is associated with the presence of antibodies to platelets.1 Recently, some cases of ITP associated with solid cancers have been reported,2,3 but there are few such reports and the underlying mechanisms are unclear. We report a patient with ITP complicated by ovarian cancer whose platelet count improved within days after surgery for the ovarian cancer. We also investigated the prevalence of solid cancers in patients with ITP and the clinical characteristics of such cases. Approval was obtained from Institutional Review Board review.
Case Report A 49-year-old woman, gravida 1, para 1, was admitted to the National Kyushu Cancer Center after detection of a pelvic tumor on ultrasonography. Her mother and sister had died of ovarian cancer, BRCA1 mutation
having been identified in her mother’s case. Two years prior to the current patient’s presentation, she had had normal pap smear and gynecologic examination, including trans-vaginal ultrasonography. Low platelet count (50 × 109/L and abdominal total hysterectomy, bilateral oophorectomy, lymphadenectomy, para-aortic lymph node biopsy, and appendectomy were performed. By the third postoperative day, platelet count had increased to 94 × 109/L; it was within the normal range by the fourth postoperative day, and stayed normal during the following 11 months (Fig. 1). On the sixth day postoperative day, urea breath test (20.7/mL; normal range,
