Characterizing Patients With Concurrent ITP and IBD

In a recent study, researchers sought to evaluate clinical presentations, course, management, and outcomes of idiopathic thrombocytopenic purpura (ITP) in patients with inflammatory bowel disease (IBD). After analyses, the authors found that ITP presented after the diagnosis of IBD and responded well to conventional treatments in most patients. The findings were published in the Journal of Crohn’s & Colitis.

This retrospective case series was conducted as part of the European Crohn’s and Colitis Organisation Collaborative Network of Exceptionally Rare case reports project. The review included 32 total patients, 10 females and 22 males with a median age of 32.0 years (interquartile range [IQR], 20.5-39.5). Of those patients, 14 had Crohn disease (CD) and 18 had ulcerative colitis (UC).

Combination of ITP in IBD Follows Expected Course

Researchers noted 26 patients were diagnosed with IBD prior to ITP with a median time between diagnoses of 7 years (IQR, 1.5-9.5). Of these patients, 17 were in clinical IBD remission at the time of ITP diagnosis.

IBD treatments included mesalamine (n=13), oral corticosteroids (n=4), rectal corticosteroids (n=1), azathioprine (n=2), and antitumor necrosis factor agents (n=5). ITP treatments included corticosteroids (n=19), anti-RhD immunoglobulin (n=1), intravenous immunoglobulins (n=12), thrombopoietin (n=4), and rituximab (n=3), and 6 patients eventually needed splenectomy. In addition, 3 patients required a colectomy in long-term follow-up for reasons related to IBD or cancer and not ITP, the authors noted.

Overall, the study’s authors suggested that the course of ITP in patients with IBD presented as expected, including treatment responses and low proportion of subsequent splenectomy.

Related: Intravenous Immunoglobulin Appears Effective in Chronic ITP