Severe Thrombocytopenia in a 30-Year-Old African American Male With Newly Diagnosed Sarcoidosis: A Case Report.

Autor:	Pasli M; Medical School, Brody School of Medicine at East Carolina University, Greenville, USA., Lovell KK; Medical School, Brody School of Medicine at East Carolina University, Greenville, USA., Vulasala SSR; Internal Medicine, East Carolina University Health, Greenville, USA., Hairr ML; Medical School, Brody School of Medicine at East Carolina University, Greenville, USA., Bandaru RR; Internal Medicine, East Carolina University Health, Greenville, USA., Khalilullah MZ; Internal Medicine, East Carolina University Health, Greenville, USA., Johnson L Jr; Internal Medicine, East Carolina University Health, Greenville, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Jan 24; Vol. 15 (1), pp. e34135. Date of Electronic Publication: 2023 Jan 24 (Print Publication: 2023).
DOI:	10.7759/cureus.34135
Abstrakt:	Sarcoidosis is a multisystem inflammatory disorder characterized by the formation of non-caseating granulomas. Hematological manifestations such as thrombocytopenia are unusual presentations of the disease. Various theories have been proposed for the development of thrombocytopenia in patients with sarcoidosis such as decreased production in bone marrow caused by granuloma formation, hypersplenism, and immune thrombocytopenia (ITP). We present a case of a 30-year-old African American male with ITP secondary to sarcoidosis who presented with a sudden onset of buccal mucosa and mucocutaneous bleeding and was found to have severe thrombocytopenia with values reaching as low as 1000/uL without prior history of easy bruising or bleeding. Overall, our patient had dyspnea, mucocutaneous bleeding, and was found to have mediastinal and hilar adenopathy, isolated thrombocytopenia, no splenomegaly, and non-necrotizing granulomas in the lymph nodes. The patient received platelet transfusions without initial response and received intravenous immunoglobulin (IVIG), romiplostim, and steroids with subsequent improvement in the platelet count after sufficient administration of a treatment regimen of approximately one week. Confounding factors that resulted in diagnostic uncertainty of our patient presentation included travel history with prophylactic antimalarial medications, doxycycline usage, only slightly elevated Angiotensin-Converting Enzyme (ACE) levels, and imaging features concerning metastatic disease vs. lymphoma. The clinical diversity of sarcoidosis often leads to diagnostic uncertainty and treatment delays due to its resemblance to other more common disorders. This is a novel case report of the earliest temporal presentation of severe thrombocytopenia and sarcoidosis in an African American male reported in the literature. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Pasli et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu