Cyclic thrombocytopenia (CTP) is a very rare disorder characterized by periodic fluctuations in platelet counts, typically resulting in episodes of thrombocytopenia alternating with normal platelet counts. Most cases are idiopathic while some are associated with a primary hematologic disease. Frequently CTP patients are misdiagnosed as idiopathic thrombocytopenic purpura (ITP), but usually they do not respond to standard ITP treatment.

A 49 year-old male presented a history of one year of symptomatic thrombocytopenia (<10x10(9)). He had been treated initially with corticosteroids without a consistent response. Later, he was subjected to splenectomy. After splenectomy platelet counts was checked weekly. On the first week the cont was 1.000x10(9)/L falling on the third week to 27x10(9)/L. As the patient had no bleeding we decided for no treatment, and platelet counts had been fluctuating from 800x10(9)/L to 20x10(9)/L about every four weeks, for three months of monitoring. No treatment was further required.

When evaluating patients with suspected ITP, CTP should always be included in the differential diagnosis, especially if they are not responding to standard ITP treatment.

Figure 1.
Figure 1.
View largeDownload slide
Disclosures

No relevant conflicts of interest to declare.

Topics:
cyclic thrombocytopenia, purpura, thrombocytopenic, idiopathic, splenectomy, thrombocytopenia, adrenal corticosteroids, glucocorticoids, hematological diseases, hemorrhage, mineralocorticoids, misdiagnosis

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2015 by The American Society of Hematology
2015
Sign in via your Institution