Graves 씨 병에 동반된 특발성 혈소판 감소성 자반증의 면역 억제제 치험 1 예 = Successful Treatment of Graves`Disease Associated with Idiopathic Thrombocytopenic Purpura by Immunosuppressant when the Antithyroid, Corticosteroid and Operations were Failed-Report of a case and review of literatures-

다국어 초록 (Multilingual Abstract)

Graves' disease associated with idiopathic thrombocytopenic purpura has been recorded many times in Korea. Although the autoimmune mechanism of these diseases is already thought to be significant role in the pathogenesis, the genetic factors also seem to be significant contributions recently. Even the understandings for relation of these two conditions and their pathogenesis are poor, the therapeutic results are relative satisfactory by antityroid medications, corticosteroid and/or operation. So that refractory cases are uncommon. Recently we experienced extreme hyperthyroid state with thrombocytopenia even after subtotal thyroidectomy and splenectomy followed by antithyroid medications. The cause of recurrence was thought due to autoimmune mechanism such as common antibody to thyroid gland and platelet. In these situations the conventional therapy were not satisfactory.
A 38 year old female was admitted to our hospital two times due to recur after medication and operation. So she had treated with immunosuppressive agent (Cyclo-phosphamide), and then platelet count was increased, the level of thyroid hormone became normal and general symptoms were markedly improved.
Although immunosuppressive agents were not the choice of drug in the treatment of Graves disease with idiopathic thrombocytopenic purpura, we proposed immunosuppressive agent might be a alternative therapeutic method when the various conventional treatment were failed.
We report a case of Graves disease with idiopathic thrombocytopenic purpura treated well by immunosuppressive agent who had been recurred by conventional treatments.