Isolated gastric mucosal hemorrhages in idiopathic thrombocytopenic purpura.

摘要

A 42-year-old woman with idiopathic thrombocytopenic purpura (ITP) presented to the emergency department because of the sudden onset of nausea and a few episodes of coffee-ground emesis in the preceding 24 hours. There was no history of splenectomy. Routine laboratory test results revealed thrombocytopenia (platelet count of 1000/muL), anemia (hemoglobin of 8.7 g/dL), and a normal total leukocyte count. EGD showed severe diffuse subepithelial hemorrhages (A). The esophagus and duodenum were strikingly normal (B). A proton pump inhibitor was given intravenously, and oral prednisone and intravenous immuno-globulin were started. The platelet count normalized quickly, and there was no recurrence of hemetemesis. She was discharged in a stable condition on oral prednisone. The uniqueness of this case lies in the observation that hem- orrhages were limited to the stomach, whereas the esophagus and duodenum were unremarkable.