Recurrent petechia and epistaxis in a patient diagnosed as diabetes mellitus for 2 years
10.3760/cma.j.issn.2095-428X.2019.01.019
- VernacularTitle:糖尿病确诊2年后,间断出现皮肤出血点、鼻出血
- Author:
Jie ZHENG
1
;
Runhui WU
;
Yan SU
;
Jie MA
;
Liqiang ZHANG
;
Shengcai WANG
;
Di WU
;
Jianxin HE
;
Xiaoling WANG
Author Information
1. 首都医科大学附属北京儿童医院血液肿瘤中心
- Keywords:
Autoimmune polyglandular syndrome;
Immune thrombocytopenia;
Diabetes mellitus;
Rituximab
- From:
Chinese Journal of Applied Clinical Pediatrics
2019;34(1):76-80
- CountryChina
- Language:Chinese
-
Abstract:
To analyze respectively a case,presented with recurrent petechial and epistaxis after a 2 years history of diabetes mellitus (DM),who was hospitalized in Beijing Children's Hospital Affiliated to Capital Medical University.The clinical manifestation,examination,diagnosis and treatment were recorded.The patient was diagnosed with immune thrombocytopenia (ITP) and DM at the first admission.The initial therapy with gamma globulin didn't show ideal effect.The pediatric specialists from the department of ENT,Hematology/Oncology,Endocrinology,Pharmacy and Immunodeficiency Clinic were invited to discuss the case.The final diagnosis of autoimmune polyglandular syndrome (APS) was made and supplementary steroid treatment was started.But the response of the steroid therapy was poor.Once again with the multidisciplinary consultation,the patient received several schemes of Rituximab under the informed consent.This treatment reached a stable condition for almost 7 years.APS should be considered when DM patient showed the manifestation of other immune organ damages.Rituximab immunosuppressive therapy should be tried when the response to first-line treatment was poor.
