Immune thrombocytopenia (ITP) is a rare but recognized hematologic complication of tuberculosis (TB), particularly miliary TB. We present a case of a 50-year-old female with severe thrombocytopenia and hemorrhagic manifestations secondary to miliary TB. The patient presented with mucocutaneous bleeding, anemia, and constitutional symptoms. Investigations revealed severe thrombocytopenia (11,000/μL), erythroid hyperplasia on bone marrow aspiration, and radiographic findings consistent with miliary TB, later confirmed by sputum GeneXpert. Management included short-course high-dose dexamethasone for acute bleeding, followed by anti-tuberculosis therapy (ATT), which led to sustained platelet recovery without further immunosuppression. This case highlights miliary TB as a reversible cause of secondary ITP and underscores the importance of investigating underlying infections in patients presenting with thrombocytopenia in TB-endemic regions.
Abdela et al. (Mon,) studied this question.