Background and Objective: In acute lymphoblastic leukemia, platelet counts are typically observed to be below the normal range. White blood cell counts may be within normal limits, decreased, or elevated depending on the individual case. Immune thrombocytopenia typically manifests as isolated severe thrombocytopenia. Our report presents a rare case of a child with leukemia who developed idiopathic thrombocytopenic purpura (ITP) several months after completing treatment.
Case Report: The patient is a 6-year-and-9-month-old girl who was hospitalized at Shafizadeh Children's Hospital in Amirkola, northern Iran, presenting with fever and right hip joint pain suggestive of septic arthritis. Following bone marrow aspiration, she was diagnosed with acute lymphoblastic leukemia and treatment was initiated. She achieved complete remission by the third week of therapy. Treatment continued for a total of two and a half years. Several months after the treatment, the patient referred with petechiae and purpura. Bone marrow aspiration was performed due to concern for disease relapse. The patient was subsequently diagnosed with immune thrombocytopenic purpura and received conventional treatment; however, she experienced recurrent episodes of severe thrombocytopenia at short intervals. She did not respond adequately to standard medications. Due to treatment difficulties and financial constraints, splenectomy was performed, following which the patient achieved complete remission. She has been followed for eight years and remains asymptomatic with no health problems.
Conclusion: According to the results of the present study, ITP should be taken into consideration when thrombocytopenia is detected after completing leukemia treatment.