Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Thrombosis Journal
Published in: Thrombosis Journal 1/2024

Open Access 29-04-2024 | Thrombocytopenia in Children | Case Report

A 11-year-old boy with Blastocystis hominis infection, presents as immune thrombocytopenia

Authors: Fajuan Tang, Dongqiong Xiao, Lin Chen, Xihong Li, Lina Qiao

Published in: Thrombosis Journal | Issue 1/2024

Login to get access

Abstract

Background

Some causes of first-line treatment failure for ITP are often closely related to infections. But parasitic infections are rarely mentioned and easily overlooked. The case is the first to describe a boy with immune thrombocytopenia associated with blastocystis hominis.

Case presentation

The case involved a boy presenting with bleeding skin spots and ecchymosis and accompanied by intermittent epigastric pain and constipation. After a series of complete examinations, the platelet count was found to be decreased to 13 × 109/L and immune thrombocytopenia was diagnosed. After first-line treatment with gamma globulin and prednisolone, the thrombocytopenia remained unchanged. Blastocystis hominis was subsequently found in the patient's stool and then the treatment of metronidazole was provided. One week later, the patient's thrombocytopenia was completely relieved. He was followed up for six months and was found to have recovered well.

Conclusions

The screening for potential predisposing factors is very important for immune thrombocytopenia patients with poor response to first-line treatment, and the best treatment strategy should include the management of potential diseases.
Literature
1.
2.
Lozano M. New developments in the diagnosis of primary immune thrombocytopenia. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 2022;33:S5–7.CrossRef
3.
Alharbi M, Alanazi N, Yousef A, Alanazi N, Alotaibi B, Aljurf M, El Fakih R. COVID-19 associated with immune thrombocytopenia: a systematic review and meta-analysis. Expert Rev Hematol. 2022;15:157–66.CrossRefPubMed
4.
Park C, Margaria B, Husnain M. Secondary Immune Thrombocytopenia Due to Mycoplasma pneumoniae Without Clinically Significant Evidence of Active Infection. Cureus. 2022;14:e23551.PubMedPubMedCentral
5.
6.
Salehi M, Mardaneh J, Niazkar H, Minooeianhaghighi M, Arshad E, Soleimani F, Mohammadzadeh A. Blastocystis hominisPrevalence and Subtype Analysis of Isolated from Patients in the Northeast of Iran. J Parasitol Res. 2021;2021:8821885.CrossRefPubMedPubMedCentral
7.
Kumarasamy V, Atroosh W, Anbazhagan D, Abdalla M, Azzani M. Blastocystis hominisAssociation of with colorectal cancer: A systematic review of and evidences. World journal of gastrointestinal oncology. 2022;14:734–45.CrossRefPubMedPubMedCentral
8.
Nagel R, Traub R, Kwan M, Bielefeldt-Ohmann H. Blastocystis specific serum immunoglobulin in patients with irritable bowel syndrome (IBS) versus healthy controls. Parasit Vectors. 2015;8:453.CrossRefPubMedPubMedCentral
9.
Tutanç M, Silfeler I, Ozgür T, Motor V, Kurtoğlu A. The case of Henoch-Schönlein Purpura associated with Blastocystis hominis. Turkiye parazitolojii dergisi. 2013;37:135–8.CrossRefPubMed
10.
El-Zawawy H, Farag H, Tolba M, Abdalsamea H. Blastocystis hominisImproving Hashimoto’s thyroiditis by eradicating : Relation to IL-17. Therapeutic advances in endocrinology and metabolism. 2020;11:2042018820907013.CrossRefPubMedPubMedCentral
11.
Asfaram S, Daryani A, Sarvi S, Pagheh A, Hosseini S, Saberi R, Hoseiny S, Soosaraei M, Sharif M. Geospatial analysis and epidemiological aspects of human infections with Blastocystis hominis in Mazandaran Province, northern Iran. Epidemiology and health. 2019;41:e2019009.CrossRefPubMedPubMedCentral
12.
Li X, Zhang M, He L, Zhou J, Shen P, Dai W, Yang X, Yuan Y, Zhu H, Wang H. Gut microbiota alterations in children and their relationship with primary immune thrombocytopenia. Front Pediatr. 2023;11:1213607.CrossRefPubMedPubMedCentral
13.
Stensvold C, Sørland B, Berg R, Andersen L, van der Giezen M, Bowtell J, El-Badry A, Belkessa S. Kurt Ö. Nielsen H: BlastocystisStool Microbiota Diversity Analysis of -Positive and -Negative Individuals. Microorganisms; 2022. p. 10.
14.
Deng L, Wojciech L, Gascoigne N, Peng G, Tan K. New insights into the interactions between Blastocystis, the gut microbiota, and host immunity. PLoS Pathog. 2021;17:e1009253.CrossRefPubMedPubMedCentral
15.
Kostic M, Zivkovic N, Cvetanovic A, Marjanović G. CD4 T cell phenotypes in the pathogenesis of immune thrombocytopenia. Cell Immunol. 2020;351:104096.CrossRefPubMed
16.
Li Q, Liu Y, Wang X, Sun M, Wang L, Wang X, Liu Y, Fan W, Zhang K, Sui X, Guo X. Regulation of Th1/Th2 and Th17/Treg by pDC/mDC imbalance in primary immune thrombocytopenia. Exp Biol Med (Maywood). 2021;246:1688–97.CrossRefPubMed
17.
Long H, Handschack A, König W, Ambrosch A. Blastocystis hominis modulates immune responses and cytokine release in colonic epithelial cells. Parasitol Res. 2001;87:1029–30.CrossRefPubMed
18.
Kumarasamy V, Kuppusamy U, Samudi C, Kumar S. Blastocystis sp. subtype 3 triggers higher proliferation of human colorectal cancer cells HCT116. Parasitol Res. 2013;112:3551–5.CrossRefPubMed
19.
Zhang J, Ma D, Zhu X, Qu X, Ji C, Hou M. Elevated profile of Th17, Th1 and Tc1 cells in patients with immune thrombocytopenic purpura. Haematologica. 2009;94:1326–9.CrossRefPubMedPubMedCentral
20.
Stimpson M, Lait P, Schewitz-Bowers L, Williams E, Thirlwall K, Lee R, Bradbury C. IL-10 and IL-17 expression by CD4 T cells is altered in corticosteroid refractory immune thrombocytopenia (ITP). J Thromb Haemost. 2020;18:2712–20.CrossRefPubMed
21.
Wu L, Fu R, Lu Z, Tang L, Zhang F, Liu D. Expressions and significance of IL-17 and IL-23 in intestinal mucosa of mice infected with Blastocystis hominis. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2012;24:676–80.PubMed
22.
Lim M, Png C, Tay C, Teo J, Jiao H, Lehming N, Tan K, Zhang Y. Differential regulation of proinflammatory cytokine expression by mitogen-activated protein kinases in macrophages in response to intestinal parasite infection. Infect Immun. 2014;82:4789–801.CrossRefPubMedPubMedCentral
Metadata
Title
A 11-year-old boy with Blastocystis hominis infection, presents as immune thrombocytopenia
Authors
Fajuan Tang
Dongqiong Xiao
Lin Chen
Xihong Li
Lina Qiao
Publication date
29-04-2024
Publisher
BioMed Central
Published in
Thrombosis Journal / Issue 1/2024
Electronic ISSN: 1477-9560
DOI
https://doi.org/10.1186/s12959-024-00611-w

Other articles of this Issue 1/2024

Thrombosis Journal 1/2024 Go to the issue

Review

Progress in the clinical effects and adverse reactions of ticagrelor

Review

The efficacy and safety of direct oral anticoagulants compared with vitamin K antagonist in patients with hypertrophic cardiomyopathy and atrial fibrillation

Case Report

Successful ECMO treatment in patients with cerebral hemorrhage and PROC gene mutation associated with VTE: a case report

Research

SERPINC1 c.1247dupC: a novel SERPINC1 gene mutation associated with familial thrombosis results in a secretion defect and quantitative antithrombin deficiency

Research

External validation and update of the International Medical Prevention Registry on Venous Thromboembolism bleeding risk score for predicting bleeding in acutely ill hospitalized medical patients: a retrospective single-center cohort study in Japan

Research

Factors influencing DVT formation in sepsis
Image Credits