Mixed connective tissue disease with secondary immune thrombocytopenic purpura -- a case report

Mixed connective tissue disease [MCTD] is a generalized connective tissue disease which is confirmed by the presence of anti-U1 ribonucleoprotein (RNP) antibodies. The etiology of MCTD remains unclear. We present a case of a young female presenting with menorrhagia, symptomatic anaemia, small joint pain and raynaud’s phenomenon. She was found to have thrombocytopenia with positive anti-U1RNP antibodies. She was diagnosed as having MCTD with pulmonary hypertension and secondary immune thrombocytopenic purpura [ITP]. She was treated with corticosteroids and immunosuppressants which led to complete remission. Even though secondary ITP is associated with autoimmune diseases, cases of MCTD with secondary ITP are rare in literature. Cases of MCTD presenting with bleeding manifestations are rare as well. This should be considered as a differential diagnosis in a patient presenting with bleeding manifestations along with symptoms suggestive of an underlying connective tissue disorder. Early diagnosis and treatment enhance prognosis.