Ryan A Denu, Daniel R Matson, Matthew J Davis, Natalie J Tedford, Christine E Brichta, Carol A Diamond, Margo L Hoover-Regan
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Association of Immune Thrombocytopenia and T-Lymphoblastic Lymphoma in a Pediatric Patient.
Immune thrombocytopenia (ITP) is characterized by isolated thrombocytopenia of unclear etiology. We present a unique case of an 8-year-old girl with chronic ITP who was subsequently diagnosed with T-lymphoblastic lymphoma at age 11. The clinical course was complicated by the occurrence of nonepileptiform events with bizarre behavior changes following the administration of nelarabine and intrathecal and high-dose systemic methotrexate. This case highlights an unusual co-occurrence of hematologic malignancy and chronic ITP in an otherwise healthy child. We speculate that underlying genetic or immunologic lesions may predispose a subset of pediatric ITP patients to the development of hematologic malignancies.
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