August 15, 2003 16:26 PHO TJ788-13

Pediatric Hematology and Oncology, 20: 573, 2003Copyright C© Taylor & Francis Inc.ISSN: 0888-0018 print / 1521-0669 onlineDOI: 10.1080/08880010390232817

Letter to the Editor

DID HE HAVE IDIOPATHIC THROMBOCYTOPENIA?

Sinasi Ozsoylu, MD ✷ Department of Paediatrics and Haematology, FatihUniversity Medical Faculty, Alparslan Turkes cad. No. 57, 06510 Emek, Ankara

De and Gilbertson [1] described a boy with thrombocytopenia (12 ×109/dL) and leukopenia (2 × 109/L) who was diagnosed as having idio-pathic thrombocytopenia purpura with associated immune neutropenia. Theauthors stated that the diagnosis “was supported by a positive direct antiglob-ulin test.” These words indicate that this boy did not have idiopathic throm-bocytopenic purpura (ITP) but immune thrombocytopenia, leukopenia, andlater Coombs-positive hemolytic anemia.

For the diagnosis of ITP, there should not be recent history of drug inges-tion, including aspirin and quinidine, or blood transfusions, and underlyingdiseases must be excluded as much as possible by lupus preparation (ordouble-stranded DNA) antiphospholipid, anticardiolipin antiglobulin anti-bodies, and throat cultures. Organomegaly and lymphadenopathy shouldalso not be detected [2]. Therefore, I believe the authors’ patient had im-mune thrombocytopenia with leukopenia and Coombs-positive hemolyticanemia, but not ITP.

REFERENCES

1. De S, Gilbertson NJ. Traumatic optic neuropathy complicating combined idiopathic thrombocytopeniaand neutropenia. Pediatr Hematol Oncol. 2002;19:529–531.

2. Ozsoylu S, Irken G, Karabent A. High dose intravenous methylprednisolone for acute childhoodidiopathic thrombocytopenic purpura. Eur J Haematol. 1989;42:431–435.

Received 9 December 2002; accepted 25 May 2003.Address correspondence to Sinasi Ozsoylu, MD, Department of Paediatrics and Haematology,

Fatih University Medical Faculty, Alparslan Turkes cad. No. 57, 06510 Emek, Ankara.

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