Background and Objective: In Acute lymphoblastic leukemia (ALL) usually shows a lower than normal platelet count. The white blood cells may be normal, lower, or higher than normal. In immune thrombocytopenia, there is usually only a severe platelet deficiency. Our report is a rare case of a child with leukemia who developed Idiopathic Thrombocytopenic Purpura (ITP) a few months after treatment.
Case Report: A 6-year-old girl was admitted to the Shafizadeh Children’s Hospital, Amirkola (northern Iran) in 2014 with fever and pain in the right hip, suspected of septic arthritis. The patient was treated with a diagnosis of ALL after bone marrow aspiration and made a complete recovery in the third week. Treatment continued for two and a half years. A few months after off treatment, the patient presented with petechiae and echymosis. Bone marrow aspiration was performed for the patient with possible relapse. The patient was treated as an immune thrombocytopenia purpura. But severe thrombocytopenia occurred several times at short intervals. She did not respond well to conventional treatment. Due to treatment problems and financial costs, splenectomy was performed and the patient recovered completely and has been followed up for eight years and has no problems yet.
Conclusion: Leukemia is often associated with thrombocytopenia. Our case had a normal platelet count at the time of diagnosis. Thrombocytopenia after treatment is usually a sign of leukemia relapse, but our patient had ITP, which is a rare condition.