Inflammatory Bowel Disease and Immune Thrombocytopenic Purpura: Combined Immune Dysregulation in an Adolescent.

Concomitant inflammatory bowel disease (IBD) and immune thrombocytopenic purpura (ITP) is a rare phenomenon. A shared immunologic pathway leading to mucosal inflammation and platelet destruction has been proposed. We report a case of a 14-year-old male who presented with abdominal pain, hematochezia, weight loss, and thrombocytopenia. Endoscopic and hematologic evaluations led to the diagnosis of ulcerative colitis (UC) and ITP, respectively. Initial treatment of his UC resulted in improvement in both gastrointestinal symptoms and platelet count. Management of this case, however, was complicated by inconsistent correlation between UC symptoms and platelet count throughout his clinical course. The co-occurrence of IBD and ITP is an important entity, albeit rare, which needs to be considered when evaluating a patient with hematochezia and thrombocytopenia.