Unveiling Thrombocytopenia in Drug-resistant Extrapulmonary Tuberculosis: A Comprehensive Review

Abstract

ABSTRACT Immune thrombocytopenia (ITP) is caused because of antibodies to platelets. ITP can be primary or secondary; secondary ITP is usually caused by infections. Tuberculosis (TB) is a rare cause of secondary ITP. Linezolid, despite being the backbone of a drug-resistant TB regimen, is the most common drug to cause thrombocytopenia in this subset of patients. Treatment of ITP requires immunosuppression with pulse steroids and intravenous immunoglobulin which can lead to dissemination of TB and can be catastrophic in patients of drug-resistant TB. Here, we present a case of drug-resistant extrapulmonary TB with ITP, which was managed with low-dose corticosteroids. This case highlights the importance of complete evaluation for the cause of thrombocytopenia and considering ITP as a differential before discontinuing any essential drug in these patients.