Immune thrombocytopenic purpura associated with rheumatoid arthritis - a report of five cases and review of the literature.

Abstract Immune thrombocytopenic purpura (ITP) associated with rheumatoid arthritis (RA) is relatively rare. We describe five cases of RA with ITP. In all five patients, platelet counts were low, platelet-associated IgG levels were elevated, and bone marrow aspiration showed megakaryocytosis. Glucocorticoid therapy was effective in three cases, but the other two cases required immunosuppressants or intravenous γ-globulin in addition to glucocorticoid. We review the reported cases of RA with ITP and discuss the pathophysiology and differential diagnosis of thrombocytopenia in RA.