Atypical mononuclear cell in Immune Thrombocytopenia Purpura (ITP) with massive bleeding

Authors

Keywords:

Atypical mononuclear cell, ITP, bleeding

Abstract

Background: Immune thrombocytopenic purpura (ITP) is a disorder that can lead to mild or severe bruising and bleeding. The bleeding results from unusually low platelet counts. Atypical mononuclear cells (AMC) in thrombocytopenia and anemia may raise doubt about the diagnosis of ITP. Furthermore, it warrants investigation.

Case report: A 50-year-old woman who came for investigation of melena and cutaneous bleeding (haemoglobin level 4.1-5.5 g/dl) for about 2-3 days. Thrombocyte count showed thrombocytopenia (2–6 × 10^3/µl), and she had a normal leucocyte count. Her peripheral blood film was anemia, normocytic, normochromic, thrombocytopenia, and normal leukocyte count with AMC. We evaluated the patient with another laboratory parameter, the antiplatelet antibody. It was positive, showing that there was an autoantibody against thrombocytes in her circulation, and we could exclude haematological cancer. AMC correlated with the activity of the mononuclear phagocyte.

Conclusion: Anti-platelet antibodies play an important role in unexplained thrombocytopenia, with or without anemia, and this parameter can exclude haematological cancer in the diagnostic process.

Keywords: Atypical mononuclear cell, ITP, bleeding

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Author Biographies

  • Edward Kurnia Setiawan Limijadi, Diponegoro University

    Department of Clinical Pathology, Faculty of Medicine, Diponegoro University, Semarang, Indonesia

  • Villa Sekar Cita, Diponegoro University

    Department of Clinical Pathology, Faculty of Medicine, Diponegoro University, Semarang, Indonesia

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Published

2025-12-22

Issue

Volume 1, Issue 1, December 2025

Section

Case Reports

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