PMC7136770_01
Left panel: upper endoscopy showing gastropathy. Right panel: flexible sigmoidoscopy showing moderate to severe proctosigmoiditis, Mayo Score-3.
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He continued to experience bloody diarrhea and underwent esophagogastroduodenoscopy and flexible sigmoidoscopy, which revealed significant body and fundus gastropathy as well as moderate to severe proctosigmoiditis (Figure 1).
Platelet count trend and treatments. The patient was treated initially with steroids from day 1 to day 29 with concurrent IVIG on day 3 and 4 where there was a slight increase in platelets. Rituximab was given on day 10 and 17 with no drastic change in platelet count. Following splenectomy and colectomy on day 25, the platelet count increased without further treatment or platelet transfusions. The patient was discharged on day 29 without steroids.
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His platelet count briefly responded to combined corticosteroids and IVIG but subsequently declined (Figure 2).