[Clinical characteristics and prognosis of primary immune thrombocytopenia complicated with diffuse alveolar hemorrhage].

Objective: This study aimed to investigate the clinical characteristics and prognosis of primary immune thrombocytopenia (ITP) complicated with diffuse alveolar hemorrhage (DAH) . Methods: This study retrospectively analyzed the clinical data of five patients with ITP complicated with DAH admitted to Peking University People's Hospital from January 2015 to June 2024. Basic characteristics, clinical symptoms, laboratory tests, imaging findings, and treatment responses were summarized, and survival and prognostic factors were evaluated. Results: All patients were female, with a median age of 56 (38-66) years. Four cases were diagnosed with chronic ITP, and three cases were complicated by infection. The main symptoms included mucocutaneous bleeding (3/5), dyspnea (3/5), and hemoptysis (2/5). The median PLT was 51 (1-83) ×10(9)/L. D-dimer was significantly increased [median 870 (220-8 578) ng/ml]. Chest computed tomography revealed diffuse ground-glass opacities in both lungs (3/5), consolidation (1/5), and air bronchogram (1/5). Three patients achieved complete remission, whereas two patients died. Conclusion: ITP complicated by DAH mainly manifests as acute respiratory failure. Increased D-dimer and failure to control infection are high-risk factors for death. Therefore, early combined immunosuppression and anti-infection treatment improves prognosis.