Thrombocytopenia as the sole symptom of an HIV infection

We report the case of a young adult who visited us because of thrombocytopenia and bleeding, clinically and cytologically compatible with autoimmune thrombocytopenic purpura (AITP). He was seropositive for HIV-1 and therefore HIV associated thrombocytopenia was diagnosed. Recent insights in the pathogenesis of this novel disease entity are discussed. The treatment is the classical AITP therapy. It is important, however, to refrain from therapy as long as possible, since a significant part of these patients improve spontaneously. We conclude that HIV associated thrombocytopenia will be increasingly important in the differential diagnosis of bleeding disorders.