Coexistence of immune thrombocytopenic purpura and idiopathic membranous glomerulonephritis successfully treated with rituximab

We describe here coexistence of immune thrombocytopenic purpura (ITP) and idiopathic membranous glomerularnephritis (IMG) in one individual who presented a decade ago after delivering a macerated dead fetus. Investigations performed then revealed clinical, biochemical and histopathological evidence of IMG. A year later she presented with bleeding diathesis and was diagnosed as ITP. Thereafter, she manifested with several episodes of serious bleeding complications especially in the central nervous system with considerable frequency, inspite of receiving treatment with steroids, intravenous immunoglobulin and cyclosporine. Subsequently, she received six courses of rituximab and went into complete remission. To date, after more than 3.5 years of follow up, she is completely symptom free. Co-existence of IMG and ITP has been reported earlier; however, this is the first instance of successful treatment of both these entities with rituximab.