A cyclic thrombocytopenia associated with Sjögren syndrome

: A 51-year-old women in menopause was admitted because of intermittent purpura. She was diagnosed as having cyclic thrombocytopenia. One platelet cycle lasted for about 22 days with platelet count fluctuating from 1.0 X 10(4)/microliters to 31.0 X 10(4)/microliters. The platelet-associated immunoglobulin was correlated with the platelet cycle. The rheumatic factor, antinuclear antibody, antimicrosome antibody, anti-thyroglobulin antibody and platelet binding immunoglobulin were all positive but did not fluctuate during the cycle. The platelet life-span was shortened. The mean platelet volume fluctuated during each cycle. The lipid emulsion test was prolonged. Symptoms of Sjogren syndrome and purpura appeared at the same time. It was strongly suggested that purpura was caused by cyclical destruction of platelets by reticuloendothelial system.