HIV associated thrombocytopenia

We report the case of 47-year-old male who presented with fever, cough and expectoration since 4 months and diarrhoea, malaise and dysphagia since 3 months. He was known to have diabetes mellitus and hypothyroidism and was receiving insulin and thyroxine supplementation. He was evaluated outside and was found to be co-infected with human immunodeficiency virus (HIV 1) and pulmonary tuberculosis and was receiving antituberculous treatment. He had hyperpigmented macular and non pruritic rash over his body. Oral thrush was present. Laboratory evaluation showed thrombocytopenia (20,000/?L) with giant platelets; bone marrow aspiration and biopsy revealed normocellular marrow with increased and hypolobated megakaryocytes. The patient was treated with tenofovir, emtricitabine and efavirenz, antituberculosis drugs and oral fluconazole. Insulin and thyroxine replacement therapy were continued. He was diagnosed to have HIV associated thrombocytopenia and was started on dapsone treatment. Two months later, his platelet count had become normal. The present case highlights the importance of being aware of HIV associated thrombocytopenia so as to facilitate the prompt recognition and treatment of this condition.