case_images: PMC10288111_01
case_images: The dashed line above the thyroid ultrasound shows the size of the anterior-posterior and superior-inferior diameters. The anterior-posterior diameter of the right lobe of the thyroid gland was 0.9 cm, the left and right diameters were 1.1 cm, the upper and lower diameters were 3.2 cm, and the anterior-posterior diameter of the left lobe was 0.7 cm, the left and right diameters were 1.0 cm, the upper and lower diameters were 3.1 cm, and the thickness of the isthmus was about 0.14 cm. The parenchymal echogenicity was hypoechoic and inhomogeneous, no exact occupancy was seen, and no significant abnormal blood flow signal was detected.
case_images: fped-11-1169064-g001.jpg
case_images: PMC10288111_01_fped-11-1169064-g001.jpg
case_images: F1
case_images: U/ml) and TPOAB (848.3 U/ml) levels compared to the reference range, indicating a possible autoimmune disorder (Supplementary Table S1). The child tested positive for H. pylori antibodies, negative for antiplatelet and antinuclear antibodies, and mildly elevated IgE, but no abnormalities were found for IgM, IgG, IgA, or complement. Ultrasound of the thyroid showed hypoechoic and heterogeneous parenchymal echogenicity with no significant abnormal blood flow signal, and the size of the thyroid was consistent with HT (Figure 1).
case_images: Bone marrow cytology image of the child in this case. Magnification:40, hematoxylin and eosin (H&E) staining. Bone marrow cell smear suggested 98 megakaryocytes and 17/50 platelet-producing megakaryocytes.
case_images: fped-11-1169064-g002.jpg
case_images: PMC10288111_01_fped-11-1169064-g002.jpg
case_images: F2
case_images: In response, we scheduled a bone marrow aspiration for the child, and upon examination, found 98 megakaryocytes and 17 out of 50 platelets (Figure 2).
case_images: The graph shows the trend of the change in the platelet count of the boy in the case during the treatment period. In the graph above, the child's treatment is marked with an asterisk.
case_images: fped-11-1169064-g003.jpg
case_images: PMC10288111_01_fped-11-1169064-g003.jpg
case_images: F3
case_images: A month later, the child returned to our hospital for a re-examination, and their platelet count was maintained at 76 x 109/L with no reported bleeding tendency or complications (Figure 3).