The case report by Huhn and Hiller is an additional interesting example of the association between hyperthyroidism and thrombocytopenia in a young woman also showing laboratory evidence of autoimmunity.
Thyrotoxicosis and thrombocytopenia have been reported together associated in a "primary" way, in which cases the adequate treatment of the former condition brings the platelet count to normal.1 In addition, Graves' disease and ITP could appear together in the same patient as independent conditions. In this situation, the thrombocytopenia is extremely refractory to treatment, the thyrotoxicosis influencing the natural history of the ITP, as we showed in our report.
In the case report by Huhn and Hiller, it is not clear whether the patient suffered from Graves' disease or from hyperthyroidism without goiter. This point might be important, since from 28 reported cases found in the literature of a primary association between thyrotoxicosis and thrombocytopenia, in 21 the thyroid gland