Severe thrombocytopenia caused by digitoxin intoxication in a patient with heart failure associated with Sjogren's syndrome

Congestive heart failure (CHF) related to Sjogren's syndrome is extremely rare. This report concerns a patient who presented with CHF and severe thrombocytopenia (5,000/μl). Serum concentrations of K, Mg and digitoxin were 3.2 mmol/L, 1.4 mg/L and 57.2 ng/ml, respectively. Digitoxin intoxication was evident, seemingly evoked by hypokalemia, hypomagnesemia; hepatorenal dysfunction and hypothyroidism. The severe thrombocytopenia was considered to have been caused by this intoxication, as it disappeared soon after the digitoxin was discontinued and potassium was supplemented.