Acute hemorrhagic purpura is a rare disease and perhaps of sufficient interest itself to warrant a case report, but a search of the literature has failed to reveal any instances in which this disease has been associated with exophthalmic goiter.
Hemorrhagic purpura is an acute or chronic disease characterized by a marked decrease in the number of blood platelets, spontaneous hemorrhages from mucous membranes and purpura. The blood platelets are greatly reduced from the normal of from 300,000 to 400,000 to less than 100,000 and, in acute cases, to even less than 20,000. If the blood vessels are injured in a case of hemorrhagic purpura, the effused blood clots, but the clots do not contract. Thrombosis does not take place readily in the injured vessels and the bleeding time is greatly prolonged.
In 1775 Werlhof1 first described this disease and established it as a distinct clinical entity. In 1916
Jackson AS. ACUTE HEMORRHAGIC PURPURA ASSOCIATED WITH EXOPHTHALMIC GOITER. JAMA. 1931;96(1):38-39. doi:10.1001/jama.1931.27220270001012