Presentation
A 44-year-old woman presented with a history of generalized purpura. She drank alcohol once or twice a week and regularly took an analgesic preparation, containing aspirin and acetaminophen, for alleviation of headaches. [ncbi.nlm.nih.gov]
While severe thrombocytopenia can present with bleeding anywhere, certain types of bleeding are characteristic of thrombocytopenia. [quizlet.com]
Campbell, PG et al., Emergency Reversal of Antiplatelet Agents in Patients Presenting with an Intracranial Hemorrhage: A Clinical Review, World Neurosurgery 2010; 74 (2/3): 279-285. [jacobiem.org]
Compared to those included in the group NO ASPIRIN, patients included in the group ASPIRIN presented a decreased baseline platelet function measured by ASP test ( P P P P = 0.01), and ASP test ( P = 0.01). [ingentaconnect.com]
Petechiae also may be present. 2, 10 As the disease progresses, abdominal pain, polyarthralgia, headaches, and renal disease may develop. Renal lesions are present in 60% of patients during the second to third week of the disorder. [doctorlib.info]
Hematological
- Easy Bruising
Use: Closure time is indicated when a disorder of platelet function is suspected by a personal or family history of easy bruising, nosebleeds, menorrhagia or post-operative bleeding. It is not recommended as a screen for potential bleeding risk. [labguide.fairview.org]
A hereditary cause is suspected if there is a lifelong history of easy bruising; bleeding after tooth extractions, surgery, childbirth, or circumcision; or heavy menstruation. [merckmanuals.com]
bruising Prolonged or heavy menstrual periods. [healthcommunities.com]
The clinical features of this group of disorders are mucocutaneous hemorrhage and hematuria, epistaxis, and easy and spontaneous bruising. Petechiae are less common than in other qualitative platelet disorders. [doctorlib.info]
The bleeding manifestations are predominantly skin-related and mucocutaneous (ie, easy bruising, epistaxis, GI hemorrhage). Most bleeding episodes occur following trauma or surgery. [emedicine.medscape.com]
Face, Head & Neck
- Epistaxis
ADP receptor defect Aggregation defect P2YR12 n/a Bernard-Soulier syndrome Adhesion disorder with deficiency or dysfunction of platelet glycoprotein Ib/IX/V complex GP1BA, GP1BB, GP9 Epistaxis, ecchymoses, menorrhagia, gingival hemorrhage, gastrointestinal [arupconsult.com]
A year before this admission with malena, she had her first bleeding episode with epistaxis following septoplasty at which time APTT was 40s, PT 20s. [medcraveonline.com]
Clinical manifestations usually include purpura, epistaxis, menorrhagia, gingival and gastrointestinal bleeding. The syndrome is transmitted as an autosomal recessive trait. [askhematologist.com]
Mild bleeding such as epistaxis may occur in early childhood, but severe postoperative hemorrhage has been observed. [doctorlib.info]
Glanzmann's thrombasthenia is an inherited autosomal recessive disorder in which patients present with mucosal type bleeding (epistaxis, gingival bleeding, and menorrhagia). [quizlet.com]
Treatment
One duodenal ulcer was recorded in the aspirin group after 14 days of treatment. [care.diabetesjournals.org]
Comparison between nasal and intravenous desmopressin for the treatment of acetylsalicylic acid-induced platelet dysfunction. Eur J Anaesthesiol. 2002;19:647–51. [link.springer.com]
Treatment options include–whenever possible–treatment of the underlying disorder or symptomatic treatment aimed at replacing the loss of vWF by either infusion of vWF-rich concentrates or administration of desmopressin (DDAVP). [askhematologist.com]
Aspirin treatment suppressed TXB2 in serum by more than 98%. [healio.com]
Treatment with penicillin resulted in mild bleeding tendency after 3 days. [thrombosisjournal.biomedcentral.com]
Prognosis
Prognosis The prognosis is very variable and will depend on the underlying condition. [patient.info]
GT can be a severe hemorrhagic disease, however the prognosis is excellent with careful supportive care. [askhematologist.com]
The prognosis is excellent although there is a 30% chance of recurrence. While this is an uncommon disorder it is important to recognize. TTP is >90% fatal if not treated properly. [quizlet.com]
Plasma exchange therapy, introduced 30 years ago, has dramatically improved the prognosis for patients with TTP. [emedicine.medscape.com]
Patients and their parents need to be reassured about the prognosis and transient nature of symptoms. [medcraveonline.com]
Etiology
The minimum criteria for the diagnosis of TTP are thrombocytopenia and microangiopathic hemolytic anemia without an apparent etiology. [emedicine.medscape.com]
Epidemiology
Clinical Epidemiology Unit, Loeb Research Institute, University of Ottawa, Canada. [email protected] Concern about the side effects of allogeneic red blood cell transfusion has increased interest in methods of minimizing perioperative transfusion. [crashingpatient.com]
[…] phenomenon is partly due to acute enhancement of the circulating levels of von Willebrand factor (vWF) ( 4 ) and indeed platelet-plasma interactions involving vWF have been previously suggested to cause increased platelet aggregability ( 5 ), and recent epidemiological [care.diabetesjournals.org]
Epidemiology of Platelet Disorders Inherited hemostatic disorders are relatively rare. The prevalence of von Willebrand disease has been estimated at 1 case per 1000-5000 population. [emedicine.medscape.com]
Pathophysiology
Pathophysiology and Types vWD is subdivided into three types, based on clinical and laboratory features Type 1 This accounts for approximately 70% of patients, has an autosomal dominant inheritance, and represents a quantitative deficiency of vWF. [askhematologist.com]
Non-immune mediated •Thrombotic Thrombocytopenia Purpura (TTP) pathophysiology -Caused by an alteration in vonWillebrand factor processing - decreased protease activity -Large vWF multimers cause platelets to stick and plug small vessels causing ischemia [quizlet.com]
The pathophysiologic relevance of this observation is uncertain because the concentrations of fibrin degradation products required are unlikely to be reached in vivo. [doctorlib.info]
Thus, the pathophysiology of this disease is similar to that of the hemolytic disease of newborns. Unlike hemolytic disease, however, thrombocytopenia occurs during the first pregnancy in 50% of cases. [emedicine.medscape.com]
Prevention
Cachexia Calcium Oxalate Stones Cancer Prevention (Reducing the Risk) Cancer Treatment Support Candida Candida/Yeast Hypersensitivity Syndrome Canker Sores Car Sickness Cardiac Arrhythmia Cardiac Autonomic Neuropathy, Diabetic Cardiomyopathy Caries, Prevention [therapy.epnet.com]
These drugs are used to prevent coronary artery stenosis, stent reocclusion. Clopidrogel (Plavix) blocks the ADP receptor and prevents platelet aggregation. This drug is commonly used in patients with vascular disease to prevent thrombosis. [quizlet.com]
Aspirin and NSAIDs prevent cyclooxygenase-mediated production of thromboxane A2. This effect can last 5 to 7 days. [merckmanuals.com]
Some cases cannot be prevented. Acquired qualitative platelet disorders; Acquired disorders of platelet function Diz-Kucukkaya R, Lopez JA. Acquired disorders of platelet function. [medlineplus.gov]
Despite that we have decided to give them both together because we know that they have the potential to prevent cardiac events. [jacobiem.org]