Presentation
BACKGROUND: The present study reports a case of piperacillin-induced thrombocytopenia in a dual heart and kidney transplant patient on January 28, 2016 (taking mycophenolate mofetil and tacrolimus). [ncbi.nlm.nih.gov]
Entire Body System
- Gaucher Disease
The most common causes of splenomegaly (enlarged spleen) are portal hypertension secondary to liver disease and splenic infiltration with tumor cells, or with macrophages in storage disorders (like Gaucher's disease ). [healthcentral.com]
disease Platelets become diluted Massive red blood cell replacement or exchange transfusion; stored red blood cells do not contain very many platelets Use or destruction of platelets increases Immune thrombocytopenia HIV infection and other viral infections [merckmanuals.com]
" - http://www.gastromd.com/lft.html Abnormalities in the spleen, such as cancer, cirrhosis, or Gaucher's disease, may cause abnormal amounts of platelets to be taken up by the spleen, which under normal conditions contains about one-third of the platelets [lymphomation.org]
Hematological
- Easy Bruising
It may result in easy bruising and excessive bleeding from wounds or bleeding in mucous membranes and other tissues A condition in which there is an abnormally small number of platelets in the circulating blood A decrease in the number of platelets in [icd9data.com]
Other symptoms include nosebleeds and easy bruising; sometimes gastrointestinal bleeding, excess menstrual bleeding, or other hemorrhage is observed. Hemorrhage in the brain can have serious consequences. [britannica.com]
Thrombocytopenia is characterized by easy bruising and increased bleeding. [rxlist.com]
bruising < 5,000 Hematologic emergency References:[2][4][5] Diagnostics ↓ Platelet count (< 150,000/mm3) ↑ Bleeding time Peripheral blood smear: to exclude abnormal platelet morphologies and cells (i.e., giant platelets in congenital disorders, blasts [amboss.com]
Gastrointestinal
- Hematemesis
Hemoptysis, hematemesis, hematuria, hematochezia, and melena are rarely the initial symptoms of a bleeding disorder. However, these may be exacerbated by an underlying bleeding disorder. Menstrual history is important. [emedicine.medscape.com]
Jaw & Teeth
- Bleeding Gums
With a low platelet count, you bleed easily You may have tiny purple spots on your skin and get nosebleeds and bleeding gums A very low platelet count may cause bleeding in your brain or severe bleeding from your intestines Many things can cause a low [merckmanuals.com]
Patients may notice petechiae or mucosal bleeding (e.g., bleeding gums, epistaxis) at lower platelet counts. Other patients with thrombocytopenia are clinically ill and have multisystem findings (e.g., acute infection, liver disease, TTP/HUS, DIC). [amboss.com]
Platelets help stop bleeding. So, a decrease in platelets can result in easy bruising, bleeding gums, and bleeding inside the body. The lower the platelet count, the greater the risk of bleeding. [stanfordchildrens.org]
But if the count drops low enough, a child might have one or more of these problems: easy bruising bleeding gums bleeding from minor wounds or nosebleeds that's hard to stop small red or purple spots on the skin called petechiae (peh-TEE-kee-eye) purple [kidshealth.org]
Skin
- Purpura
At presentation, acquired thrombotic thrombocytopenia purpura in a very young child is commonly misdiagnosed as other conditions like idiopathic thrombocytopenic purpura, Evans syndrome, atypical hemolytic-uremic syndrome, or malignancy. [ncbi.nlm.nih.gov]
PMID 22314603. ^ "How Is Thrombotic Thrombocytopenic Purpura Treated? - NHLBI, NIH". www.nhlbi.nih.gov. Retrieved 2015-05-20. ^ Thrombocytopenic Purpura: New Insights for the Healthcare Professional: 2013 Edition: ScholarlyPaper. [en.wikipedia.org]
MDS) *TTP/HUS = Thrombotic thrombocytopenic purpura/Hemolytic Uremic Symptom Table 5. [antimicrobe.org]
- Petechiae
These pinpoint-sized dots are called petechiae (peh-TEE-kee-ay). Petechiae may look like a rash. Purpura and Petechiae The photograph shows purpura (bruises) and petechiae (red and purple dots) on the skin. [nhlbi.nih.gov]
Suspect ITP in a child with thrombocytopenia and petechiae following a viral illness! [amboss.com]
Painless, round and pinpoints (1 to 3 mm in diameter), petechiae usually appear and fade, and sometimes group to form ecchymoses. [healthcentral.com]
Signs and Symptoms Diagnosis Treatment The most common symptoms of ITP are petechiae (red or purple dots on the skin), bruising and bleeding. [ucsfhealth.org]
Face, Head & Neck
- Epistaxis
The patient was admitted to hematology service with epistaxis, ecchymoses, fever, thrombocytopenia (0.6 x 103/μL) and anemia. His initial diagnosis was idiopathic thrombocytopenic purpura. [ncbi.nlm.nih.gov]
Patients may notice petechiae or mucosal bleeding (e.g., bleeding gums, epistaxis) at lower platelet counts. Other patients with thrombocytopenia are clinically ill and have multisystem findings (e.g., acute infection, liver disease, TTP/HUS, DIC). [amboss.com]
It presents in infancy or in neonates (in severe cases) with patients bruising easily along with further manifestations of thrombocytopenia including epistaxis, petechiae, ecchymoses, or splenomegaly. [enerca.org]
Neurologic
- Somnolence
Findings suggestive of intracranial hemorrhage include the following: Headache, blurred vision, somnolence, or loss of consciousness Hypertension and bradycardia, which may be signs of increased intracranial pressure On neurologic examination, any asymmetrical [emedicine.medscape.com]
Workup
Other laboratory tests should be obtained based on the initial workup and history. [clinicaladvisor.com]
Disseminated Intravascular Coagulation (DIC) Liver disease induced coagulopathy Uremic bleeding syndrome Genetic Hemophilia Factor VIII inhibitor Lupus anticoagulant Evaluation Algorithm for the Evaluation of Thrombocytopenia Platelet count (CBC) Additional workup [wikem.org]
It is not still clear if detection of H. pylori infection should be routinely included in the initial workup of chronic thrombocytopenia. Key words. H. pylori. Thrombocytopenia. Purpura. Mexico. [scielo.org.mx]
Evaluation begins with risk-stratification using the 4T score.2 interpretation of the 4T score: 0-3 points: Low probability (<<1%) No further workup of HITT is indicated (avoid checking heparin-PF4 antibodies). 4-5 points: Intermediate probability (~10% [emcrit.org]
Serum
- Decreased Platelet Count
PGRN deficiency further decreased platelet count in a passive-transfer ITP murine model. By contrast, administration of recombinant PGRN increased platelet count in SCID mice with chronic ITP. [ncbi.nlm.nih.gov]
In addition to a complete medical history and physical examination, laboratory testing of the blood can show decreased platelet counts. [chop.edu]
Thrombocytopenia is a decreased platelet count. Normal platelet count should range from 150,000 to 400,000 per microliter. [youtube.com]
Treatment
Therefore, warfarin treatment was replaced with dabigatran (300 mg/day). Her platelet count decreased (41,000/μL) significantly and dabigatran treatment was discontinued. [ncbi.nlm.nih.gov]
Prognosis
Quantifying Th17 cells may allow physicians to predict prognosis of glucocorticoid treatment and stratify therapy for those with ITP. This strategy may provide a new approach to the treatment of glucocorticoid-insensitive patients. [ncbi.nlm.nih.gov]
Prognosis Prognosis depends on the severity of the disease. Quality of life may be affected in those with a serious form of the disease, and iron overload due to repeated blood transfusions to treat anemia can be very damaging if left untreated. [orpha.net]
Etiology
Additional etiologies include hereditary syndromes, such as Wiskott-Aldrich syndrome and Alport syndrome. [amboss.com]
On further work up we found a coexistent autoimmune etiology. Thrombocytopenia promptly responded to steroids, a cost effective option. [ncbi.nlm.nih.gov]
While most patients will have asymptomatic, incidentally-found thrombocytopenia, and likely a benign etiology, those with the signs/symptoms just described, evidence of infection, or thrombosis are more likely to have a serious etiology and require an [mdedge.com]
Epidemiology
34/2, 8036, Graz, Austria. 3 Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria. [ncbi.nlm.nih.gov]
Summary Epidemiology The prevalence is unknown. At least 3 families have been described with thrombocytopenia with CDA and GATA1 mutations in the literature. [orpha.net]
Pathophysiology
However, a decrease in AIPC after admission was independently associated with the development of severe thrombocytopenia and mortality, suggesting the importance of suppressed thrombopoiesis in the pathophysiology of sepsis-induced thrombocytopenia. [ncbi.nlm.nih.gov]
Prevention
CONCLUSIONS: Dabigatran application may cause bleeding; therefore, careful monitoring during dabigatran treatment is required to prevent thrombocytopenia. [ncbi.nlm.nih.gov]
Can it be prevented? Thrombocytopenia can happen to anyone, although severe thrombocytopenia is considered to be rare among people with HIV. [poz.com]
The main goal of treatment is to prevent death and disability caused by bleeding. If your condition is mild, you may not need treatment. A fully normal platelet count isn't necessary to prevent bleeding, even with severe cuts or accidents. [hoacny.com]