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Thrombocytopenia

Thrombocytopenia is a low platelet count in the blood. A normal platelet count ranges from 150,000 to 450,000 platelets/µL.


Presentation

  • 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]
  • IL-10 level and polymorphisms as well as disturbed T-cell subsets percentages are demonstrable effectors of immune dysfunction in ITP and can affect the presentation and outcome of childhood ITP.[ncbi.nlm.nih.gov]
  • Here we present a pediatric case of persistent thrombocytopenia associated with T-cell ALL.[ncbi.nlm.nih.gov]
  • An immunofluorescence test applying flow cytometry and monoclonal antibody immobilization of platelet antigens (MAIPA) assay were used to evaluate the reaction between IgG present in the IVIG preparations and the patient's or healthy donors' platelets[ncbi.nlm.nih.gov]
  • This article describes a practical approach to the diagnosis and initial management of patients presenting with acute thrombocytopenia, with the aid of a case vignette.[ncbi.nlm.nih.gov]
Easy Bruising
  • Thrombocytopenia is characterized by easy bruising and increased bleeding.[rxlist.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]
  • It may result in easy bruising and excessive bleeding from wounds or bleeding in mucous membranes and other tissues.[fpnotebook.com]
  • This can cause red or purple dots on the skin, called petechiae, and problems with easy bruising, nosebleeds, blood blisters in the mouth or internal bleeding.[ucsfhealth.org]
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]
  • disease Zika virus Medication-induced [ edit ] The following medications can induce thrombocytopenia through direct myelosuppression. [12] Valproic acid Methotrexate Carboplatin Interferon Isotretinoin Panobinostat H 2 blockers and proton-pump inhibitors[en.wikipedia.org]
  • ." - 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 in the body.[lymphomation.org]
Bleeding Gums
  • Use a soft toothbrush to prevent bleeding gums. Wear a seatbelt in the car, and put on gloves and goggles when you work with power tools to prevent injury.[webmd.com]
  • If you have a low platelet count, you may experience: red, purple, or brown bruises, which are called purpura a rash with small red or purple dots called petechiae nosebleeds bleeding gums bleeding from wounds that lasts for a prolonged period or doesn[healthline.com]
  • A decrease in platelets can result in easy bruising, bleeding gums, and internal bleeding. The older name that is still sometimes seen is idiopathic thrombocytopenic purpura: Idiopathic means the cause is unknown.[stanfordchildrens.org]
  • Some individuals with thrombocytopenia may experience external bleeding such as nosebleeds , and/or bleeding gums . Some women may have heavier or longer periods or breakthrough bleeding.[en.wikipedia.org]
Purpura
  • The treatment of refractory immune-mediated thrombocytopenia purpura (ITP) can be challenging. This case report describes treatment of refractory ITP with bortezomib, a proteasome inhibitor.[ncbi.nlm.nih.gov]
  • "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 . ScholarlyEditions. 2013-07-22.[en.wikipedia.org]
  • This suggested that dabigatran had caused thrombocytopenia and purpura; therefore, dabigatran administration was discontinued.[ncbi.nlm.nih.gov]
  • Idiopathic thrombocytopenic purpura and MMR vaccine.Arch Dis Child. 2001 Mar;84(3):227-9.[whale.to]
  • We describ the case of a young soldier who, after returning from Central Africa, presented a fever associated with petechial purpura and gingivorrhagia, hemogram showed deep thrombocytopenia and macrocytic normochrome anemia, thick peripheral blood smears[ncbi.nlm.nih.gov]
Petechiae
  • Larger than petechiae, ecchymoses are purple, blue or yellow-green areas of skin that vary in size and shape.[en.wikipedia.org]
  • 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]
  • Case 1 was a 61-year-old female patient admitted to our hospital because of skin petechiae and purpura for 6 days.[ncbi.nlm.nih.gov]
  • Findings on his physical examination are normal except for scattered crops of petechiae and multiple bruises. There is no active bleeding from the nose or other sites.[pedsinreview.aappublications.org]
Epistaxis
  • 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.[orpha.net]
  • Hemorrhagic complications were not important: 2 patients had a mild inguinal hematoma, 1 of whom also had occasional epistaxis. Only 1 patient required a blood transfusion, of 2 units of concentrated red cells.[revespcardiol.org]
  • […] peripheral blood smear on a freshly taken specimen should be performed. [ 9 ] Presentation Careful and thorough history and examination, including any features associated with platelet dysfunction and any indication of the underlying cause. [ 10 ] History Epistaxis[patient.info]
  • Epistaxis, gingival bleeding, rash or bruising on the skin, menorrhagia or abnormal vaginal bleeding in women, rectal bleeding (hematochezia or melena), hematuria, bleeding after surgeries, or dental procedures. b.[clinicaladvisor.com]
Somnolence
  • […] ankles in ambulatory patients or on the back in bedridden ones suggest mild thrombocytopenia and a relatively low risk for a serious bleeding complication Findings suggestive of intracranial hemorrhage include the following: Headache, blurred vision, somnolence[emedicine.medscape.com]
Neglect
  • It's suggested that vascular endothelial cell injury and barrier function damage were induced after SFTSV infection, which is a vital but neglected pathogenesis of SFTS.[ncbi.nlm.nih.gov]
Uremia
  • ., uremia, hyponatremia, fever) 90, 101–103 Cerebral hemorrhage due to thrombocytopenia 102 Other concurrent factors that may cause seizures independently of TTP (e.g., TTP-like infections, drugs such as cyclosporine A or FK506, 100 connective tissue[epilepsy.com]

Workup

  • Other laboratory tests should be obtained based on the initial workup and history.[clinicaladvisor.com]
  • Direct or circulating antiplatelet antibodies has no value in the workup of thrombocytopenia in pregnancy because they usually are nonspecific and will not distinguish GT from ITP.[emedicine.medscape.com]
  • […] future reference, as corticosteroids can change marrow morphology Biopsy is performed before splenectomy to evaluate for possible hypoplasia or fibrosis Unresponsiveness to standard treatment after 6 months is an indication for bone marrow aspiration See Workup[emedicine.medscape.com]
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]
  • : Primary immune thrombocytopenia (ITP) is an autoimmune disorder characterized by decreased platelet count of which dysfunctional cellular immunity in its pathogenesis.[ncbi.nlm.nih.gov]
  • She had increased monocyte cell count (1.82   10/L), markedly decreased platelet count (2   10/L), hypercellularity of the megakaryocyte lineage with many immature megakaryocytes, and ZRSR2(zinc finger CCCH-type, RNA binding motif and serine/arginine[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]
Toxoplasma Gondii
  • Candida sp. [30] ), and Toxoplasma gondii . [29] The severity of thrombocytopenia may be correlated with pathogen type; some research indicates that the most severe cases are related to fungal or gram-negative bacterial infection. [30] The pathogen may[en.wikipedia.org]

Treatment

  • Treatment with alemtuzumab for multiple sclerosis increases the risk for autoimmune adverse events including immune thrombocytopenia (ITP).[ncbi.nlm.nih.gov]
  • Currently, there is no single treatment regimen for these disorders.[ncbi.nlm.nih.gov]
  • The current treatment suggestions are conservative, as a result of the lack of evidence, built on defensive treatment strategies and the fear of bleeding complications.[ncbi.nlm.nih.gov]
  • 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]
  • Alternative treatments for the latter patients including thrombopoietin-mimetic agents are increasingly used and found to be promising.[ncbi.nlm.nih.gov]

Prognosis

  • Early confirmation and treatment may improve the prognosis.[ncbi.nlm.nih.gov]
  • 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]
  • Total four cases of SFTS with IPA are reviewed and detailing the disease progression, treatment options, and prognosis were summarized and analyzed.[ncbi.nlm.nih.gov]
  • Future studies should control for platelet count in assessment of PMP prognosis in sepsis.[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

  • It has an acute or subacute onset of unknown etiology, although some pathological features resemble those of multicentric Castleman disease. We here report two cases of TAFRO syndrome.[ncbi.nlm.nih.gov]
  • Thrombocytopenia after ACS can have multiple etiologies. Human immunodeficiency virus (HIV) infection has also been implicated in immune-mediated thrombocytopenia.[ncbi.nlm.nih.gov]
  • However, the initial investigation failed to identify its etiology. Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by SFTS bunyavirus (SFTSV), which was first discovered in 2009.[ncbi.nlm.nih.gov]
  • The etiology can be anticipated by the history.[oncologynurseadvisor.com]
  • Common Etiologies of Thrombocytopenia with Clinical Findings and Suggested Treatment Etiology Severity Clinical presentation Evaluation Treatment Comments Bone marrow suppression by irradiation, chemotherapy, or neoplasia Moderate to severe History of[aafp.org]

Epidemiology

  • The mysterious pathogen of the cluster in 1996 was proved to be SFTSV on the basis of its epidemiological data, clinical data and serological results.[ncbi.nlm.nih.gov]
  • In this study, 355 specimens with pseudo-thrombocytopenia (PTCP) were evaluated via epidemiology, identification, remedies, and platelet (PLT) count.[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]
  • Current Zika virus epidemiology and recent epidemics . Med Mal Infect 2014 ; 44 : 302 – 7 . 12 . Thrombocytopenia in dengue: interrelationship between virus and the imbalance between coagulation and fibrinolysis and inflammatory mediators .[academic.oup.com]
Sex distribution
Age distribution

Pathophysiology

  • Little is known about TAFRO syndrome, especially in relation to the associated kidney pathophysiology.[ncbi.nlm.nih.gov]
  • Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder of heterogeneous pathophysiological mechanisms.[ncbi.nlm.nih.gov]
  • However, the role of the NLRP3 inflammasome in the pathophysiology of immune thrombocytopenia (ITP) remains unclear. RT-PCR was used to examine the polymorphism and expression of genes involved in the NLRP3 inflammasome in ITP patients.[ncbi.nlm.nih.gov]
  • These novel findings provide important insights into the pathophysiology of SFTS.[ncbi.nlm.nih.gov]
  • 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

  • Dabigatran application may cause bleeding; therefore, careful monitoring during dabigatran treatment is required to prevent thrombocytopenia.[ncbi.nlm.nih.gov]
  • Comprehensive measures, especially community-based tick control, may be a promising means of preventing SFTS in endemic regions.[ncbi.nlm.nih.gov]
  • This may be preventable by low-dose steroids.[ncbi.nlm.nih.gov]
  • Our study contributes to better understanding of SFTS dynamics and provides predictive tools for the control and prevention of SFTS.[ncbi.nlm.nih.gov]
  • Treatment endpoints include elevation of platelets and reduction of bleeding risk, elevation of quality of life, reduction of concomitant therapies and prevention from bleeding.[ncbi.nlm.nih.gov]

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Last updated: 2018-06-22 07:46