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Thrombocytopenia Due to Sequestration

Platelet Sequestration


Presentation

  • A comprehensive textbook of adult emergency medicine for trainee doctors - covers all the problems likely to present to a trainee in the emergency department.[books.google.com]
  • In patients with normal hepatic function, splenectomy corrects the thrombocytopenia; however, splenectomy is not indicated unless severe thrombocytopenia due to simultaneous bone marrow failure is present.[merckmanuals.com]
  • Click for pdf: neonatal thrombocytopenia General presentation Thrombocytopenia is one of the most common haematological problems encountered in the neonatal period presenting in 1-5% of newborns at birth.[learn.pediatrics.ubc.ca]
Splenectomy
  • Twenty-three patients (92%) had complete or good partial remissions after splenectomy.[annals.org]
  • In patients with normal hepatic function, splenectomy corrects the thrombocytopenia; however, splenectomy is not indicated unless severe thrombocytopenia due to simultaneous bone marrow failure is present.[merckmanuals.com]
  • Some of those patients may benefit from splenectomy.[nature.com]
  • It must be given at least 2 weeks before splenectomy or, in the event of emergency splenectomy, 2 weeks after splenectomy. 13 Similar guidelines can also be used for PSE.[evtoday.com]
  • In such cases, splenectomy may improve the response to transfusion.[medtextfree.wordpress.com]
Sepsis
  • Significant updating of following topics - acute coronary syndrome management, trauma, sepsis management, imaging, arrhythmias. Expansion of administration section - especially patient safety. Changes to drug overdose sections in toxicology section.[books.google.com]
  • […] and MODS, sequestration also occurs in sepsis through binding to endothelium the spleen normally sequesters 1/3 of the body’s platelets, this increases to 90% in massive splenomegaly spleen contraction stimulated by the sympathetic nervous system can[lifeinthefastlane.com]
  • Sepsi s and Thrombocytopenia: Thrombocytopenia occurs in up to 20-35% of patients admitted to intensive care unit. Sepsis is responsible for half of these.[antimicrobe.org]
  • "Early-onset Pseudomonas aeruginosa sepsis and Yersinia enterocolitica neonatal infection: a unique combination in a preterm infant". European Journal of Pediatrics. 146 (2): 192–93. doi : 10.1007/BF02343233. PMID 3569360.[en.wikipedia.org]
  • Disseminated intravascular coagulapathy (DIC) associated with perinatal asphyxia and sepsis is responsible for 10-15%, almost always in neonates who are extremely ill.[learn.pediatrics.ubc.ca]
Physician
  • […] coverage of normal childhood growth and development, as well as the diagnosis, management, and prevention of common pediatric diseases and disorders, make this an ideal medical reference book for students, pediatric residents, nurse practitioners, and physician[books.google.com]
  • *Medscape Business of Medicine Academy Survey, September 2015 Learn from Experienced Professionals Courses were developed especially for physicians by business health experts and experienced physicians.[medscape.org]
  • Thrombocytopenia is usually evaluated by internist (internal) physicians, family physicians, or blood-disorder specialists (hematologists). Advertisement[ahealthhuman.com]
  • During the patient history, physicians should inquire about easy bruising or petechiae, melena, rashes, fevers, and bleeding.[aafp.org]
  • Two days later, after a transient nosebleed, he is brought to his physician’s office. His past medical history and family history are unremarkable.[pedsinreview.aappublications.org]
Refractory Anemia
  • Seven of the nine patients had refractory anemia (RA), one had refractory anemia with excess of blasts (RAEB) and one had chronic myelomonocytic leukemia (CMML).[nature.com]
Hodgkin Lymphoma
  • Dailey MO, Coleman CN, Kaplan HS: Radiation-induced splenic atrophy in patients with Hodgkin disease and non-Hodgkin lymphoma. N Engl J Med 302:215, 1990. 68.[medtextfree.wordpress.com]
Thrombosis
  • Brand-new chapters on Thrombosis and Head and Neck Infections ensure coverage of the topics most relevant to each reader's needs. Student Consult eBook version included with purchase.[books.google.com]
  • This approach carries a 30-day risk of thrombosis (de novo deep venous thrombosis) of 53%.[askhematologist.com]
  • Morbidity related to platelet dysfunction is generally due to bleeding, but occasionally, thrombosis is dominant.[accessmedicine.mhmedical.com]
  • However, it is not possible to prevent thrombosis at all times, even if heparin is ceased at the earliest moment that the decrease of platelets is recognized [ 19 ].[omicsonline.org]
Palpitations
  • This edition's highlights include new chapters on palpitations, cystic fibrosis, travel related emergencies, and ultrasound and a new appendix on practice pathways.[books.google.com]
  • Palpitations — Throbbing or pulsation. Heart palpitations usually infer an irregular or rapid rhythm. Polycythemia vera — A chronic disorder characterized by increased red blood cell mass and other malfunctions of the blood system.[medical-dictionary.thefreedictionary.com]
Purpura
  • Abstract Seventeen patients with idiopathic autoimmune thrombocytopenic purpura were studied in order to establish whether the amount of platelet-bound antibody influenced the rate and site at which these platelets were destroyed.[ncbi.nlm.nih.gov]
  • Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for the American Society of Hematology. ‏ الصفحة 48 - Fanucchi M, Glaspy J, Crawford J, et al.[books.google.com]
  • The 17 patients with idiopathic thrombocytopenic purpura patterns had progressive splenic sequestration; 2 also had hepatic sequestration. Significant splenic sequestration was detected in seven of these patients only by posterior counting.[annals.org]
  • ( D47.3 ) purpura fulminans ( D65 ) thrombotic thrombocytopenic purpura ( M31.1 ) Waldenström hypergammaglobulinemic purpura ( D89.0 ) Purpura and other hemorrhagic conditions D69.5 ICD-10-CM Diagnosis Code D69.5 Secondary thrombocytopenia 2016 2017[icd10data.com]
  • MDS) *TTP/HUS Thrombotic thrombocytopenic purpura/Hemolytic Uremic Symptom Table 5.[antimicrobe.org]
Stroke
  • Take advantage of a wealth of images that capture the clinical manifestations and findings associated with Kawasaki disease, lupus, lymphoma, stroke, and many other disorders seen in children.[books.google.com]
  • Thrombosis is usually venous, in the form of deep venous thrombosis or pulmonary embolism), but can be arterial as well, in the form of myocardial infarction or stroke.[askhematologist.com]
  • The maternal mortality rate with HELLP is 1%, resulting from ruptured subcapsular hematomas, hemorrhage, and stroke.[emedicine.medscape.com]
  • […] may affect arterial and venous systems, even after heparin is discontinued. 23 Characteristic features are erythematous or necrotizing skin reactions at the site of injection or severe manifestations, such as deep venous thrombosis, pulmonary emboli, stroke[aafp.org]
  • Incidence Thrombosis 30%–50% Amputation 20% (arterial thrombosis) Death 22% to 28%. 51. 30%–50% of untreated patients with thrombocytopenia progress to thrombosis 4:1 Incidence Ratio Venous to Arterial Arterial Aortic/Ileofemoral Thrombosis Acute Thrombotic Stroke[slideshare.net]

Workup

  • Algorithm for workup of thrombocytopenia based on observation of the peripheral blood film. TTP/HUS indicates thrombotic thrombocytopenic purpura/hemolytic uremic syndrome.[mcwhealthcare.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]
Decreased Platelet Count
  • A decreased platelet count can result from a variety of mechanisms: Impaired Platelet Production: This is the major mechanism underlying neonatal thrombocytopenia.[learn.pediatrics.ubc.ca]
  • Additional laboratory evaluation should be performed as clinically indicated, and a trial of discontinuing agents known to decrease platelet counts is recommended.[aafp.org]
Streptococcus Pneumoniae
  • PREPROCEDURE PREPARATION PSE, like splenectomy, can theoretically increase the risk of infection by encapsulated organisms including Streptococcus pneumoniae, Haemophilus influenza type B, and Neisseria meningitides.[evtoday.com]

Treatment

  • Median lung "survival" was significantly longer ( 240 vs. 162 min reference, p 0.016), and platelet activation (as CD62P and βTG) were significantly inhibited, when pigs were pre-treated with DDAVP, with or without αGPIb Fab treatment.[ncbi.nlm.nih.gov]
  • Also has boxes featuring controversial areas of treatment. Practical and clinically orientated. Major changes to resuscitation guidelines. Complete rewriting of ENT section.[books.google.com]
  • Treatment The treatment of choice is IVIG, 400 mg/kg/day for 5 days or 1 g/kg/day for 2 days for severe thrombocytopenia. Further transfusions should be washed or Pl(A1) antigen–negative.[askhematologist.com]
  • Overall, 859 treatments were administered to 546 patients: in 38 % of the treatments, patients had moderate baseline thrombocytopenia with platelets between 75 and 150 10 9 /L, and in 6 % of the treatments, patients had severe baseline thrombocytopenia[link.springer.com]
  • Treatment Special treatment is not usually required. Adequate treatment of underlying disease is necessary.[iliveok.com]

Prognosis

  • What is the prognosis for a person with thrombocytopenia (low platelet count)? The prognosis for someone with thrombocytopenia depends on the cause and the severity of the disease.[rxlist.com]
  • In addition to being an indicator of advanced disease and poor prognosis, it frequently prevents crucial interventions.[dovepress.com]
  • Prognosis Prognosis depends on the underlying cause and progression of the disease. Left untreated, spleen enlargement can lead to serious complications. Hypersplenism can also lead to complications due to decreased blood cell counts.[medical-dictionary.thefreedictionary.com]
  • Describe the usual presentation and laboratory tests in the child who has acute idiopathic thrombocytopenic purpura, review the treatments, and know the usual prognosis.[pedsinreview.aappublications.org]

Etiology

  • Sulfisoxazole : suspected etiology Sulfamerazine : suspected etiology Sulfamethazine : suspected etiology Sulfamethoxypyridazine : suspected etiology Sulfamethoxazole (see Sulfamethoxazole-Trimethoprim, [[Sulfamethoxazole-Trimethoprim]]): suspected etiology[mdnxs.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]
  • Etiology of thrombocytopenia in HIV patients. Primary HIV associated thrombocytopenia Hypersplenism Opportunistic infections Malignancy (Lymphoma, etc.) Medications TTP/HUS* Bone marrow problems (e.g.[antimicrobe.org]
  • The most common cause is chronic alcohol abuse; however, other etiologies include infectious hepatitis, drug-induced liver disease, nonalcoholic liver disease, and metabolic disorders.[mcwhealthcare.com]
  • TABLE 14-1 Overview of Platelet Disorders View Table Favorite Table Download (.pdf) TABLE 14-1 Overview of Platelet Disorders Disorder Etiology Occurrence Examples Bleeding Thrombocytopenia Acquired Common ITP, DIC, marrow aplasia or malignancy Qualitative[accessmedicine.mhmedical.com]

Epidemiology

  • […] sequestration Lymphoma (see Lymphoma, [[Lymphoma]]): however, many patients with lymphoma have both marrow infiltration and splenic sequestration Abnormal Platelet Distribution/Pooling Hypothermia (see Hypothermia, [[Hypothermia]]) Massive Transfusion Epidemiology[mdnxs.com]
  • An epidemiologic study from Europe and the United States showed an annual incidence of 10 cases per 1 mil lion persons, but numbers could be higher in older persons and in hospitalized patients. 29 Drug-induced thrombo cytopenia should be suspected in[mcwhealthcare.com]
  • About this article Publication history Received 25 September 2000 DOI Further reading Thrombocytopenia in MDS: epidemiology, mechanisms, clinical consequences and novel therapeutic strategies W Li, K Morrone, S Kambhampati, B Will, U Steidl & A Verma[nature.com]
  • EDTA-dependent pseudothrombocytopaenia: a 12-month epidemiological study. Scand J Clin Lab Invest. 1988;48(6):537–542. 18. Sane DC, Damaraju LV, Topol EJ, et al.[aafp.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology The pathophysiology involves antibody formation against the heparin-platelet factor 4 complex, with resultant thrombosis.[askhematologist.com]
  • Pathophysiology Etiology is unknown, but endothelial damage is suspected as the initiator.[emedicine.medscape.com]
  • An in-depth understanding of the complex pathophysiology of the thrombocytopenia of CLD is crucial when considering treatment strategies. This review outlines the recent advances in our understanding of thrombocytopenia in cirrhosis and CLD.[dovepress.com]
  • Therefore, a review of the pathophysiology, differential diagnosis, and management of thrombocytopenia is in order.[pedsinreview.aappublications.org]

Prevention

  • Policy statement recommendations for the prevention of pneumococcal infections, including the use of pneumococcal conjugate vaccine (Prevnar), pneumococcal polysaccharide vaccine, and antibiotic prophylaxis. Pediatrics. 2000;! 06:362-366. 3.[books.google.com]
  • Prevention Some of the underlying causes of hypersplenism or enlarged spleen can be prevented, such as certain forms of anemia and cirrhosis of the liver due to alcohol.[medical-dictionary.thefreedictionary.com]
  • Can thrombocytopenia (low platelet count) be prevented? Thrombocytopenia may be preventable only if its underlying cause is known and preventable. For example, in patients with alcohol-induced thrombocytopenia, alcohol avoidance is recommended.[emedicinehealth.com]
  • Can thrombocytopenia be prevented? In general, thrombocytopenia can be prevented if the cause is known and it is preventable.[rxlist.com]

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