Idiopathic Thrombocytopenic Purpura Presenting Research Articles

Spectrum of Clinical Manifestations among Paediatrics and Adult Patients of Idiopathic Thrombocytopenic Purpura Presenting to Tertiary Care Hospital

Spectrum of Clinical Manifestations among Paediatrics and Adult Patients of Idiopathic Thrombocytopenic Purpura Presenting to Tertiary Care Hospital

Treatment in idiopathic thrombocytopenic purpura in the elderly: about a retrospective study.

There are no specific recommendations on the care of elderly patients with ITP. A retrospective study over two academic centers (Reims and Strasbourg), focused on patients over 65 who have been diagnosed idiopathic thrombocytopenic purpura in two unit of internal medicine. 41 patients were enrolled, including 27 women (66%). The median age is 76.75 years. On admission, the average thrombocytopenia is 34.45 G/L; 24 patients (58.5%) showed severe bleeding mucosal and/or visceral signs; 37 patients (90%) had a first-line treatment. Corticosteroids established for 23 patients (56%). At 1 and 6 months, complete response was 9 patients (39%) and 2 patients (9%) respectively. Adverse events reported for 20 patients (87%). Polyvalent immunoglobulins were used for 6 (16%) with no response at 6 months. 5 patients were treated with danazol. At 6 months, partial response in 3 patients (60%) and failure in 2 patients (40%). Splenectomy was performed for 8 patients (21%). At 1 month, a complete response observed for 7 patients. At 6 months, a failure observed in 4 patients. After failure of first-line treatments, we noted the use of rituximab for 4 patients (9.7%) with a complete response for 1 patient, partial response in 2 patients and a failure for a patient for whom the "eltrombopag" was set up with a partially response. Monitoring of 41 patients, during 7 years, objectified 3 deaths. The clinical presentation of idiopathic thrombocytopenic purpura in the elderly seems more severe. Therapeutic responses are essentially identical to those observed in younger patients, but greater toxicity. Data on biologics is nonexistent in elderly outside small retrospective series. Studies are underway to better assess their effectiveness, long-term safety as well as their mechanism of action.

Haemorrhagic Lesions in Oral Mucosa as the Presentation of Idiopathic Thrombocytopenic Purpura

t i m m i aron de 78 anos, en tratamiento con antiagregantes plauetarios por isquemia miocardica, que acude al Servicio de rgencias por sensacion de cuerpo extrano y aparicion de esiones en la mucosa oral de 12 h de evolucion. En la exploracion se evidencian telangiectasias en la oveda del paladar y lesiones sobreelevadas de tamano ariable en la mucosa yugal, labial y lengua, de contorno egular, limites bien definidos, con superficie rugosa, conistencia dura y coloracion rojo-violacea (fig. 1). Mediante broendoscopia se objetiva en la zona retrocricoidea una esion de aproximadamente 1,5 cm, de las mismas caraceristicas que las lesiones de la mucosa oral. El resto de a exploracion fue normal. En la analitica realizada a su legada, destaca un recuento plaquetario de 4 × 109/l. En ocas horas el paciente desarrollo multiples lesiones equioticas sobre todo en las extremidades. La purpura trombocitopenica idiopatica (PTI) es una nfermedad autoinmune adquirida, en la cual se crean nticuerpos contra las plaquetas causando su destruccion. a aparicion de lesiones hemorragicas es un signo de

A Patient with Idiopathic Thrombocytopenic Purpura Presenting with an Acute Ischemic Stroke

We report a 63 year-old man with an acute right occipital lobe infarction coincident with idiopathic thrombocytopenic purpura. The patient's thrombocytopenia responded to steroids and intravenous immune globulin with no further cerebrovascular complications. We suggest that ITP-induced platelet microparticles contributed to our patient's stroke. Proper management of acute ischemic stroke in the setting of idiopathic thrombocytopenic purpura is unclear.

Idiopathic Thrombocytopenic Purpura Presenting as Post-extraction Hemorrhage

The aim of this article is to present a case of idiopathic thrombocytopenic purpura (ITP) in order to emphasize the importance of the clinical exam since the anamnesis leads to a diagnostic hypothesis of ITP. Acute ITP is considered an autoimmune disease characterized by the production of antibodies against platelets, antigens produced by a viral infection, or a platelet sparing drug combination. These antibodies adhere to platelets and are recognized and destroyed by the reticulo-endothelial system. Consequently, the platelet count gradually diminishes and is insufficient for the maintenance of primary hemostasis. A 77-year-old woman presented with post-extraction intermittent bleeding. The physical examination revealed discoloration of the skin, multiple petechiae, hematomas, ecchymosis of the upper lip, bruises all over the body, gingiva that bled spontaneously, and a malformed blood clot at the extraction site of tooth #44. The hematological exams confirmed the hypothesis of ITP. The patient was immediately hospitalized in the Hematology Department of a local hospital and received platelet replacement, hydration, medication, and general care. After the spontaneous bleeding stopped, the malformed clot was removed using alveolar curettage along with a thorough cleaning of the extraction site with a 0.9% saline solution before suturing the wound and prescribing medication. After the sixth day of hospitalization, the patient presented with the following results: Hb: 12.3 mg/dL, Ht: 36.1%, and PC: 87,000 mm3. The patient was then discharged and was placed under outpatient follow-up care. The importance of the clinical exam must be emphasized since the anamnesis leads to a diagnostic hypothesis of ITP and provides the dental surgeon with an opportunity to make important systemic alterations to improve the prognosis of a patient with ITP.

An unusual presentation of idiopathic thrombocytopenic purpura in pregnancy

A 35-year-old, 39-week pregnant woman underwent an uneventful emergent cesarean delivery for suspected placental abruption or uterine dehiscence. Given the urgency of the situation and the unremarkable airway anatomy, general anesthesia was the chosen technique. Four hours after her surgery, she returned to the operating room for persistent vaginal bleeding. Hematology tests performed before the cesarean delivery revealed severe thrombocytopenia. This was later diagnosed as idiopathic thrombocytopenia, which was treated successfully with steroid therapy.

Idiopathic thrombocytopenic purpura presenting with infraorbital nerve paraesthesia

A case of severe chronic idiopathic thrombocytopenic purpura is reported which presented with infra-orbital paraesthesia and haemorrhagic bullae of the oral mucosa.