Whole Course Management and Therapeutic Strategy of Traditional Chinese Medicine for Thrombocytopenia Induced by Tumor Treatment / 中医杂志

Based on the traditional Chinese medicine （TCM） theories of holism， syndrome differentiation and treatment， and preventive treatment of disease， the concept of whole course management of tumors throughout the treatment process is advocated. The strategy includes preventive treatment before tumor therapy， focusing on protecting the body's vital qi and strengthening the spleen and Qi. TCM formulas such as Sijunzi Decoction （四君子汤）， Shenling Baizhu San （参苓白术散） and Xiangsha Liujunzi Decoction（香砂六君子汤） are used to enhance platelet reserves. The main therapeutic methods during tumor conventional therapy include preventing disease transformation and strengthening vital qi to eliminate pathogenic factor， by invigorating spleen and soothing liver， nourishing liver and kidney， purging fire for removing toxin， and removing blood stasis for promoting tissue regeneration. TCM formulas such as Xiangsha Liujunzi Decoction （香砂六君子汤）， Shenling Baizhu Powder （参苓白术散）， Fuzi Lizhong Decoction （附子理中汤）， Zhibai Dihuang Decoction （知柏地黄汤）， and Qiangen Powder （茜根散）are used to reduce platelet destruction and depletion during tumor therapy and reverse the worsening trend. After tumor conventional therapy， the focus is on preventing relapse， adjusting the balance of Yin and Yang， by nourishing the kidneys， spleen， and lungs. TCM formulas such as Dingkun Pill （定坤丹）and Zuogui Pill （左归丸） are used with modifications to prevent thrombocytopenia. The staged prevention and treatment of tumor treatment-induced thrombocytopenia using TCM can maximize the benefits for patients.

Rifampicin-induced thrombocytopenia in a patient of disseminated tuberculosis

Thrombocytopenia may be associated with a variety of conditions and risks depending on its severity, ranging from mild epistaxis to life-threatening bleeding. Many drugs or herbal remedies can cause thrombocytopenia by either inhibiting platelet production and/or enhancing their destruction from the peripheral blood-mediated through an immunological mechanism implicating drug-dependent antibodies. Drugs are a common cause of acute immune-mediated thrombocytopenia in adults, the drug etiology is often initially unrecognized. Most cases of drug-induced thrombocytopenia are caused by drug-dependent antibodies that are specific for the drug structure and bind tightly to platelets by their Fab regions but only in the presence of the drug. Thrombocytopenia is an uncommon but life-threatening complication of certain antitubercular drugs. The discovery of isolated thrombocytopenia in a patient taking several medications presents a challenging clinical problem. We report a case of a young immunocompetent female who presented with disseminated tuberculosis and was found to have rifampicin-induced thrombocytopenia

Caracterización clínica y hematológica de pacientes pediátricos con Dengue en Honduras / Clinical and hematological characterization of pediatric patients with Dengue in Honduras

Objetivo: Caracterizar de forma clínica y hematológica los casos de dengue en población pediátrica, en el año 2010. Lugar del estudio: Hospital Escuela Universitario (HEU), Tegucigalpa, Honduras. Diseño: estudio descriptivo. Pacientes: Pediátricos hospitalizados en HEU con diagnóstico de dengue. Mediciones: Se evaluaron variables demográficas, clínicas y hematológicas. Resultados: De un total de 2.428 pacientes, 1.220 (50,2%) fueron masculinos. Los grupos etarios predominantes fueron escolares 793 (32,7%) y adolescentes 1.164 (47,9%). Según el tipo de dengue fueron clasificados en dengue sin signos de alarma; 1.107 (45,6%), dengue con signos de alarma; 836 (34,4%) y dengue grave; 485 (20,0%). Las manifestaciones clínicas más frecuentes fueron fiebre 1956 (80,6%), mialgias 1.506 (62,0%), artralgias 1.351 (55,6%) y cefalea 1.242 (51,2%). Se confirmaron 48 (1,9%) fallecidos. Conclusión: El cuadro clínico mostró sintomatología muy inespecífica lo que dificulta un acertado diagnóstico, la trombocitopenia fue la prueba hematológica que podría ser útil para la evaluación inicial de los casos sospechosos dengue.

Objective: Characterize cases of dengue in clinic and hematological form of pediatric population in 2010. Place of study: Hospital Escuela Universitario, Tegucigalpa, Honduras. Design Study: Observational Descriptive retrospective. Measurements: Were evaluated demographic, clinic and hematologic variables. Results: Out of a total of 2428 patients, 1220 (50.2%) were males. For kind of dengue, were classificated without warnings signs 1107 (45.6%), with warnings signs 836 (34.4%) and severe dengue 485 (20.0%). The mostly frequent clinic manifestations were fever 1956 (80.6%), myalgia 1.506 (62.0%), arthralgia 1.351 (55.6%) and headache 1.242 (51.2%). Were confirmed 48 (1.9%) deaths. Conclusion: The clinic evaluation shown nonspecific symptoms, thereby is difficult get a good diagnostic, the thrombocytopenia was it hematologic test that could be useful in the initial evaluation with suspected cases of dengue.