ABSTRACT
Idiopathic aplastic anemia is a pancytopenia disorder that is a rare but life threatening for both mother and fetus during pregnancy. Association of aplastic anemia with pregnancy is unclear but considered to be interrelated. Bone marrow transplantation is the most effective treatment for adult aplastic anemia but is inadvisable to perform during pregnancy because of the teratogenic effect of immunosuppressive agents or radiation therapy to the growing fetus. Supportive care, withdrawal from offending drugs and involving erythrocytes and platelets transfusion is a promising way to save the life. Here author present a case report of 36-year-old lady with idiopathy aplastic anemia. In this case medical investigation revealed severe anemia of unknown origin. The patient was treated with hematinics, blood transfusion and glucocorticoids. A healthy baby was delivered without evidence of hemolysis at her eight month and one week of pregnancy, the patient recovered and discharged with normal incidence. Being a rare case, it becomes a necessity to report such life-threatening disorder and management. Moreover, to our knowledge this is the first case reported of its kind from Jammu and Kashmir Division of India.
ABSTRACT
La refractariedad plaquetaria representa un problema clínico significativo que complica la transfusión de plaquetas, está asociada con resultados clínicos adversos y elevados costos hospitalarios. Se define como una respuesta inadecuada a la transfusión de plaquetas después de dos transfusiones consecutivas. Las causas no inmunes son las más frecuentes y las primeras que deben ser investigadas en el diagnóstico de refractariedad plaquetaria. La refractariedad de causa inmune está mediada por anticuerpos contra antígenos HLA o HPA. Si se identifican los anticuerpos, existen tres formas de identificar unidades de plaquetas compatibles: el tipaje HLA, la prueba cruzada y la predicción de la especificidad del anticuerpo. Se recomienda el empleo de plaquetas fresca ABO idénticas y fenotipadas para eliminar estas variables potenciales como causa de refractariedad(AU)
Platelet refractoriness represent a significant clinical problem that complicates the provision of platelet transfusions, it is associated with adverse clinical outcomes and increases health care costs. Platelet refractoriness is defined as an inadequate response to platelet transfusions after two sequential transfusions. Nonimmune causes are the most likely and the first that should be explored in the diagnosis of platelet refractoriness. Immune-mediated platelet refractoriness is cause by antibodies to human leukocyte antigens (HLAs) and/or human platelet antigens. If antibodies are identified, there are 3 strategies for identifying compatible platelet units: HLA matching, crossmatching, and antibody specificity prediction. It is recommended to use fresh and ABO-matched platelets in the diagnosis of platelet refractoriness to eliminate these potential variables as causes of refractoriness(AU)
Subject(s)
Humans , Male , Female , Platelet Adhesiveness , Platelet Transfusion/methods , Treatment OutcomeABSTRACT
Objective To estimate efficacy and safety of transfusion of cryopreserved platelets in different patients. Methods 1294 patients in recent years with hemorrhage or risk of hemorrhage, who received transfusion of cryopreserved platelets,were included in this study. The following indexes were recorded:bleeding time before and one hour after transfusion, the persistent time of blood oozing from wound after transfusion, platelet count before and one hour after transfusion, change of subcutaneous petechia, and complications of blood transfusion. Results Cryopreserved platelets could bring about the immediate cessation of blood oozing from the wound,and elevation of peripheral blood platelet count without distinct complications of blood transfusion. The total effective rates of 747 medical cases and 547 surgical cases were 89.8% and 95.1% respectively. Conclusion It is safe and efficacious to transfuse cryopreserved platelets in medical and surgical patients.
ABSTRACT
Objective To estimate the efficacy and safety of cryopreserved platelets in surgical patients.Methods 238 patients in recent years with hemorrhage or high risk of hemorrhage induced by thrombocytopenia or functional platelet defects during or after surgery, who had been transfused with cryopreserved platelets, were included in our study. The following items were recorded: bleeding time before and two hours after transfusion of cryopreserved platelets; the persist time of blood oozing from wound after transfusion; platelet count before and one hour after transfusion; platelet count before and immediately after surgery; and the number of patients with adverse transfusion reactions. The hemostatic efficacy was judged by the bleeding time and platelet count change.Results Bleeding times before and two hours after cryopreserved platelets transfusion were (9?3)min,(4?2)min respectively; blood oozing from wound stopped 0.5～2 hours after transfusion; the platelet level was elevated by(5～42)?10 9/L one hour after transfusion; the postoperative platelet count was decreased by(130?69)?10 9/L compared to preoperative count; four patients had urticaria and five had febrile reaction. The hemostatic efficacy was 95%(226/238) Conclusion Cryopreserved platelets function immediately to bring about the cessation of blood oozing from the wound,and elevation of peripheral blood platelet count.