ABSTRACT
Las plaquetas son fragmentos citoplasmáticos anucleados derivados de los megacariocitos que presentan función central, tanto en procesos fisiológicos como la hemostasia, así como también en procesos patológicos como la inflamación, la ateroesclerosis. El tamaño de las plaquetas, medido como volumen medio de plaquetas, es un marcador de reactividad plaquetaria, que proporciona información importante sobre el curso y pronóstico de una variedad de afecciones inflamatorias. El estudio de este marcador se ha utilizado como pronóstico en enfermedades cardiovasculares, preeclampsia y en la púrpura trombocitopénica. El objetivo de este trabajo es revisar los conceptos actuales basados en la evidencia científica relacionados con el volumen plaquetario medio e insistir en su evaluación y significado en la práctica clínica cotidiana(AU)
Platelets are enucleated cytoplasmic fragments derived from megakaryocytes, which have a central function, both in physiological processes such as hemostasis, as well as in pathological processes such as inflammation, atherosclerosis. Platelet size, measured as mean volume of platelets, is a marker of platelet reactivity, providing important information on the course and prognosis of a variety of inflammatory conditions. The study of this marker has been used as a prognostic in cardiovascular diseases, preeclampsia and in thrombocytopenic purpura. The objective of this paper is to review the current concepts based on scientific evidence related to the mean platelet volume and to insist on its evaluation and meaning in daily clinical practice(AU)
Subject(s)
Humans , Male , Female , Purpura, Thrombocytopenic/diagnosis , Cardiovascular Diseases , Atherosclerosis , Mean Platelet Volume/methods , Pathologic ProcessesABSTRACT
Desde siempre los episodios de sangrado muco-cutáneos, al ser tan evidentes, causan mucha preocupación y zozobra, más aún si ocurren sin causa aparente. La púrpura trombocitopénica suele ser la responsable de estos desagradables sucesos. Esta revisión tiene por objetivo actualizar los conocimientos acerca de la fisiopatología, el diagnóstico y el tratamiento de la púrpura trombocitopénica inmunológica (PTI), una patología hematológica que afecta tanto a niños como a adultos y que se ve con relativa frecuencia en la actividad diaria de un hospital general...
Thrombocytopenic purpura is mostly responsible for episodes of muco-cutaneous bleeding. This review updates topics on the pathophysiology, diagnosis and treatment of immunologic thrombocytopenic purpura (IPT), an hematologic condition that afects both childern and adults, which is seen relatively frequent in daily practice in a general hospital...
Subject(s)
Humans , Purpura, Thrombocytopenic , Purpura, Thrombocytopenic/diagnosis , Purpura, Thrombocytopenic/physiopathology , Purpura, Thrombocytopenic/therapySubject(s)
Autoantibodies/metabolism , Female , Humans , Immunosuppressive Agents/therapeutic use , Male , Platelet Activation/immunology , Platelet Activation/physiology , Platelet Count , Prognosis , Purpura, Thrombocytopenic/diagnosis , Purpura, Thrombocytopenic/drug therapy , Purpura, Thrombocytopenic/immunology , Risk Assessment , Severity of Illness Index , Thrombopoiesis/immunology , Thrombopoiesis/physiologyABSTRACT
Immune thrombocytopenic purpura (ITP) is the commonest cause of sudden onset thrombocytopenia in a healthy child. The condition is frequently preceded by a viral infection. The hematological parameters are essentially normal except a low platelet count. Bone marrow examination is not routinely indicated except in specific situations. The pros and cons of drug treatment have been discussed as the disease is benign with excellent prognosis in majority of the cases. The various treatment options including low and high dose steroids, intravenous immunoglobulins and anti D have been discussed at length with other modalities of treatment and role of splenectomy. Current therapeutic options with rituximab and other drugs for stimulating platelet production in chronic cases have also been included in discussion.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Child , Glucocorticoids/therapeutic use , Humans , Immunoglobulins, Intravenous/therapeutic use , Immunologic Factors/therapeutic use , Methylprednisolone/therapeutic use , Platelet Transfusion , Prognosis , Purpura, Thrombocytopenic/diagnosis , Rho(D) Immune Globulin/therapeutic use , Splenectomy , Treatment OutcomeABSTRACT
A 45-year-old heterosexual male patient with retroviral disease since 12 years presented with hyperpigmented lesions, misdiagnosed initially as purpura due to an associated thrombocytopenia, but was biopsy proven to be Kaposi's sarcoma (KS). Bone marrow examination revealed excess megakaryocytes. Low CD4 count and absence of platelet specific IgG reduced the likelihood of immune thrombocytopenia (ITP). However after 6 weeks of antiretroviral therapy the patient's lesions have reduced and platelet counts are improving, possibly suggesting a sequestration thrombocytopenia in the abnormal tumor vessels of KS.
Subject(s)
Diagnosis, Differential , Heterosexuality , Humans , Male , Middle Aged , Purpura , Purpura, Thrombocytopenic/diagnosis , Retroviridae Infections/complications , Sarcoma, Kaposi/diagnosisABSTRACT
BACKGROUND: When a patient is steroid-dependant, a currently available strategy in chronic idiopathic thrombocytopenic purpura (ITP) is to follow a trial and error approach with any of the known drugs which has been found effective in the condition. OBJECTIVE: To evaluate the response of chronic ITP to dapsone, an inexpensive drug now reported to be effective in the disease. DESIGN : A controlled trial of abstinence and rechallenge type. SUBJECTS: Eight subjects with chronic ITP. INTERVENTIONS: Phase I - Intake of 100 mg of dapsone daily until response (in form of rise of platelet count in blood), Phase II - Above followed by drug abstinence, minimum for four weeks, and then rechallenge with the drug. MAIN OUTCOME MEASURES: Platelet counts during various phases viz during drug intake, withdrawal and rechallenge. RESULTS: Four (50%) patients responded to treatment. The mean pre-dapsone and post-dapsone platelet counts of blood were 29.6 x 10(9)/l and 142.5 x 10(9)/l respectively during the first phase of trial. The rechallenge was done in five patients following withdrawal of drug and the mean values of platelet count before and after rechallenge were 32.2 x 10(9)/l and 83 x 10(9)/l respectively. There was a remarkable response in two patients; one is now off the drug and the other on a maintenance dose of 50 mg of dapsone daily. CONCLUSION: Dapsone caused significant rise of platelet count in some patients of chronic ITP. It can be tried as an alternative to other second-line drugs in chronic ITP.
Subject(s)
Adolescent , Adult , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Chronic Disease , Dapsone/administration & dosage , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Inosine Triphosphate , Male , Purpura, Thrombocytopenic/diagnosis , Treatment OutcomeABSTRACT
The authors report two cases of isolated splenic tuberculosis treated since 1989 in Nizam's Institute of Medical Sciences. One case presented as pyrexia of unknown origin (PUO) and another with idiopathic thrombocytopenic purpura (ITP). Both were found to have splenic tuberculosis after splenectomy. Pre operative diagnosis could not be made in these cases. Splenectomy followed by antituberculous chemotherapy cured the condition in both the cases. The authors underline the diagnostic difficulties, essentially related to the rarity of this condition inspite of the progress in modern imaging.
Subject(s)
Adolescent , Antitubercular Agents/administration & dosage , Combined Modality Therapy , Diagnosis, Differential , Female , Fever of Unknown Origin/diagnosis , Follow-Up Studies , Humans , Male , Purpura, Thrombocytopenic/diagnosis , Splenectomy/methods , Treatment Outcome , Tuberculosis, Splenic/complicationsABSTRACT
Os autores apresentam relato de caso de um homem de 55 anos de idade que desenvolveu púrpura trombocitopênica com sangramento da pele e membranas mucosas e macro-hematúria após infecçäo das vias aéreas superiores tratada com o macrolídeo roxitromicina. Foi feito o diagnóstico de púrpura trombocitopênica idiopática crônica com início agudo e excluído o de citopenia droga-induzida devido ao rápido início após ingestäo de apenas três comprimidos, à recuperaçäo retardada, ao curso crônico e aos dados epidemiológicos. O diagnóstico deferencial e o tratamento säo discutidos resumidamente
Subject(s)
Humans , Male , Middle Aged , Immunization, Passive , Immunoglobulins, Intravenous/administration & dosage , Immunoglobulins, Intravenous/therapeutic use , Respiratory Tract Infections/drug therapy , Prednisolone/administration & dosage , Prednisolone/therapeutic use , Purpura, Thrombocytopenic, Idiopathic/diagnosis , Purpura, Thrombocytopenic, Idiopathic/chemically induced , Purpura, Thrombocytopenic/diagnosis , Purpura, Thrombocytopenic/chemically induced , Roxithromycin/adverse effectsABSTRACT
Se revisaron los expediantes de 85 pacientes con anemia refractaria, estudiados en el Laboratorio de Investigación en Hematología del Hospital, de abril de 1053 a julio de 1965. La condición se presentó con una frecuencia de 0.74 por cada 1000 egresos y predominió en los grupos avanzados de edad y en el sexo masculino en la proporción de 2 a 1. Su pronóstico se ha mejorado sensiblemente con la introducción de sangre fresca rica en plaquetas, eliminación de la administración preventiva de antibióticos y empleo de testosterona y dosis moderadas de corticoesteroides y en casos especiales el empleo de esplenectomía. La respuesta al tratamiento está condicionada por la situación hematologíca del paciente al ingreso, considerándose una situación favorable cuando el paciente tiene más de 2 por ciento de reticulocitos, más de 1 por ciento de reticulocitos coregidos, más de 500 neutrófilos por mm al cubo en sangres periférica y más de 10 por ciento de neutrófilos maduros en médula ósea
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Adolescent , Anemia/complications , Anemia/diagnosis , Anemia/mortality , Purpura, Thrombocytopenic/diagnosis , Purpura, Thrombocytopenic/physiopathology , Blood Transfusion , Diagnosis, Differential , PrognosisABSTRACT
La presencia de púrpura gástrica como causa de sangrado de tubo digestivo proximal, es una entidad rara de presentación aislada y relacionada a trombocitopenia. En este tipo de pacientes al sitio potencial de sangrado puede estar confinado a la mucosa gastroduodenal como primera manifestación de la enfermedad sistématica. La valoración endoscópica temprana establece el origen del sangrado y su probable etilogía. Informamos de un caso de sangrado de tubo digestivo proximal en un paciente con trombocitopenia severa, en quien se diagnosticó púrpura gástrica por endoscopia
Subject(s)
Humans , Female , Aged , Endoscopy, Gastrointestinal , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Purpura, Thrombocytopenic/diagnosis , Purpura, Thrombocytopenic/physiopathologyABSTRACT
El objetivo del presente trabajò fuè evaluar la presencia de anticuerpos antiplaquetarios de tipo IgG e IgM en pacientes con enfermedades trombocitopenicas. Fueron estudiados 31 pacientes con el diagnòstico clìnico de purpura trombocitopenica, 23 niños y 8 adultos, provenientes del hospital de clìnicas. Se determinò la presencia de anticuerpos antiplaquetarios de tipo IgG e IGM por el mètodo de Inmunofluorescencia indirecta. Del total de pacientes estudiados, 87 por ciento de los pacientes presentaron anticuerpos antiplaquetarios. De los cuales 36 por ciento fueron anticuerpos de tipo IgG positivo, 1,6 por ciento anticuerpos de tipo IgM positivo y 35 por ciento presentaron ambos anticuerpos, IgG e IgM. este estudio demuestra que el test de Inmunofluorescencia es un mètodo ùtil para la detecciòn de anticuerpos antiplaquetarios que se deberìa utilizar de rutina para el diagnòstico de las trombocitopenias.
Subject(s)
Antibodies/radiation effects , Antibodies/immunology , Purpura, Thrombocytopenic/diagnosis , Purpura, Thrombocytopenic/nursing , Purpura, Thrombocytopenic/immunology , Immunologic Tests , Fluorescent Antibody Technique, Direct/nursingABSTRACT
Realizado un breve relato acerca de la naturaleza de G.G.C.P., su presentación clínica, radiográfica, histopatológica y diagnóstico diferencial con otros lesiones que se presentan en cavidad bucal, se indica la terapia correspondiente. Seguidamente se presenta el caso clínico de un G.G.C.C. con asiento en el maxilar inferior, en un niño de 7 años de edad, caracterizado por un crecimiento acelerado y recidivas luego de cada extirpación, lo que llevó a la resección del cuerpo mandibular, con posteriores complicaciones generales (PTA y LE), quedando el mismo con graves secuelas físicas e inmunológicas
Subject(s)
Humans , Male , Child , Granuloma, Giant Cell/surgery , Granuloma, Giant Cell/diagnosis , Recurrence , Age Distribution , Diagnosis, Differential , Granuloma, Giant Cell/complications , Granuloma, Giant Cell/etiology , Granuloma, Giant Cell , Purpura, Thrombocytopenic/diagnosis , Sex DistributionABSTRACT
El objetivo del presente trabajò fuè evaluar la presencia de anticuerpos antiplaquetarios de tipo IgG e IgM en pacientes con enfermedades trombocitopenicas. Fueron estudiados 31 pacientes con el diagnòstico clìnico de purpura trombocitopenica, 23 niños y 8 adultos, provenientes del hospital de clìnicas. Se determinò la presencia de anticuerpos antiplaquetarios de tipo IgG e IGM por el mètodo de Inmunofluorescencia indirecta. Del total de pacientes estudiados, 87 por ciento de los pacientes presentaron anticuerpos antiplaquetarios. De los cuales 36 por ciento fueron anticuerpos de tipo IgG positivo, 1,6 por ciento anticuerpos de tipo IgM positivo y 35 por ciento presentaron ambos anticuerpos, IgG e IgM. este estudio demuestra que el test de Inmunofluorescencia es un mètodo ùtil para la detecciòn de anticuerpos antiplaquetarios que se deberìa utilizar de rutina para el diagnòstico de las trombocitopenias
Subject(s)
Antibodies/immunology , Antibodies/radiation effects , Purpura, Thrombocytopenic/diagnosis , Purpura, Thrombocytopenic/nursing , Purpura, Thrombocytopenic/immunology , Fluorescent Antibody Technique, Direct/nursing , Immunologic TestsABSTRACT
A case of tuberculous adenitis presenting as thrombocytopenic purpura is reported with a brief review of the literature.