Clinical feature and management of immune thrombocytopenic purpura in a tertiary hospital in Northwest Nigeria

Abstract

Background:Immune thrombocytopenic purpura (ITP) is a rare bleeding disorder that may remit spontaneously. Life-threatening bleeding may require transfusion support, steroids, and other immunosuppressive therapy or splenectomy.Objective:To review the clinical presentation and laboratory features of ITP at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria.Subjects and Methods:A retrospective analytic study of case notes and bone marrow (BM) records of patients diagnosed with ITP at Haematology Department, ABUTH, Zaria, from January 1, 2004, to December 31, 2012.Results:There were nine cases (six females, three males), aged 6–20 (mean 11.11) years. The presentations were epistaxis 8 (88.9%), purpura 4 (44.4%), gum bleeding 4 (44.4%), menorrhagia 2 (22.2%), and intracranial hemorrhage (ICH) 1 (11.1%). Only 1 (11.1%) had clinical splenomegaly. Platelet count of <20 × 109/L was found in 4 (44.4%) while 6 (66.7%) had packed cell volume of <25%. All the nine cases had BM megakaryocytic hyperplasia. Six patients had blood transfusion support while 7 (77.8%) patients received oral prednisolone therapy with time to cessation of bleeding of 12–16 (mean of 8) weeks. One case had spontaneous remission while another had anti-D due to relapse after steroid therapy; this resulted in transient rise in platelet counts. None had other immunosuppressive therapy or splenectomy. Six (66.7%) cases were lost to follow-up after achieving remission and one died of ICH.Conclusion:ITP is not common in our center though its clinical presentations are varied. However, prednisolone and blood transfusion therapy are central to the management of these patients with favorable outcome.

Menstrual problems in chronic immune thrombocytopenia: A monthly challenge ‐ a cohort study and review

“…This proportion seems higher than the 30% reported for the general population, although a direct comparison should confirm this 15,16 . At diagnosis, a high prevalence of HMB has been previously reported 4,37–41 . Our study suggests, however, that the proportion remains high despite management of ITP in a specialized centre.…”

“…15,16 At diagnosis, a high prevalence of HMB has been previously reported. 4,[37][38][39][40][41] Our study suggests, however, that the proportion remains high despite management of ITP in a specialized centre. Of note, the prevalence of HMB throughout the course of disease was found to vary largely in different studies be much lower (17%-79%).…”

“…At diagnosis, the reported prevalence ranged from 6% to 55%. 4,[37][38][39][40][41] None of these articles provided a clear definition of HMB. During the disease, the proportion of self-reported HMB ranged from −17% to 79%.…”

“…Table 4 shows the proportion of patients with HMB, as assessed by eight studies. At diagnosis, the reported prevalence ranged from 6% to 55% 4,37–41 . None of these articles provided a clear definition of HMB.…”

Successful treatment of a patient with herbal drug-induced immune thrombocytopenic purpura using freshly donated blood

“…The overall prevalence rate in Nigeria is 0.005% of hospital cases. (18) No case has ever been reported in the Niger-Delta region of Nigeria. There is no clear cause of ITP in most cases of the disease.…”