Guidelines on the diagnosis of primary immune thrombocytopenia in children and adolescents: Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Guidelines Project: Associação Médica Brasileira - 2012

Braga, Josefina Aparecida Pellegrini; Loggetto, Sandra Regina; Hoepers, Andréa Thives de Carvalho; Bernardo, Wanderley Marques; Medeiros, Letícia Ferreira; Veríssimo, Mônica Pinheiro de Almeida

doi:10.5581/1516-8484.20130105

Cited by 8 publications

(5 citation statements)

References 100 publications

(62 reference statements)

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“…Nuestra paciente fue sometida a aspirado y biopsia de médula ósea como estudio de extensión, considerando diagnósticos diferenciales por la refractariedad al tratamiento. Parte de la literatura ha sugerido la implementación de este estudio en presentaciones atípicas de la enfermedad, como individuos mayores de 60 años, cuando se indique la esplenectomía como línea de tratamiento o en individuos con signos y síntomas de condiciones alternativas (citopenias adicionales, organomegalias) 17 sin lograr un acuerdo general sobre indicaciones generales para todas las poblaciones con TIP; de igual forma, no se sugiere el estudio sistemático de búsqueda activa de sangrado espontáneo en el escenario de TIP refractaria (con estudios endoscópicos, por ejemplo) sin elementos de juicio clínico que orienten a un daño de órgano blanco [16][17][18] , como en nuestro caso.…”

Section: Discussionunclassified

Hemorragia alveolar difusa en paciente con trombocitopenia inmune primaria refractaria: reporte de caso

Rondón-Carvajal,

Álvarez-López,

Escudero-Correa

2024

Rev Medicas UIS

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La hemorragia alveolar difusa, manifestación de varias enfermedades de estirpe inmune y no inmune, constituye una rara complicación de la trombocitopenia autoinmune primaria. Se considera en pacientes con disnea, opacidades alveolares en imágenes torácicas y presencia de más de 20 % de macrófagos cargados de hemosiderina en lavado broncoalveolar. Se presenta el caso de una mujer con diagnóstico conocido de trombocitopenia inmune primaria, remitida de consulta externa por recuento plaquetario menor de 10 000 plaquetas/mililitro, quien cursó con hipoxemia de rápida instauración, opacidades en vidrio esmerilado y lavado broncoalveolar con gran cantidad de macrófagos cargados de hemosiderina, configurando el diagnóstico de hemorragia alveolar, que respondió a terapia citostática combinada en términos de mejoría sostenida en el recuento plaquetario. Se aduce la importancia de identificar elementos de juicio clínico que permitan lograr un diagnóstico temprano, así como establecer puentes transdisciplinarios que conduzcan a un tratamiento efectivo en un escenario potencialmente fatal.

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Section: Discussionunclassified

Hemorragia alveolar difusa en paciente con trombocitopenia inmune primaria refractaria: reporte de caso

Rondón-Carvajal,

Álvarez-López,

Escudero-Correa

2024

Rev Medicas UIS

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“…A platelet count >100 x 10-9 may also indicate a positive response to thrombolytic treatment. (13) Alteplase is a thrombolytic agent often used in cases of central venous catheter thrombosis to achieve local clot lysis with intracatheter administration. However, careful monitoring is required as systemic administration increases the possibility of local blood vessel damage and the formation of new thrombi.…”

Section: Discussionmentioning

confidence: 99%

Fibrinolytic therapy in newborns with superior vena cava syndrome. Case report

et al. 2020

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Introduction: Superior vena cava syndrome is described as the obstruction of blood flow through the superior vena cava. The literature reports that the incidence of this pathology varies from 1 case in every 650 inhabitants and 1 case in every 3 100 inhabitants. Since this condition is very rare in the pediatric population, no clear figure has been reported regarding its incidence in children. The use of a central venous catheter in newborns is a risk factor for this condition, as it may cause a thrombus due to the inflammatory reaction against the device. Therefore, it is necessary to initiate anticoagulation management and remove the catheter.Case presentation: Premature male newborn, (31.4 weeks gestation), with acute respiratory distress syndrome, early neonatal sepsis, pneumonia, necrotizing enterocolitis on 2 occasions, intestinal obstruction due to adhesions and intestinal volvulus. At 90 days of age, he presented thrombosis of the superior vena cava without involvement of the jugular and subclavian vein junction in the right atrium. Anticoagulant management was started, but given his unfavorable evolution, a multidisciplinary medical board was held to assess the risks, benefits, and treatment options in this age group. It was decided to start intracavitary tissue plasminogen activator treatment associated with mechanical thrombectomy and angioplasty of the superior vena cava. Due to the difficulty of conducting clinical trials in this population and the rates of major bleeding complications obtained with thrombolytic therapies, there is very little information available on the use of tissue plasminogen activator in newborns. For this reason, alteplase is seldom considered as the therapy of choice. However, in patients with life-threatening thrombosis, such as the present case, the results obtained in adults could be extrapolated in search of a favorable outcome.Conclusions: Fibrinolytic therapy is a way to reduce the size of the thrombus, but it dramatically increases the risk of bleeding; consequently, these patients must be strictly monitored. In pediatric populations, due to the diameter of the blood vessels, thrombectomy is difficult to perform; additionally, recurrent thrombosis and the need for transfusion of blood products are frequent.

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“…8 Partial response to treatment was defined based on platelet count of >30 x 10 9 /L and doubling of the baseline value and complete response to treatment was defined based on a platelet count of >100x 10 9 /L. 9 Development of bleeding events like gastrointestinal (GIB), skin, mucocutaneous, central nervous system (CNS), genitourinary, epistaxis, hemoptysis, and muscles hematoma were investigated in the setting of COVID-19 infection. Patients with CNS bleeding or who developed hemorrhagic shock secondary to bleeding, or required blood transfusion were considered to have major bleeding events.…”

Section: Methodsmentioning

confidence: 99%

Prognosis of chronic immune thrombocytopenia in the setting of COVID-19 infection

Alayan

Kewan

Alwakeel

et al. 2021

Preprint

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Guidelines on the diagnosis of primary immune thrombocytopenia in children and adolescents: Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Guidelines Project: Associação Médica Brasileira - 2012

Cited by 8 publications

References 100 publications

Hemorragia alveolar difusa en paciente con trombocitopenia inmune primaria refractaria: reporte de caso

Hemorragia alveolar difusa en paciente con trombocitopenia inmune primaria refractaria: reporte de caso

Fibrinolytic therapy in newborns with superior vena cava syndrome. Case report

Prognosis of chronic immune thrombocytopenia in the setting of COVID-19 infection

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