1/11. Subdural haematoma with spontaneous resolution--rare manifestation of idiopathic thrombocytopenic purpura.Spontaneous intracranial haemorrhage presenting as subdural haematoma is an extremely rare presentation in adults due to idiopathic thrombocytopenic purpura. There are only five such case reports available in the literature and four had surgical evacuation of haematoma, while only one had spontaneous resolution. We report the case of a middle aged female who presented with bilateral papilloedema and later diagnosed to have subdural haematoma as a complication of idiopathic thrombocytopenic purpura, which had a spontaneous resolution.- - - - - - - - - - ranking = 1keywords = intracranial haemorrhage, haemorrhage (Clic here for more details about this article) |
2/11. pituitary apoplexy with optic tract oedema and haemorrhage in a patient with idiopathic thrombocytopenic purpura.Bilateral optic tract oedema, left optic tract haemorrhage and subarachnoid haemorrhage occurred in a 70-year-old man with pituitary apoplexy associated with idiopathic thrombocytopenic purpura. Left optic tract haemorrhage was confirmed on MRI.- - - - - - - - - - ranking = 1.020226350012keywords = haemorrhage (Clic here for more details about this article) |
3/11. Anaesthetic management of splenectomy in Evan's syndrome during pregnancy with pregnancy induced hypertension.The management of idiopathic thrombocytopenic purpura (ITP) during pregnancy, especially with ongoing bleeding diathesis, has not been highlighted sufficiently in the literature. Aortocaval compression and reduction in uteroplacental circulation resulting in foetal hypoxia and acidosis, Mendelson's syndrome due to gravid uterus, trauma to airway with resultant haemorrhage and aspiration into lungs, compromised airway due to short neck, anasarca and heavy breast, limitation in using invasive monitoring and regional anaesthesia and uncontrolled bleeding leading to placental hypoperfusion and foetal hypoxia are some of the important risks. In the present case report, anaesthetic management for splenectomy during pregnancy complicated with pregnancy induced hypertension and bleeding diathesis secondary to ITP is described with reference to above risks.- - - - - - - - - - ranking = 0.14574662143029keywords = haemorrhage (Clic here for more details about this article) |
4/11. Repeated antenatal intracranial haemorrhage: magnetic resonance imaging in a fetus with alloimmune thrombocytopenia.magnetic resonance imaging was used to show repeated antenatal intracranial haemorrhage in a fetus with alloimmune thrombocytopenia.- - - - - - - - - - ranking = 5keywords = intracranial haemorrhage, haemorrhage (Clic here for more details about this article) |
5/11. Oesophageal carcinoma and refractory idiopathic thrombocytopenic purpura: a challenging combination.We report the case of a 72-year-old lady who presented with fatigue and bruising. Initial investigations were compatible with iron deficiency anaemia and idiopathic thrombocytopenic purpura (ITP). The anaemia and recent heartburn symptoms led to endoscopy, which revealed an extensive oesophageal squamous cell carcinoma. The tumour was inoperable due to local extension and the patient was not deemed fit enough for aggressive chemotherapy. A course of radical local radiotherapy was given. The patient's ITP, which had initially been responsive to high-dose intravenous immunoglobulin, subsequently became refractory to all therapeutic modalities. The patient developed significant dysphagia but therapeutic options were limited due to her severe thrombocytopenia. The patient eventually died from a combination of gastrointestinal and intrapulmonary haemorrhage. This case is of interest for two reasons. First, the development of refractory ITP appeared to mirror the progression of the carcinoma, and to our knowledge this is the first case of ITP associated with oesophageal carcinoma. Second, despite recent endoscopic advances in palliating oesophageal tumours, this case highlights the difficulties that can still occur.- - - - - - - - - - ranking = 0.14574662143029keywords = haemorrhage (Clic here for more details about this article) |
6/11. Dental treatment for children with chronic idiopathic thrombocytopaenic purpura: a report of two cases.Idiopathic thrombocytopaenic purpura (ITP) is the most common acquired bleeding disorder occurring in previously healthy children. The condition is benign and self-limiting, with a high possibility of recovery. Only 15-30% of children with acute ITP develop the chronic form. Clinically, ITP presents with petechiae, ecchymoses, haematomas, epistaxis, haematuria, mucocutaneous bleeding, and occasionally, haemorrhage into tissues. oral manifestations include spontaneous gingival bleeding, petechiae or haematomas of the mucosa, tongue or palate. Two paediatric case reports are described concerning female patients diagnosed with chronic ITP. Oral findings and dental procedures are described. Standard dental treatment was performed with a platelet count higher than 50,000/mm3. The importance of adequate dental plaque control techniques in order to prevent inflammation, potential bleeding and infection in these patients is emphasized. The paediatric dentist must be aware of the clinical appearance of ITP in order to recognize the condition and successfully manage the patient.- - - - - - - - - - ranking = 0.14574662143029keywords = haemorrhage (Clic here for more details about this article) |
7/11. Recombinant FVIIa in the management of intracerebral haemorrhage in severe thrombocytopenia unresponsive to platelet-enhancing treatment.Intracranial haemorrhage (ICH) is a dramatic and potentially life-threatening presentation of children with thrombocytopenia. Management is limited to supportive care. Recent evidence suggests that ongoing bleeding following the initial ICH may result in greater neurological morbidity and mortality. Haemostatic agents, including recombinant factor viia (rFVIIa), a product licensed for use in patients with haemophilia and inhibitors, may be helpful in reducing bleeding in children with refractory thrombocytopenia. We present the case of a 16-year-old girl with severe refractory immune thrombocytopenia, who presented with a major ICH and responded to treatment that included rFVIIa and platelet transfusions. The dose of rFVIIa was empirically chosen and based on reported cases in the literature. The case highlights a number of issues regarding off-label use of rFVIIa and demonstrates the need to prospectively collect accurate information on the off-label use of this new potentially useful medication.- - - - - - - - - - ranking = 0.72873310715144keywords = haemorrhage (Clic here for more details about this article) |
8/11. Pegylated interferon alpha-2a-associated life-threatening Evans' syndrome in a patient with chronic hepatitis c.In this report, we describe an unusual and unreported complication with the new licensed form of pegylated interferon alpha2a (PEG-IFN-alpha2a). We report the first case of severe autoimmune cytopenias, an Evans' syndrome, in a patient with chronic hepatitis c, 2 months after PEG-IFN-alpha2a initiation. Haemolytic anaemia and thrombocytopenia developed, complicated by gastric bleeding and brain haemorrhage. Outcome was favourable under immunosuppressive treatment. Treatment with PEG-IFN-alpha2a requires careful follow-up, as IFNalpha can induce or exacerbate autoimmune diseases.- - - - - - - - - - ranking = 0.14574662143029keywords = haemorrhage (Clic here for more details about this article) |
9/11. pituitary apoplexy and idiopathic thrombocytopenic purpura: a new case and review of the literature.pituitary apoplexy can occur as a complication of idiopathic thrombocytopenic purpura. We report here a new case of such association. A male patient aged 59 years, complaining of decreased libido for one year, was referred to the emergency department for purpura and severe thrombocytopenia (4000 platelets/mm3). 24 hours after the cutaneous rash the patient presented with clinical symptoms of bilateral cavernous sinus compression comprising ptosis, bilateral ophtalmoplegia and right supraorbital hypoesthesia. Cranial CT scan showed an enlarged sella and a pituitary mass with signs of intrapituitary haemorrhage. Hormonal evaluation showed hyperprolactinemia (50 ng/mL) and hypopituitarism, and the patient needed substitution with hydrocortisone and levothyroxine. immunoglobulins and corticosteroids were given to the patient to treat thrombocytopenia, then worsening of neurological and ophtalmological symptoms led to pituitary surgery. Histopathological examination found necrotical pituitary tissue. Immunostaining with an anti-prolactin antibody was positive in several groups of cells. Neurological symptoms subsided and thrombocytopenia was corrected by treatment. In conclusion, we report a case of pituitary apoplexy due to severe thrombocytopenia occurring as a complication of a preexisting macroprolactinoma.- - - - - - - - - - ranking = 0.14574662143029keywords = haemorrhage (Clic here for more details about this article) |
10/11. Acute idiopathic thrombocytopaenic purpura in childhood: report of a case presenting in general dental practice.Acute idiopathic thrombocytopaenic purpura is the most common of the thrombocytopaenias of childhood. Clinically it is associated with petechiae, mucocutaneous bleeding and occasionally haemorrhage into tissues. The oral mucosa is frequently involved. This paper describes a case presenting in general dental practice.- - - - - - - - - - ranking = 0.14574662143029keywords = haemorrhage (Clic here for more details about this article) |
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