Thrombocytopenia

Thrombocytopenia

The terms thrombocytopenia and thrombopenia refer to a disorder in which there is a relative decrease of platelets.

These limits are determined by the 2.5th lower and upper percentile, so values outside this range do not necessarily indicate disease. One common definition of thrombocytopenia is a platelet count below 50,000 per microlitre.

Severe thrombocytopenia can result in petechial hemorrhages or spontaneous intracerebral hemorrhage (ICH).

Hypertension and thrombocytopenia are potentially modifiable predictors of reoperation for hematoma, which were associated greater odds of 30-day death 1).


see Heparin induced thrombocytopenia.


A free valproic acid (VPA) serum concentration of 14.67 mcg/mL had the optimal discriminating power for the occurrence of thrombocytopenia. Ammonemia should be monitored even if free VPA concentration is within the safety range 2).


Yoo et al. report the first case of severe fever with thrombocytopenia syndrome (SFTS) and a intracranial acute spontaneous subdural hematoma (SDH) in Korea. A 79-year-old male presented with fever and thrombocytopenia. On the third day of hospitalization, his mental changed from drowsy to semi-coma. Brain computed tomography indicated an acute subdural hemorrhage on the right convexity. He was given early decompressive craniectomy, but did not survive. Real-time reverse transcription polymerase chain reaction analysis of a blood sample indicated the presence of SFTS virus (SFTSV). This is the first reported case with intracranial hemorrhage and SFTS. This case report describes our treatment of a patient with acute SDH and an infection from a tick-borne species of Bunyaviridae 3).

References

1)

Dasenbrock HH, Yan SC, Chavakula V, Gormley WB, Smith TR, Claus E, Dunn IF. 145 Unplanned Reoperation After Craniotomy for Tumor: A National Surgical Quality Improvement Program Analysis. Neurosurgery. 2016 Aug;63 Suppl 1:159. doi: 10.1227/01.neu.0000489715.29455.af. PubMed PMID: 27399424.
2)

Tseng YJ, Huang SY, Kuo CH, Wang CY, Wang KC, Wu CC. Safety range of free valproic acid serum concentration in adult patients. PLoS One. 2020;15(9):e0238201. Published 2020 Sep 2. doi:10.1371/journal.pone.0238201
3)

Yoo J, Oh JW, Jang CG, Moon JH, Kim EH, Chang JH, Kim SH, Kang SG. Spontaneous Acute Subdural Hemorrhage in a Patient with a Tick Borne Bunyavirus-Induced Severe Fever with Thrombocytopenia Syndrome. Korean J Neurotrauma. 2017 Apr;13(1):57-60. doi: 10.13004/kjnt.2017.13.1.57. Epub 2017 Apr 30. PubMed PMID: 28512621; PubMed Central PMCID: PMC5432452.

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