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A 19 year old with a 3-week history of diarrhoea
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
LMWH should be used to prevent venous thromboembolism. A high platelet count is a manifestation of the acute inflammatory response. This hyper-coagulable state, combined with bed rest, increases the risk of DVT and PE (see p. 156).
Platelet-Rich Plasma
Published in Rubina Alves, Ramon Grimalt, Techniques in the Evaluation and Management of Hair Diseases, 2021
Lu Yin, Katerina Svigos, Kristen Lo Sicco, Jerry Shapiro
Although no study has been performed assessing risk of skin cancer recurrence after local PRP treatment, given its mechanism of action via growth factors, it should be used with caution in patients with either active or history of skin cancers involving the scalp. Caution should be taken when considering PRP treatment for alopecia in these patients, as there is a theoretical risk that injected growth factors may stimulate cell proliferation. Care should also be taken when treating patients who are on antiplatelet therapy or have low platelet counts, as these conditions may decrease the treatment's efficacy. However, there are no studies evaluating associations between patients' serum platelet counts and responses to PRP injections. Finally, the safety profile of PRP injections for treatment of alopecia in pregnant women is currently unknown. Blood composition is also altered during pregnancy, which may theoretically impact treatment efficacy. During pregnancy, blood volume is increased, and though increased erythropoietin compensates somewhat for the increased blood volume, there is still a degree of dilutional anemia [47, 48]. Due to dilution and sequestration in the spleen from splenic enlargement, platelet counts also decrease [47, 49]. However, no study has evaluated whether these physiologic changes impact PRP efficacy. We recommend that physicians consider the option of PRP treatment carefully when treating patients who are pregnant or breastfeeding with regard to both treatment safety and efficacy.
Retinoids and Concomitant Surgery
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
A clinical study reported that isotretinoin lowered platelet counts in 110 patients treated for acne. Platelet counts for all the patients in this study were at least 200,000/microliter, and this is a value which is normal by any standard. According to the results of this study, there is no increased risk of bleeding as a result of thrombocytopenia in patients who are on systemic retinoid therapy (2).
Evaluation of blood cellular and biochemical parameters in rats under a chronic hypoxic environment at high altitude
Published in Annals of Medicine, 2023
Chunlong Yan, Dengfeng Tian, Chenhong Zhang, Qiang Zhang, Yanqiu Sun
Platelets are small pieces of cytoplasm detached from the cytoplasm of mature megakaryocytes in the bone marrow [17]. In addition, the main function of platelets is to coagulate and stop bleeding and to repair damaged blood vessels [18–19]. Table 3 shows that compared with the Control group, PLT in the HA group decreased significantly (p < 0.05) (Figure 3(A)), PDW, MRV, and P-LCR increased significantly (p < 0.05) (Figure 3(B–D)), and PCT in the HA group decreased compared with the Control group, but the difference was not statistically significant (p > 0.05). These results show that the composition of platelets in the blood of rats at high altitude changes, with a decrease in platelet count and increases in the distribution of platelet size in the blood, the average platelet volume, and the percentage of large platelets in total blood platelets. This may indicate that coagulation and hemostasis functions may be affected in the low hypoxic environment at high altitudes, with a risk of bleeding.
Platelet to white blood cell ratio was an independent prognostic predictor in acute myeloid leukemia
Published in Hematology, 2022
Shuqi Zhao, Hanzhang Pan, Qi Guo, Wanzhuo Xie, Jinghan Wang
Notably, clinical parameters are still important factors for classification in CN-AML [3]. In clinical practice, patients with AML often present with leukocytosis and thrombocytopenia. Leukocytosis is usually caused by leukemia blasts, which release from bone marrow storage pool to peripheral blood. At the same time, leukemia blasts can suppress hematopoiesis including the inhibition of the generation of platelets [4]. Notably, high WBC had been regarded as a reliable indicator of poor clinical outcome [5]. Generally, platelet count has been used to predict bleed risk in AML. Low platelet count can contribute to bleeding complications, which is a dangerous and potentially fatal complication [5]. Recently, a combinational index of platelet and WBC had been proved as an independent prognostic predictor in several diseases such as acute-on-chronic liver failure, renal malignancy, ischemic stroke, and acute promyelocytic leukemia [5–8]. However, whether this ratio of platelet and WBC counts (PWR) has somewhat prognostic indication in CN-AML is still not investigated. Therefore, we analyzed the prognostic value of PWR in a large cohort of CN-AML patients.
Alternatives for managing patients with newly diagnosed immune thrombocytopenia: a narrative review
Published in Expert Review of Hematology, 2022
David Gómez-Almaguer, Edgar A. Rojas-Guerrero, Andrés Gómez-De León, Perla R. Colunga-Pedraza, José C. Jaime-Pérez
Conventionally, first-line therapy for ITP aims to obtain a rapid response and reduce bleeding risk by increasing the platelet count. This situation is especially important in patients with an elevated risk of active bleeding. The durability of response, tolerability, and long-term safety of pharmacologic interventions are considered less a priority during the initial treatment stage [11]. It is a heterogeneous disease. Symptoms and signs can differ from patient to patient and do not necessarily correlate with the platelet count. Treatment options must include patients’ values and preferences since improving health-related quality of life (HRQoL) is an important objective [12,13]. The American Society of Hematology ITP clinical guidelines, in an updated version, recommend managing a newly diagnosed adult patient with a platelet count <30 x 109/L with corticosteroids [3]. The addition of intravenous immunoglobulin (IVIG) is for patients in whom a rapid increase in the platelet count is favored. IVIG, where available, may be appropriate in patients with bleeding or at high risk for bleeding, who require a surgical procedure, or who are unresponsive to corticosteroids [14]. Moreover, the International Consensus Report on the investigation and management of primary immune thrombocytopenia still suggests using corticosteroids as a standard initial treatment [4].