Posts Tagged ‘thrombocytopenia’

Fever, Rash, and Renal Failure

Posted by Sara Fazio • February 14th, 2014

In the latest Case Record of the Massachusetts General Hospital, a 59-year-old man was admitted to the hospital because of fever, confusion, rash, thrombocytopenia, and renal failure, 10 days after a hunting trip in the Nevada valley. The combination of suspected infection, vasculopathy of small or medium-size vessels, thrombocytopenia, myositis, myocarditis, encephalitis, and possible tick… Read More…

Anemia and Thrombocytopenia

Posted by Sara Fazio • November 21st, 2013

In the latest Case Record of the Massachusetts General Hospital, a 38-year-old woman was admitted to this hospital because of fatigue, malaise, and lightheadedness, with dyspnea on exertion, bruising, dark urine, and headache. Laboratory tests revealed anemia and thrombocytopenia. Diagnostic tests were performed. Hemolytic anemia associated with normal red cells can be caused by destruction… Read More…

Fever and Altered Mental Status

Posted by Sara Fazio • May 17th, 2013

In the latest Case Record of the Massachusetts General Hospital, 76-year-old man with chronic renal disease was admitted to this hospital because of fever, worsening renal function, and confusion. Brain imaging revealed a small amount of material with restricted diffusion layering in the occipital horns of the lateral ventricles. Typical bacterial organisms that commonly cause… Read More…

Prophylactic Platelet Transfusions: Are They Really Necessary?

Posted by Rena Xu • May 8th, 2013

Many patients with hematologic malignancies develop dangerously low platelet counts due to their disease, their treatment, or both. To mitigate the risk of bleeding, such patients have historically received prophylactic platelet transfusions. Recently, however, the value of this practice has been called into question. Does it really help to give platelets on a preventative basis?… Read More…

Eltrombopag in Cirrhosis

Posted by Sara Fazio • August 24th, 2012

In a trial involving patients with cirrhosis and thrombocytopenia, treatment with eltrombopag before invasive procedures reduced the need for platelet transfusions. More thrombotic events of the portal venous system were observed with eltrombopag than with placebo. Thrombocytopenia is frequently observed in patients with chronic liver disease, with studies suggesting that it occurs in up to 76%… Read More…

Breathtaking Journey

Posted by Sara Fazio • August 3rd, 2012

A 48-year-old man came to the emergency department in early August with a 3-day history of influenza-like symptoms and profound dyspnea on exertion, which had started 3 days after his return to Boston from a vacation in California. Read this latest Clinical Problem-Solving case on NEJM.org. The hantavirus pulmonary syndrome came to national attention in… Read More…

Low-Molecular-Weight Heparin in Medical Patients

Posted by Sara Fazio • December 30th, 2011

Pharmacologic thromboprophylaxis has been proven to reduce the incidence of venous thromboembolism in both  surgical patients and acutely ill medical patients. In surgical patients, thromboprophylaxis has been shown to reduce  the incidence of fatal pulmonary embolism and the rate of death from any cause; in medical patients, studies have  shown that thromboprophylaxis is associated with… Read More…

Primary Immune Thrombocytopenia

Posted by Graham McMahon • August 26th, 2011

In the latest article in our Clinical Therapeutics review series, a young woman with immune thrombocytopenia (ITP) who has been treated with a thrombopoietin-receptor agonist presents for advice regarding long-term treatment. The agents in this therapeutic class, romiplostim and eltrombopag, are effective in increasing platelet counts.       Immune thrombocytopenia is a disorder that is characterized by immune-mediated… Read More…

Thrombotic Thrombocytopenic Purpura

Posted by Graham McMahon • December 10th, 2010

In this week’s Case Record of the Massachusetts General Hospital, a 16-year-old girl with a history of lupus nephritis was seen in the emergency department because of altered mental status. She was somnolent and agitated and had no focal neurologic signs. Brain CT revealed no abnormalities. Laboratory studies revealed anemia and thrombocytopenia. A diagnosis of… Read More…