Displaying publications 1 - 20 of 90 in total

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  1. Fulltext Autosomal dominant thrombocytopenia with microthrombocytes: a family study
    Jackson N, Mohammad S, Zainal N, Jamaluddin N, Hishamuddin M
    Med J Malaysia, 1995 Dec;50(4):421-4.
    PMID: 8668069
    A family demonstrating autosomal dominant thrombocytopenia is described. A 28-year-old Malay housewife was found to have a platelet count of 40 x 10(9)/l with a low mean platelet volume (6.8 fl) while being investigated prior to ovarian cystectomy. The bone marrow was consistent with immune thrombocytopenia but she failed to respond to appropriate therapy. Five siblings, one parent and one nephew have easy bruising and platelet counts of 39-82 x 10(9)/l. Platelet aggregation studies excluded a major functional defect. Survival of homologous platelets in the circulation was normal. Familial thrombocytopenias are rare but important to differentiate from the common acquired thrombocytopenias in order to spare the patient unnecessary treatments.
    Matched MeSH terms: Thrombocytopenia/genetics*
  2. Fulltext Evaluation of immature platelet fraction as a marker of dengue fever progression
    Looi KW, Matsui Y, Kono M, Samudi C, Kojima N, Ong JX, et al.
    Int J Infect Dis, 2021 Sep;110:187-194.
    PMID: 34302960 DOI: 10.1016/j.ijid.2021.07.048
    OBJECTIVES: Progression of dengue is often associated with thrombocytopenia resulting from viral-induced bone marrow suppression and immune-mediated peripheral platelet consumption. Immature platelet fraction (IPF), which can be measured using a haematology analyser, is a precursor indicating platelet formation in the bone marrow. This study evaluated the trend of IPF as an early recovery indicator of platelets in dengue patients with thrombocytopenia, and its relationship with severe dengue in conjunction with reticulocyte count.

    METHODS: Hospitalized patients with dengue were enrolled and followed-up daily until discharge. Blood investigations included daily full blood counts and IPF measured using a haematology analyser.

    RESULTS: In total, 287 patients with confirmed dengue were enrolled in this study, 25 of whom had severe dengue. All patients had a decreasing trend in platelet count in the first week of illness, concomitant with an increasing trend in the percentage of immature platelets to total platelets (IPF%) for more than 3 days prior to platelet recovery. IPF% was significantly increased in patients with severe dengue compared with patients with non-severe dengue on days 3-5 after the onset of fever. Reticulocyte count increased significantly in patients with severe dengue on day 5.

    CONCLUSIONS: IPF can be utilized as an early recovery indicator of platelets in patients with dengue and thrombocytopenia.

    Matched MeSH terms: Thrombocytopenia*
  3. Prenatal diagnosis of an extensive haemangioma of the fetal leg: a case report
    Raman S, Ramanujam T, Lim CT
    J Obstet Gynaecol Res, 1996 Aug;22(4):375-8.
    PMID: 8870422
    Extensive haemangioma with platelet consumption (Kasabach-Merritt syndrome) is rare. The lesion is usually a single cutaneous cavernous haemangioma similar to that found in our patient. Multiple superficial strawberry naevi were also seen all over the rest of the body. This condition was diagnosed antenatally in this patient with the use of colour Doppler. There is one recent report where the thrombocytopaenia was diagnosed by cordocentesis. Unfortunately the baby developed heart failure with intractable coagulopathy and died 2 days later.
    Matched MeSH terms: Thrombocytopenia/complications
  4. Predictors and Clinical Outcomes of Poor Platelet Recovery in Adult Dengue With Thrombocytopenia: A Multicenter, Prospective Study
    Archuleta S, Chia PY, Wei Y, Syed-Omar SF, Low JG, Oh HM, et al.
    Clin Infect Dis, 2020 07 11;71(2):383-389.
    PMID: 31626692 DOI: 10.1093/cid/ciz850
    BACKGROUND: Platelet transfusion is common in dengue patients with thrombocytopenia. We previously showed in a randomized clinical trial that prophylactic platelet transfusion did not reduce clinical bleeding. In this study, we aimed to characterize the predictors and clinical outcomes of poor platelet recovery in transfused and nontransfused participants.

    METHODS: We analyzed patients from the Adult Dengue Platelet Study with laboratory-confirmed dengue with ≤20 000 platelets/μL and without persistent mild bleeding or any severe bleeding in a post hoc analysis. Poor platelet recovery was defined as a platelet count of ≤20 000/μL on Day 2. We recruited 372 participants from 5 acute care hospitals located in Singapore and Malaysia between 29 April 2010 and 9 December 2014. Of these, 188 were randomly assigned to the transfusion group and 184 to the control group.

    RESULTS: Of 360 patients, 158 had poor platelet recovery. Age, white cell count, and day of illness at study enrollment were significant predictors of poor platelet recovery after adjustment for baseline characteristics and platelet transfusion. Patients with poor platelet recovery had longer hospitalizations but no significant difference in other clinical outcomes, regardless of transfusion. We found a significant interaction between platelet recovery and transfusion; patients with poor platelet recovery were more likely to bleed if given a prophylactic platelet transfusion (odds ratio 2.34, 95% confidence interval 1.18-4.63).

    CONCLUSIONS: Dengue patients with thrombocytopenia who were older or presented earlier and with lower white cell counts were more likely to have poor platelet recovery. In patients with poor platelet recovery, platelet transfusion does not improve outcomes and may actually increase the risk of bleeding. The mechanisms of poor platelet recovery need to be determined.

    CLINICAL TRIALS REGISTRATION: NCT01030211.

    Matched MeSH terms: Thrombocytopenia*
  5. Prophylactic platelet transfusion plus supportive care versus supportive care alone in adults with dengue and thrombocytopenia: a multicentre, open-label, randomised, superiority trial
    Lye DC, Archuleta S, Syed-Omar SF, Low JG, Oh HM, Wei Y, et al.
    Lancet, 2017 Apr 22;389(10079):1611-1618.
    PMID: 28283286 DOI: 10.1016/S0140-6736(17)30269-6
    BACKGROUND: Dengue is the commonest vector-borne infection worldwide. It is often associated with thrombocytopenia, and prophylactic platelet transfusion is widely used despite the dearth of robust evidence. We aimed to assess the efficacy and safety of prophylactic platelet transfusion in the prevention of bleeding in adults with dengue and thrombocytopenia.
    METHODS: We did an open-label, randomised, superiority trial in five hospitals in Singapore and Malaysia. We recruited patients aged at least 21 years who had laboratory-confirmed dengue (confirmed or probable) and thrombocytopenia (≤20 000 platelets per μL), without persistent mild bleeding or any severe bleeding. Patients were assigned (1:1), with randomly permuted block sizes of four or six and stratified by centre, to receive prophylactic platelet transfusion in addition to supportive care (transfusion group) or supportive care alone (control group). In the transfusion group, 4 units of pooled platelets were given each day when platelet count was 20 000 per μL or lower; supportive care consisted of bed rest, fluid therapy, and fever and pain medications. The primary endpoint was clinical bleeding (excluding petechiae) by study day 7 or hospital discharge (whichever was earlier), analysed by intention to treat. Safety outcomes were analysed according to the actual treatment received. This study was registered with ClinicalTrials.gov, number NCT01030211, and is completed.
    FINDINGS: Between April 29, 2010, and Dec 9, 2014, we randomly assigned 372 patients to the transfusion group (n=188) or the control group (n=184). The intention-to-treat analysis included 187 patients in the transfusion group (one patient was withdrawn immediately) and 182 in the control group (one was withdrawn immediately and one did not have confirmed or probable dengue). Clinical bleeding by day 7 or hospital discharge occurred in 40 (21%) patients in the transfusion group and 48 (26%) patients in the control group (risk difference -4·98% [95% CI -15·08 to 5·34]; relative risk 0·81 [95% CI 0·56 to 1·17]; p=0·16). 13 adverse events occurred in the transfusion group and two occurred in the control group (5·81% [-4·42 to 16·01]; 6·26 [1·43 to 27·34]; p=0·0064). Adverse events that were possibly, probably, or definitely related to transfusion included three cases of urticaria, one maculopapular rash, one pruritus, and one chest pain, as well as one case each of anaphylaxis, transfusion-related acute lung injury, and fluid overload that resulted in serious adverse events. No death was reported.
    INTERPRETATION: In adult patients with dengue and thrombocytopenia, prophylactic platelet transfusion was not superior to supportive care in preventing bleeding, and might be associated with adverse events.
    FUNDING: National Medical Research Council, Singapore.
    Study site: Hospitals, Singapore; University Malaya Medical Centre (UMMC). Kuala Lumpur, Malaysia
    Study protocol: https://clinicaltrials.gov/ct2/show/NCT01030211
    Matched MeSH terms: Thrombocytopenia*
  6. Clinicopathological Profile of Dengue Infection in a Tertiary Care Centre in Nepal
    Thapa B, Pandey A, Gautum S, Kc S, Chhetri PD, Pokhrel E, et al.
    J Nepal Health Res Counc, 2023 Jul 20;20(4):859-867.
    PMID: 37489668 DOI: 10.33314/jnhrc.v20i4.4172
    BACKGROUND: Dengue is a mosquito-borne viral disease with a wide spectrum of presentations ranging from subclinical disease to severe dengue. Dengue is endemic to the Terai of Nepal. Interestingly, an increasing incidence has been reported from hilly areas like Kathmandu valley. This study explored the clinicopathological profile of dengue infection.

    METHODS: A total of 84 serologically confirmed dengue cases from September to November 2019 at KIST Medical College were recruited in a cross-sectional study after obtaining ethical approval. Dengue was categorized as dengue without warning signs, dengue with warning signs, and severe dengue. Clinicopathological information was recorded in the proforma by reviewing patients' records. A descriptive statistical tool and chi-square test were carried out.

    RESULTS: Out of 84 patients, 76% (64) were dengue without warning signs, 21.4% (18) were dengue with warning signs and 2.4% (2) were severe dengue. About 97.6% (82) presented with fever. During the course of illness, anemia was identified in 38.1% (32), thrombocytopenia in 65.5% (55), hemoconcentration in 6% (5), and leucopenia in 82.1% (69). Similarly, elevated aspartate transaminase and alanine transaminase (ALT) was observed in 67.7% (42) and 53.2% (33) respectively. The severity of dengue on presentation to hospital was significantly associated with thrombocytopenia, leucopenia, and elevated ALT. Similarly, the severity during course of illness in hospital was significantly associated with hemoconcentration, thrombocytopenia, leucopenia, and elevated ALT.

    CONCLUSIONS: Most common presentation of dengue infection was fever. The most common laboratory abnormalities were leucopenia, thrombocytopenia, hemoconcentration, anemia, and elevated liver enzymes. Awareness of these clinical and laboratory parameters is important for the prompt diagnosis, severity estimation, and overall management of dengue infection.

    Matched MeSH terms: Thrombocytopenia*
  7. Fulltext Isolated non-traumatic, non-aneurysmal convexal subarachnoid hemorrhage in a patient with Evans syndrome
    Abdul Rashid AM, Md Noh MSF
    BMC Neurol, 2017 Aug 25;17(1):165.
    PMID: 28841841 DOI: 10.1186/s12883-017-0944-9
    BACKGROUND: Non-traumatic, spontaneous subarachnoid hemorrhage occurs in approximately 85% of cases where there is a ruptured saccular aneurysm. An additional 10% of cases arise from non-aneurysmal peri-mesencephalic hemorrhages.

    CASE PRESENTATION: We report a rare case of a young female, with underlying Evans syndrome, who was initially thought to have non-hemorrhagic stroke, eventually diagnosed having isolated non-traumatic, non-aneurysmal convexal subarachnoid haemorrhage.

    CONCLUSIONS: Spontaneous non-traumatic, non-aneurysmal convexal subarachnoid hemorrhage is a rare entity - of which there are multiple possible etiologies.

    Matched MeSH terms: Thrombocytopenia*
  8. Heparin-induced thrombocytopenia and recent advances in its therapy
    Hassan Y, Awaisu A, Aziz NA, Aziz NH, Ismail O
    J Clin Pharm Ther, 2007 Dec;32(6):535-44.
    PMID: 18021330
    To highlight therapeutic controversies, and present a critical review of the most recent evidence on the management of heparin-induced thrombocytopenia (HIT).
    Matched MeSH terms: Thrombocytopenia/chemically induced*; Thrombocytopenia/diagnosis; Thrombocytopenia/drug therapy
  9. Fulltext Severe thrombocytopenia due to hypersplenism treated with partial splenic embolisation
    Hanafiah M, Shahizon AM, Low SF, Shahrina MH
    BMJ Case Rep, 2013 Jul 05;2013.
    PMID: 23833091 DOI: 10.1136/bcr-2013-010163
    A 35-year-old woman with background of liver cirrhosis and portal hypertension secondary to chronic hepatitis C presented with complication of hypersplenism and thrombocytopenia. She developed severe menorrhagia requiring multiple blood transfusions. In addition, her interferon therapy was withheld owing to the underlying thrombocytopenia. Partial splenic embolisation was performed, which improved her platelet counts. Subsequently, the menorrhagia was resolved and her interferon therapy was restarted.
    Matched MeSH terms: Thrombocytopenia/etiology*
  10. An unusual presentation of gestational thrombocytopenia
    Lim CC, Patel DK, Bakhtiari A, Subrayan V
    Platelets, 2013;24(6):498-9.
    PMID: 22994680 DOI: 10.3109/09537104.2012.724484
    Thrombocytopenia is classically defined as a platelet count of less than 150 000/µl. Counts from 100 000 to 150 000/µl are considered mildly depressed, 50 000 to 100 000/µl moderately depressed, and less than 50 000/µl severely depressed. Thrombocytopenia occurs in about 10% of pregnant women. Gestational thrombocytopenia (GT) is a diagnosis of exclusion and considered the most prevalent cause of thrombocytopenia in pregnancy. GT accounts for almost 75% of cases of thrombocytopenia in pregnancy. The cause of GT is unclear, although existing studies denote the possibility of accelerated platelet consumption and the increased plasma volume during pregnancy. The presence of antiplatelet antibodies is not specific to GT. The degree of thrombocytopenia in GT is usually mild to moderate, usually remaining greater than 70 000/µl. Patients are asymptomatic with no evidence of bleeding and rarely preconception history of thrombocytopenia. The platelet count returns to normal within 2-12 weeks post partum. We wish to report a unique case of GT presenting as blurred vision due to retinal hemorrhages.
    Matched MeSH terms: Thrombocytopenia/diagnosis*
  11. Fulltext Typhoid fever presenting as acute cerebellar ataxia and severe thrombocytopenia
    Cheong BM
    Med J Malaysia, 2008 Mar;63(1):77-8.
    PMID: 18935745 MyJurnal
    Typhoid fever being a systemic infection can present in a multitude of ways, involving various systems. Here we describe a case of typhoid fever presenting with acute cerebellar ataxia and marked thrombocytopenia. This atypical presentation is not common in typhoid fever and can lead to misdiagnosis as well as a delay in the initiation of appropriate therapy. Prompt clinical improvement and the return of platelet counts to normal were noted after the patient was started on IV Ceftriaxone.
    Matched MeSH terms: Thrombocytopenia/etiology*
  12. Fulltext Clinical features of acute febrile thrombocytopaenia among patients attending primary care clinics
    Tong SF, Abd Aziz NA, Chin GL, Khairani O
    Malays Fam Physician, 2006;1(1):15-8.
    PMID: 26998201 MyJurnal
    Identifying clinical features that differentiate acute febrile thrombocytopaenia from acute febrile illness without thrombocytopaenia can help primary care physician to decide whether to order a full blood count (FBC). This is important because thrombocytopaenia in viral fever may signify more serious underlying aetiology like dengue infection.
    Matched MeSH terms: Thrombocytopenia*
  13. Bleeding manifestations in snake bite
    Devaraj T
    Southeast Asian J. Trop. Med. Public Health, 1979 Jun;10(2):255-7.
    PMID: 524151
    Bleeding following bites by the Malayan Pit Viper can either be local or systemic. Bleeding at the site of the bite is due to the local action of the venom as a vasculotoxin. Systemic bleeding occurs with severe poisoning and appears to be mainly dependent on platelet deficiency and the co-existing defibrination syndrome appears to play a minor role in the initiation of bleeding. Thus in the clinical situation non-clotting blood with no overt bleeding can continue up to weeks when specific antivenene is not given. Assessment of the severity of poisoning can easily be made at the bedside. Specific viper antivenene rapidly corrects the spontaneous bleeding and clotting defect of severe systemic poisoning but has no effect on local poisoning.
    Matched MeSH terms: Thrombocytopenia/blood
  14. Laparoscopic splenic artery ligation in a patient with immune thrombocytopenia with intracranial haemorrhage (two clips that stopped a timebomb)
    Chan YQ, Lee ZM, Tan SL
    Med J Malaysia, 2020 07;75(4):433-435.
    PMID: 32724010
    Intracranial haemorrhage (ICH) in a patient with relapse of idiopathic thrombocytopaenic purpura (ITP) can be lethal. The site of haemorrhage, compounded by low platelets in this disease, makes its management extremely challenging, especially when a neurosurgical procedure is warranted. We report a case report of an unconventional way of increasing platelet counts in ITP rapidly in an emergency setting.
    Matched MeSH terms: Thrombocytopenia/physiopathology*
  15. Fulltext Hematological Findings among COVID-19 Patients Attending King Khalid Hospital at Najran, Kingdom of Saudi Arabia
    Elkhalifa AME, Elderdery AY, Al Bataj IA, Tamomh AG, Alyami MM, Almakrami HA, et al.
    Biomed Res Int, 2022;2022:4620037.
    PMID: 35224093 DOI: 10.1155/2022/4620037
    COVID-19 is a global pandemic viral infection that has affected millions worldwide. Limited data is available on the effect of COVID-19 on hematological parameters in Saudi Arabia. This study is aimed at examining the role of hematological parameters among COVID-19 patients admitted to King Khalid Hospital in Najran, Saudi Arabia. This is a retrospective, hospital-based study of 514 cases who were recruited during August to October 2020. 257 COVID-19 patients formed the study group, and a further 257 negative subjects formed the control group. Anemia was significantly elevated in positive subjects over controls (respectively, 64.2% and 35.8%), with patients 2.5 times more likely to be anemic (p < 0.01). Thrombocytopenia was higher in patients over controls (respectively, 62% and 38%), with patients ~1.7 times more likely to be thrombocytopenic (p < 0.01). Moreover, leukopenia was significantly higher in patients over controls (respectively, 71% and 29%), with positive subjects ~2.6 times more likely to be leukopenic. Our study results indicate that mild anemia associated with leukopenia may have diagnostic value for COVID-19. Careful assessment of hematological parameters, at baseline and throughout the disease path, will assist physicians in formulating personalized approaches to treatment and promptly offer intensive care to those in greater need.
    Matched MeSH terms: Thrombocytopenia/virology
  16. Fulltext Case series of naturally acquired Plasmodium knowlesi infection in a tertiary teaching hospital
    Azira NM, Zairi NZ, Amry AR, Zeehaida M
    Trop Biomed, 2012 Sep;29(3):398-404.
    PMID: 23018503 MyJurnal
    Plasmodium knowlesi is a simian malaria parasite and is recently recognized as the fifth malaria parasite infecting humans. Manifestation of the infection may resemble other infection particularly dengue fever leading to inappropriate management and delay in treatment. We reported three cases of naturally acquired P. knowlesi in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Clinical manifestations were quite similar in those cases. Microscopically, the diagnosis might be challenging. These cases were confirmed by polymerase chain reaction method which serves as a gold standard.
    Matched MeSH terms: Thrombocytopenia/diagnosis*; Thrombocytopenia/drug therapy; Thrombocytopenia/parasitology
  17. Fulltext A Descriptive Study of Blood Films of Patients Serologically Positive for Dengue in Hospital Tengku Ampuan Afzan, Kuantan.
    Rusmawati, I., Asma Hanim, H., Naznin, M., Salman, M.S., Norlelawati, A.T.
    International Medical Journal Malaysia, 2010;9(2):35-37.
    MyJurnal
    Introduction: Dengue is one of the commonest infections in Malaysia and it is a notifi able disease. Even
    though the diagnosis of classical dengue fever and dengue haemorrhagic fever can be recognized clinically, the diagnosis remains a challenge in areas where it could not be differentiated with other febrile illnesses. The aim of this study was to focus on the specifi c and consistent morphological features observed in blood fi lms of dengue infection. Materials and Methods: In all 400 cases of dengue infection serologically diagnosed in the Tengku Ampuan Afzan Hospital (HTAA) during May to October 2007, only a total of 27 cases had blood fi lms examined, and thus were included in this study. These blood fi lms were re-examined by two pathologists from HTAA. The full blood count parameters were also retrieved and studied. Results: We consistently found typical reactive lymphocytes [n= 23 (85%)] and thrombocytopenia [n=21, (77.8%)] in the cases. However, leucopenia was present only in 9 cases (33%). Conclusion: The presence of typical reactive lymphocyte is a consistent fi nding in dengue fever and thus could have a signifi cant role in supporting the diagnosis of dengue infection.
    Matched MeSH terms: Thrombocytopenia
  18. Fulltext Human hemoglobin G-Makassar variant masquerading as sickle cell anemia
    Mohamad AS, Hamzah R, Selvaratnam V, Yegapan S, Sathar J
    Hematol Rep, 2018 Sep 05;10(3):7210.
    PMID: 30344984 DOI: 10.4081/hr.2018.7210
    Human hemoglobin of G-Makassar variant has been reported very rarely with Beta Thalassemia. In year 1969 Hb GMakassar was first identified in Makassar, Sulawesi (Celebes), Republic of Indonesia. The disease was first published in 1969 and 33 years later it has been reported at a family of Thailand origin. We report a 45-yearold Malay man who was investigated for anemia and thrombocytopenia then diagnosed with Hb G-Makassar. This finding describes as a new Hemoglobin GMakassar discovered in Malaysia after 14 years diagnosed in Thailand.
    Matched MeSH terms: Thrombocytopenia
  19. Persistent thrombocytopenia following dengue fever: What should we do?
    Boo YL, Lim SY, P'ng HS, Liam C, Huan NC
    Malays Fam Physician, 2019;14(3):71-73.
    PMID: 32175045
    Thrombocytopenia is a common laboratory finding in dengue infection. However, it usually resolves as the patient recovers from the infection. Persistent thrombocytopenia following dengue infection requires further investigation. Here, we present a case of immune thrombocytopenic purpura (ITP) following dengue infection complicated by intracranial bleeding.
    Matched MeSH terms: Thrombocytopenia
  20. Fulltext The Pharmacotherapy of Heparin-Induced Thrombocytopenia (HIT) : A Review of Contemporary Therapeutic Challenges in Clinical Practice
    Hassan Y, Awaisu A, Al-Meman AA, Aziz NA
    Malays J Med Sci, 2008 Apr;15(2):3-13.
    PMID: 22589618
    Our objectives were to discuss a general overview on the description and recognition of heparin-induced thrombocytopenia (HIT) and present a critical review of the traditional and most recent advances in its pharmacotherapy. Computerized searches were done on MEDLINE and Iowa Drug Information Service (IDIS) databases from June 2001 until June 2007 and from May 2005 until May 2007, respectively. Search terms used included 'heparin-induced thrombocytopenia', 'heparin-associated thrombocytopenia', therapeutics, HIT, HAT. We largely selected publications within the timeframe above, but did not exclude commonly referenced and highly regarded older publications. The commonly referenced published articles were obtained through manual searches derived from bibliographic citations and retrievals from the authors' personal files. Pertinent literatures (89 key articles) that were thought to have substantially contributed new information to the therapeutics of HIT within the last 6 years were identified, reviewed and presented. The following limits were used for the MEDLINE and IDIS searches: 'human', drug therapy', 'review', 'meta-analysis', 'clinical trial', and case reports. The therapeutics of HIT is rapidly evolving and needs to consider an evidence - based approach. It is imperative that practitioners be aware of the associated risk and be up-to-date with the current advances in the management of this fatal clinical condition.
    Matched MeSH terms: Thrombocytopenia
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