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Fulltext Hematological changes in tuberculous spondylitis patients at the Hospital Universiti Sains Malaysia

Muzaffar TM, Shaifuzain AR, Imran Y, Haslina MN

Southeast Asian J Trop Med Public Health, 2008 Jul;39(4):686-9.
PMID: 19058606

In this study, we compared the platelet count with erythrocyte sedimentation rates (ESR) in patients with tuberculous spondylitis to evaluate the correlation. This was a retrospective 3-year study covering January 2004 to December 2006 at the Hospital Universiti Sains Malaysia. Platelet counts, hemoglobin levels, ESR, peripheral blood counts and peripheral blood smears on 17 patients with tuberculous spondylitis were obtained. The ages of the patients ranged from 20- to 70-years-old. The male to female ratio was 3.2:1. The majority of the patients were anemic (88.2%) and 52.9% of the patients had thrombocytosis. All the patients had normal lymphocyte counts and a high in ESR at diagnosis. There was a linear correlation between the platelet count and ESR (r = 0.60, p < 0.01). The platelet count was also significantly correlated with the hemoglobin level (r = -0.6, p < 0.02). The degree of thrombocytosis was related to the degree of inflammation measured by the ESR. Thrombocytosis also correlated with the hemoglobin level. We suggest that evaluating hematological values in suspected cases of tuberculosis should be considered. The presence of hematological changes should raise the suspicion of tuberculosis in spondylitis patients.

Matched MeSH terms: Thrombocytosis/blood; Thrombocytosis/microbiology
Fulltext Two cases of pseudohyperkalemia that occurred after emergency splenectomy: what goes up, will come down

Tan, G.H., Nor Faezan, A.R., Hairol, A.O., Bong, J.J.

Journal of Surgical Academia, 2011;1(1):32-34.
MyJurnal

Pseudohyperkalemia is a spuriously high serum potassium measurement in a patient with no clinical evidence of hyperkalemia. It has been reported to occur in patients with leukocytosis and thrombocytosis. Only a few cases of pseudohyperkalemia have been reported in patients after splenectomy. Two cases of pseudohyperkalemia occurring after emergency splenectomy for abdominal trauma are presented to highlight their clinical presentation and sequalae. Consecutive patients who underwent emergency splenectomy for trauma and subsequently developed pseudohyperkalemia were monitored in Universiti Kebangsaan Malaysia Medical Centre for their clinical sequalae. Both the patients developed leukocytosis, thrombocytosis and high serum potassium level within 2-weeks of their splenectomies. They did not demonstrate any symptoms and signs of hyperkalemia. Their conditions resolved spontaneously without any specific treatment. Pseudohyperkalemia should be suspected in a similar clinical scenario to avoid unnecessary treatment that could lead to severe hypokalemia.

Matched MeSH terms: Thrombocytosis
Fulltext Clozapine and Polycythemia Rubra Vera: a rare side effect or a separate medical condition? – a case report

Tan, H.P.J.

Malaysian Journal of Psychiatry, 2016;25(2):0-0.
MyJurnal

This article highlights the case of a 44-year old Malay man who is diagnosed as having treatment resistant schizophrenia on Clozapine, which then developed Polycythemia Rubra Vera (PRV). It is known that a major side effect for Clozapine is of agranulocytosis, that is a potentially fatal side effect. However, there have been reported disturbances of other hematological parameters, which result in other abnormalities including leucopenia, leucocytosis, thrombocytopenia, thrombocytosis and eosinophilia. Could this case be a pure medical condition of PRV or is there a relation to the effects of Clozapine? In this paper, the aim is to report a case of blood dyscrasia in a 44-year old male who developed Polycythemia Rubra Vera a year after he was observed to have abnormal full blood count results.

Matched MeSH terms: Thrombocytosis
Fulltext BCR-ABL positive essential thrombocythaemia: a variant of chronic myelogerous leukaemia or a distinct clinical entity: a special case report

Fadilah SA, Cheong SK

Singapore Med J, 2000 Dec;41(12):595-8.
PMID: 11296785

A 37-year-old Malay man presented initially with the clinical picture of essential thrombocythaemia (ET) without the extreme leukocytosis, marked splenomegaly and low neutrophil alkaline phosphatase characteristic of chronic myelogenous leukaemia (CML). Bone marrow examination showed massive megakaryocytic hyperplasia; cytogenetic studies showed the presence of Philadelphia chromosome. The patient was treated with hydroxyurea that resulted in reduction in the platelet count. Seventeen months later, he presented with fever associated with tender massive splenomegaly. Bone marrow finding was consistent with chronic phase CML. The presence of a rearrangement involving the major breakpoint cluster region (M-bcr) on chromosome 22 was confirmed by reverse transcriptase-polymerase chain reaction. The clinical importance of finding the Philadelphia chromosome in patients who seem to have ET is in assessing prognosis. ET generally follows a chronic, indolent course. However, this patient who had Philadelphia chromosome underwent clinical transition to chronic phase CML17 months and blast crisis 29 months after presentation.

Matched MeSH terms: Thrombocytosis/diagnosis*; Thrombocytosis/drug therapy; Thrombocytosis/genetics
Factors associated with ultrasound-guided water enema reduction for pediatric intussusception in resource-limited setting: potential predictive role of thrombocytosis and anemia

Lim RZM, Lee T, Ng JYZ, Quek KF, Abdul Wahab N, Amansah SL, et al.

J Pediatr Surg, 2018 Nov;53(11):2312-2317.
PMID: 29459045 DOI: 10.1016/j.jpedsurg.2018.01.004

BACKGROUND/PURPOSE: Although ultrasound-guided hydrostatic reduction (USGHR) is increasingly used in managing pediatric intussusception, there is limited literature concerning its use in Malaysia. We aim to examine the experience and factors associated with the effectiveness of USGHR using water.
METHODS: This is a single-center retrospective observational study in a Malaysian tertiary referral center. Children with intussusception admitted between year 2012 and 2016 were included and medical records reviewed. Factors associated with success or failure of USGHR were identified using multivariable logistic regression.
RESULTS: Of the 172 cases included, 151 cases (87.8%) underwent USGHR, of whom 129 cases were successfully reduced (success rate of 85.4%). One perforation (0.7%) was reported. Age more than 3years old (aOR=7.16; 95% CI=1.07-47.94; p=0.042), anemia (aOR=10.12; 95% CI=1.12-91.35; p=0.039), thrombocytosis (aOR=11.21; 95% CI=2.06-64.33; p=0.005) and ultrasound findings of free fluid (aOR=9.39; 95% CI=1.62-54.38; p=0.012) and left-sided intussusception (aOR=8.18;95% CI=1.22-54.90, p=0.031) were independently associated with USGHR irreducibility. Symptom duration, blood in stool, vomiting and other clinical presentations, however, showed no association.
CONCLUSIONS: USGHR with water is effective in the non-operative management of pediatric intussusception. Prolonged symptom duration need not necessarily preclude USGHR. The findings of anemia and thrombocytosis as independent predictors of USGHR irreducibility deserve further study.
TYPE OF STUDY: Treatment study LEVEL OF EVIDENCE: III.

Matched MeSH terms: Thrombocytosis/complications*
Fulltext Diplopia in a post-splenectomy Thalassemic patient

Neoh, Pei Fang, Tai, Evelyn L.M., Liza Sharmini A.T.

Journal of Biomedical and Clinical Sciences, 2017;2(2):26-28.
MyJurnal

We report a case of cavernous sinus thrombosis in a post-splenectomy male with underlying Haemoglobin E Thalassemia major. A 35-year-old man presented with a first episode of sudden onset of diplopia on lateral gaze for 1 week. He had no other ocular and systemic symptoms. There was no history of trauma or recent infection. However, he admitted that he was not compliant to his oral penicillin V and aspirin, which was prescribed to all post splenectomy patients. Unaided visual acuity in both eyes was 6/6. On examination, there was limited abduction over the left eye, suggestive of left lateral rectus palsy. Full blood count revealed leucocytosis with thrombocytosis. Magnetic resonance imaging, magnetic resonance angiography and magnetic resonance venography of the brain showed bulging of the left cavernous sinus, with a persistent focal filling defect, in keeping with left cavernous sinus thrombosis (CST). He was diagnosed with left isolated sixth nerve palsy secondary to aseptic cavernous sinus thrombosis with pro-thrombotic state post-splenectomy. He was started on subcutaneous fondaparinux and oral warfarin. His diplopia fully resolved after 1 month of treatment with complete resolution of CST on computed tomography venogram.

Matched MeSH terms: Thrombocytosis