MyMedR

Glanzmann disease (thrombasthenia)--A case report

Zulkifli A

Med J Malaysia, 1979 Dec;34(2):174-5.

PMID: 575788

Matched MeSH terms: Purpura, Thrombocytopenic/diagnosis; Purpura, Thrombocytopenic/genetics*

Fulltext Helicobacter pylori infection in chronic immune thrombocytopenic purpura patients in Malaysia

Gan GG, Norfaizal AL, Bee PC, Chin EF, Habibah AH, Goh KL

Med J Malaysia, 2013 Jun;68(3):231-3.

PMID: 23749012 MyJurnal

Helicobacter Pylori has been implicated with a possible link to immune thrombocytopenia purpura (ITP) and studies have shown contradicting results in platelet recovery after eradication of H pylori infection.

Matched MeSH terms: Purpura, Thrombocytopenic, Idiopathic*

Splenectomy in idiopathic thrombocytopaenic purpura

Singh N

Med J Malaysia, 1974 Jun;28(4):257-9.

PMID: 4278838

Matched MeSH terms: Purpura, Thrombocytopenic/therapy*

Fulltext Detection of antiplatelet antibodies in patients with idiopathic thrombocytopenic purpura (ITP) by immunofluorescence

Pereira RA, Bosco J, Pang T

Singapore Med J, 1981 Aug;22(4):203-C.

PMID: 7034209

An immunofluorescence test (IFT) using platelet suspensions was used to detect the presence of serum anti-platelet antibodies (APA) in the sera of Malaysian patients with idiopathic thrombocytopenic purpura. Of the 28 patients tested, 19 (or 68%) had detectable APA with percentage platelet fluorescence ranging from 34% - 80% (mean 51% +/- 10). Normal sera gave fluorescence values of 6 - 15% (mean 9% +/- 5). Sera from patients with SLE, thyrotoxicosis and dengue haemorrhagic fever gave mean values of 29%, 8% and 9% respectively. Additionally, no apparent correlation was observed between percentage platelet fluorescence and the severity of thrombocytopenia. The importance and significance of these findings are discussed.

Matched MeSH terms: Purpura, Thrombocytopenic/immunology*

Primary versus secondary immune thrombocytopenia in adults; a comparative analysis of clinical and laboratory attributes in newly diagnosed patients in Southern Pakistan

Sultan S, Ahmed SI, Murad S, Irfan SM

Med J Malaysia, 2016 10;71(5):269-274.

PMID: 28064294

BACKGROUND: Immune thrombocytopenic purpura (ITP) is a hemorrhagic diathesis, characterized by platelets destruction alongside impaired production. Patients from Asian regions often exhibit distinctive characteristics in comparison to the western patients. We accomplished this study to evaluate the prevalence of primary versus secondary ITP along with the comparative analysis between them. The secondary objective was to determine the etiological spectrum of secondary ITP.

METHODS: We illustrate the results of a large cohort of newly diagnosed adults ITP from southern Pakistan. The study extended from January 2009-December 2013. Complete blood counts, HbsAg, Anti-HCV, ANA, stool for Helicobacterpylori were done on all. HIV, TSH, anti-dsDNA, RA factor, APLA and direct coombs test were evaluated in cases where indicated.

RESULTS: A total of 417 patients were included with a mean age of 40.95±14.82 years. Primarily disease was observed in the 3rd decade of life. Male to female ratio was 1:1.5. Mean platelets count was 46.21±27.45x109/l. At diagnosis 43.16% (n=180) patients had hemorrhagic manifestations whilst 56.8% (n=237) were asymptomatic. None of the patient presented with visceral, retropharyngeal or intracranial bleed. The prevalence of secondary ITP was substantially higher (64.8%) as compared to primary ITP (35.2%). Secondary ITP was predominantly seen in HCV reactive patients (24.4%) followed by helicobacter-pylori infection (11%). Nevertheless 16.4% patients had underlying autoimmune disorders. Providentially no study subject was found to be HIV reactive.

CONCLUSIONS: Our study revealed predominance of secondary ITP. However bleeding manifestations and degree of thrombocytopenia were high in primary-ITP. Infectious etiology followed by autoimmune disorders is mainly implicated for secondary ITP in our setting.

Matched MeSH terms: Purpura, Thrombocytopenic, Idiopathic/complications; Purpura, Thrombocytopenic, Idiopathic/diagnosis*; Purpura, Thrombocytopenic, Idiopathic/etiology

A four-point clinical criteria distinguishes immune thrombocytopenia from acute lymphoblastic leukaemia

Lum SH, How SJ, Ariffin H, Krishnan S

Med J Malaysia, 2016 02;71(1):28-9.

PMID: 27130741

Immune thrombocytopenia is the most common diagnosis of isolated thrombocytopenia. The dilemma encountered by paediatricians is missing diagnosis of acute leukaemia in children with isolated thrombocytopenia. We demonstrated childhood ITP could be diagnosed using a four point clinical criteria without missing a diagnosis of acute leukaemia. Hence, bone marrow examination is not necessary in children with typical features compatible with ITP prior to steroid therapy. This can encourage paediatricians to choose steroid therapy, which is cheaper and non-blood product, as first line platelet elevating therapy in children with significant haemorrhage.

Matched MeSH terms: Purpura, Thrombocytopenic, Idiopathic/diagnosis*

Kaposi's sarcoma following long term steroid therapy

Akmal SN, Wahab YA

Malays J Pathol, 1989 Aug;11:65-8.

PMID: 2633002

An 18-year-old Malay lady was treated with high dose steroids for three and a half years for idiopathic thrombocytopaenic purpura. At 21 years, after a series of relapses, a splenectomy was carried out. In addition, two nodules at the hilum of the spleen were also removed. Histological examination of these nodules revealed features of Kaposi's sarcoma. Kaposi's sarcoma resulting from immunosuppression by corticosteroids is rare. Our patient is the first such case reported in Malaysia.

Matched MeSH terms: Purpura, Thrombocytopenic/drug therapy

Fulltext Acquired platelet dysfunction with eosinophilia (APDE): an underrecognised condition

Ramanathan M, Duraisamy G

Med J Malaysia, 1987 Mar;42(1):53-5.

PMID: 3431503

We present three cases of Acquired Platelet Dysfunction with Eosinophilia (APDE). The importance of recognising this benign condition, which usually does not require any specific therapy, is stressed to avoid the pitfalls of diagnosing more serious bleeding disorders in children presenting with ecchymosis.

Matched MeSH terms: Purpura, Thrombocytopenic/blood

Fulltext Haemangioma-thrombocytopenia syndrome--a case report

Liam CK, Nuruddin R

Med J Malaysia, 1989 Sep;44(3):263-6.

PMID: 2626143

A 29 year old Chinese female who presented with spontaneous purpura, was found to have gross hepatomegaly and thrombocytopenia. The thrombocytopenia responded to steroid therapy but relapsed when the dose of steroid was tapered down. Subsequent investigations revealed that the hepatomegaly was due to a large haemangioma of her liver. For symptomatic hepatic haemangioma, surgical excision is the treatment of choice; this was refused by the patient.

Matched MeSH terms: Purpura, Thrombocytopenic/complications*

Fulltext A rare case of autoimmune hepatitis overlapping with autoimmune haemolytic anaemia and immune thrombocytopenic purpura in a male patient

Palaniappan S, Ramanaidu S

Med J Malaysia, 2012 Jun;67(3):326-8.

PMID: 23082427 MyJurnal

Matched MeSH terms: Purpura, Thrombocytopenic, Idiopathic/complications*; Purpura, Thrombocytopenic, Idiopathic/diagnosis; Purpura, Thrombocytopenic, Idiopathic/drug therapy

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: Purpura, Thrombocytopenic, Idiopathic

Fulltext Corticosteroid-responsive prolonged thrombocytopenia following dengue haemorrhagic fever

Leong KW, Srinivas P

Med J Malaysia, 1993 Sep;48(3):369-72.

PMID: 8183156

A case of prolonged thrombocytopenia following dengue haemorrhagic fever in a 15 year old boy is reported. The mechanism was presumed to be immunological and he responded dramatically to oral prednisolone.

Matched MeSH terms: Purpura, Thrombocytopenic, Idiopathic/drug therapy; Purpura, Thrombocytopenic, Idiopathic/etiology*

User-driven health care - answering multidimensional information needs in individual patients utilizing post-EBM approaches: a conceptual model

Biswas R, Martin CM, Sturmberg J, Shanker R, Umakanth S, Shanker S, et al.

J Eval Clin Pract, 2008 Oct;14(5):742-9.

PMID: 19018905 DOI: 10.1111/j.1365-2753.2008.00998.x

Evidence based on average patient data, which occupies most of our present day information databases, does not fulfil the needs of individual patient-centred health care. In spite of the unprecedented expansion in medical information we still do not have the types of information required to allow us to tailor optimal care for a given individual patient. As our current information is chiefly provided in disconnected silos, we need an information system that can seamlessly integrate different types of information to meet diverse user group needs. Groups of certain individual medical learners namely patients, medical students and health professionals share the patient's need to increasingly interact with and seek knowledge and solutions offered by others (individual medical learners) who have the lived experiences that they would benefit to access and learn from. A web-based user-driven learning solution may be a stepping-stone to address the present problem of information oversupply in medicine that mostly remains underutilized, as it doesn't meet the needs of the individual patient and health professional user. The key to its success would be to relax central control and make local trust and strategic health workers feel more engaged in the project such that it is truly user-driven.

Matched MeSH terms: Purpura, Thrombocytopenic, Idiopathic/diagnosis; Purpura, Thrombocytopenic, Idiopathic/psychology; Purpura, Thrombocytopenic, Idiopathic/therapy

Fulltext Spontaneous intracranial haemorrhage in children with chronic immune thrombocytopenic purpura

Muda Z, Ibrahim H, Abdulrahman EJ, Mahfuzah M, Othman IS, Asohan T, et al.

Med J Malaysia, 2014 Dec;69(6):288-90.

PMID: 25934964 MyJurnal

Spontaneous intracranial haemorrhage (ICH) is a rare complication of chronic immune thrombocytopenic purpura (ITP) in children. We report four patients with cITP who developed ICH. The latency between onset of ITP and ICH varied from 1-8 years. All our patients were profoundly thrombocytopenic (platelet count of <10 x 109/l) at the time of their intracranial bleed. The presenting features and management are discussed. All patients survived, three had complete neurological recovery while one had a minimal residual neurological deficit.

Matched MeSH terms: Purpura, Thrombocytopenic, Idiopathic

Essential thrombocytopenia

Haridas G

Journal of the Malaya Branch of the British Medical Association, 1940;4:198-204.

Matched MeSH terms: Purpura, Thrombocytopenic

Extragastrointestinal manifestations of Helicobacter pylori infection: facts or myth? A critical review

Tan HJ, Goh KL

J Dig Dis, 2012 Jul;13(7):342-9.

PMID: 22713083 DOI: 10.1111/j.1751-2980.2012.00599.x

Helicobacter pylori (H. pylori) infection is reported to be associated with many extragastrointestinal manifestations, such as hematological diseases [idiopathic thrombocytopenic purpura (ITP) and unexplained iron deficiency anemia (IDA)], cardiovascular diseases (ischemic heart diseases), neurological disorders (stroke, Parkinson's disease, Alzheimer's disease), obesity and skin disorders. Among these, the best evidence so far is in ITP and unexplained IDA, with high-quality studies showing the improvement of IDA and ITP after H. pylori eradication. The evidence of its association with coronary artery disease is weak and many of the results may be erroneous. The role of H. pylori infection in affecting serum leptin and ghrelin levels has attracted a lot of attention recently and available data to date have been conflicting. There have also been many uncontrolled, small sample studies suggesting an association between H. pylori infection and neurological disorders or chronic urticaria. However, more studies are required to clarify such proposed causal links.

Matched MeSH terms: Purpura, Thrombocytopenic, Idiopathic/microbiology

Fulltext Adult idiopathic thrombocytopenic purpura without the option of splenectomy

Jackson N, Mustapha M, Baba AA

Med J Malaysia, 1995 Sep;50(3):250-5.

PMID: 8926904

In this part of Malaysia, consent of splenectomy is virtually unobtainable, so we studied the outcome of ITP without this treatment option. Thirty-two adult patients were seen, but 7 defaulted before therapy evaluation. Of the remaining 25, 17 achieved a complete remission with prednisolone, but in only 8 was this prolonged. Twelve patients, who failed to respond to prednisolone or who required > 15 mg/day as maintenance, were offered splenectomy, but all fused. Of these 12: one has died from an intracranial haemorrhage; three others have defaulted while on no treatment with platelet counts of < 16 x 10(9)/1; one has had a baby who died from intracranial bleeding. The other seven patients have platelet counts ranging from 4 - 202 x 10(9)/1 with moderate bleeding on doses of prednisolone of 0-60 mg/day: long-term corticosteroid side-effect are evident in all but one of them. This study demonstrates that ITP patients who refuse splenectomy have a high morbidity.

Matched MeSH terms: Purpura, Thrombocytopenic/drug therapy*

Unlicensed medical practice in West Malaysia

Chen PC

Trop Geogr Med, 1971 Jun;23(2):173-82.

PMID: 4327992

Matched MeSH terms: Purpura, Thrombocytopenic/complications

Fulltext Efficacy of helicobacter pylori eradication as an upfront treatment of secondary immune thrombocytopenia: an experience from Pakistan

Sultan S, Irfan SM, Kaker J, Hasan M

Med J Malaysia, 2016 04;71(2):53-6.

PMID: 27326941

BACKGROUND: The effect of Helicobacter-pylori eradication therapy on the platelet counts in patients with immune thrombocytopenia is still debatable. The aim of this study was to assess the response rates of standard triple eradication therapy in secondary immune thrombocytopenia with Helicobacter pylori infection.

METHODS: From January 2012 to December 2013, 197 patients were diagnosed to have immune thrombocytopenia, out of which 22(11.1%) patients infected with Helicobacter- Pylorus were enrolled in this study. Helicobacter-Pylori infection was documented by Helicobacter-pylori stool antigen enzyme immunoassay method. All positive patients were put on triple eradication therapy. The responses rates to treatment were defined as per International Working Group on ITP.

RESULTS: Mean age of patients was 43.18±12.5 years. There were 10(45.5%) males and 12 (54.5%) females. Of the 22 patients, 7(31.8%) exhibited a complete response (CR) to Hpylori eradication therapy; 10(45.4%) attained a response; and 5(22.7%) had no response. Mean base line platelet counts were 53.36±24.5x109/l, while platelet counts at 4 week following eradication was 80.86±51.0x109/l (P=0.003). The predictive factor of response following eradication therapy was baseline platelet counts. Virtually all responders had baseline platelet counts >30x109/l and all non-responders had <30x109/l of platelet counts.

CONCLUSIONS: Though the prevalence of H-pylori is low, this study confirmed the efficacy of eradication in increasing the platelet counts in H-pylori positive patients with ITP. It is an important measure in short time, safe and very cost effective to achieve platelets increment. We endorse the routine detection and eradication treatment of H-pylori infective ITP patients.

Matched MeSH terms: Purpura, Thrombocytopenic, Idiopathic/complications*

A case of immune thrombocytopenic purpura with prolonged aPTT time: A clotter hidden in a bleeder?

Lee MH, Khoo PJ, Gew LT, Ng CF

Med J Malaysia, 2017 12;72(6):365-366.

PMID: 29308775 MyJurnal

We report the case of a 23-year-old woman who presented with prolonged menstruation and multiple bruises on the limbs and trunk. Investigations revealed severe thrombocytopenia and deranged coagulation profile with markedly prolonged activated partial thromboplastin time (aPTT). Lupus anticoagulant, anti-cardiolipin antibody and anti-beta-2-glycoprotein 1 antibody were positive. She was diagnosed with Immune Thrombocytopenic Purpura (ITP) with positive antiphospholipid antibody serology and given a course of intravenous methylprednisolone and tapering doses of oral prednisolone. She was steroid free and had no bleeding or thrombotic event over two years follow up.

Matched MeSH terms: Purpura, Thrombocytopenic, Idiopathic/drug therapy*

Displaying publications 1 - 20 of 24 in total