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LITERATURE NO. FINDINGS CLAIMS EVIDENCE

1) The Frequency andClinical Significance ofThrombocytopenia

Complicating Critical Illness

-Thrombocytopenia appearsto increase the risk of death-The main concern for the

critically illthrombocytopenic patient isbleeding-Thrombocytopenia was anindependent predictor ofdeath among critically illpatients in most studies

-Literature nos. 2 & 4presents similarity that ITPare most common in

children.

- Literature nos.2 & 7presented that VWFsfunction affect in Plateletand hemostasis

- Literature nos. 2 & 3proved that Autoimmunediseases and bleedingdisorders have genetic

linkage

- drug of choice common inITP is steroids based onliterature nos. 6, & 4however it was contrast inliterature no.9 because thestudy shown that there is aremission in takingprednisone

-ITP is common in SouthAfrica based on literaturenos.10 & 4

- Weakness, bruising andbleeding is commonsymptoms of ITP that wascited on literature nos. 4 &8

-6 out of 8 studies usingmultivariate analysis foundthat thrombocytopenia

increased the risk of death-5 studies ofthrombocytopenia in theICU reported bleedingoutcomes-5 out of 8 studies weremore likely to receive RBCtransfusions-6 out of 8 studies foundthat thrombocytopenia wasan independent predictor of

death2) Evaluating the child withpurpura

-both genders are equallyaffected-anemia withthrombocytopenia indicatesleukemia-platelet disorder presentvasculitic disorder includingVWF-chronic idiopathicthrombocytopenic purpura

is more likely in teenagegirls and children-genetic counseling is usefulin families with inheritedbleeding disorder

-Idiopathicthrombocytopenic purpurais usually a temporarydisorder, with 80 to 90percent of childrenrecovering within 6-12months, usually within afew weeks

3) Autoimmune diseases ina Nigerian woman-A casereport

-genetic influence via thehistocompatibility leukocyteantigen is prominent amongthe autoimmune disease

-presence of combinationsof autoimmune diseasespectrum in this case aswell as the presence ofvitiligo in her daughter may

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-Thrombocytopenia/ ITP isa rare condition and itsserious if not treatedcorrectly

well suggest a genetic link-the roles of genetic,environmental andimmunoregulatory factorswere outlined by Van Noort

et al, when they reinforcedthe multifactorial origin ofautoimmunity

4) A survey of themanagement of idiopathicthrombocytopenic purpurain South Africa: Do we needguidelines for developingcountries

-steroids were the first lineof choice in treating ITP-ITP is the most commonbleeding disorder ofchildhood-ITP is the most commonbleeding disorder inchildren in south africa

-vast majority of doctorswould prescribe steroids orimmunoglobulins-most cases are treated inacademic centers indicatinga high rate referrals

5) The Diagnostic dilemmaof thromboticthrombocytopenicpurpura/hemolytic uremicsyndrome in the obstetrictriage and emergencydepartment: lessons from 4tertiary hospitals

-TTP /HUS are both rare-the most common reportedsymptoms includeweakness, bleeding, andeasily bruisabilty

-they afflict 1 in 100,000pregnancies to 1:1,000,000people in generalpopulation

6) International consensusreport on the investigation

and management ofprimary immunethrombocytopenia

-ITP is an acquired immunemediated disorder

characterized by isolatedthrombocytopenia, definedas a peripheral bloodplatelet, count less than100X10g/L-incidence in adults isapproximately equal for thesexes-Corticosteroids are thestandard initial treatment

-a positive directantiglobulin test (DAT) was

found in 22% of 205patients with ITP

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-Prednisone is the standardinitial first line therapy forITP patients

7) The Laboratory diagnosisof Platelet disorder

- an abnormality of VWF hasbleeding symptoms verysimilar to plateletdysfunction, and evaluationfor von Willebrand diseaseshould be included in theinitial evaluation of apossible platelet disorder

-platelets adhere to VWFand to fibrinogen throughglycoprotein receptoraccording to Arch PatholLab Med-Vol 126, February2002 Laboratory Diagnosisof Platelet Disorders-Kottke-Marchant et al

8) Current Concepts inThromboticThrombocytopenic Purpura

-Patients typically presentwith weakness,pallor,petechiae, headacheor subtle mental changes.Ifnot treated, the diseasemay rapidly deteriorate tostupor, coma or cardiacarrest

-TTP ha reduced its casefatality from 90% to 10%-20% by the use of plasmainfusion and plasmaexchange

9)Autoimmunethrombocytopenic Purpuraand Common VariableImmuodeficiency: Analysisof 21 Cases and review ofthe literature

-steroids seem to have thesame efficacy as inidiopathic AITP, but theincreased risk of severeinfections must be takeninto considerations-AITP I not prevented by

IVIG substitutive therapy

-62% were in treatment freeremission and 23% where inremission while onprednisone

10) Platelet Counts andmean Platelet VolumeAmongst elderly Nigerians

-healthy elderly and youngadult control femaleshaving higher plateletcounts than the elderly andyoung adult control males-there is need for separatevalues for platelet countand mean platelet volumefor the elderly

-Lazomo et al(1998)reported sex difference inplatelet count with highervalues in females than inmales-study suggests that thereis significant difference inplatelet count between thehealthy elderly subjects and

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young adult control