Singh Abhay, Chaudhary Rajendra, Nityanand Soniya
Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India.
Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India.
Transfus Apher Sci. 2014 Feb;50(1):56-8. doi: 10.1016/j.transci.2013.07.035. Epub 2013 Nov 28.
This case represents the challenging role of automated cell separators in management of acute hemorrhagic crisis in a young female patient of essential thrombocythemia. A 17 year old girl having body weight of 41 kg presented to us with profuse nasal bleed. Complete blood counts revealed extremely high platelet counts of 2987×10(9)/l. Due to no response by oral hydroxyurea for last 2 months, urgent mechanical platelet reduction was planned to prevent further complication. A rebound phenomenon of increase in circulating platelet count was observed after every therapeutic platelet reduction. Seven procedures had to be performed on alternate days to bring down the platelet counts to less than 600×10(9)/l. Patient was maintained on oral anagrelide therapy and discharged in a stable condition after 14 days. Therapeutic platelet reduction causes rapid platelet reduction and helps in managing acute complications.
本病例体现了自动细胞分离器在一名年轻女性原发性血小板增多症患者急性出血危机管理中的挑战性作用。一名体重41公斤的17岁女孩因大量鼻出血前来就诊。全血细胞计数显示血小板计数极高，达2987×10⁹/L。由于过去两个月口服羟基脲无反应，计划紧急进行机械性血小板减少以预防进一步并发症。每次治疗性血小板减少后均观察到循环血小板计数增加的反弹现象。不得不每隔一天进行七次操作，以使血小板计数降至600×10⁹/L以下。患者接受口服阿那格雷治疗，14天后病情稳定出院。治疗性血小板减少可导致血小板快速减少，并有助于处理急性并发症。
