Salous Abdelghaffar K, Zalatimo Omar
General Surgery, Sinai Hospital of Baltimore, Baltimore, USA.
Neurological Surgery, Sinai Hospital of Baltimore, Baltimore, USA.
Cureus. 2021 Jun 1;13(6):e15370. doi: 10.7759/cureus.15370. eCollection 2021 Jun.
Immune thrombocytopenia, also known as immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by a very low number of platelets and associated excessive bleeding. Primary ITP is a diagnosis of exclusion and secondary causes of ITP including lymphoproliferative disorders, medications, and certain infections must be ruled out during workup. This is the first report to highlight intraoperative ITP or an ITP-like novel variant in the perioperative setting leading to increased bleeding. The patient's extensive workup failed to reveal any secondary causative factors. The clinical presentation of ITP was transient. She received tranexamic acid (TXA), intravenous steroids, and intravenous immunoglobulins (IVIG) and recovered without complication. This case report explores a potentially underreported cause for intraoperative and postoperative hemorrhage in surgical patients.
免疫性血小板减少症,也称为免疫性血小板减少性紫癜(ITP),是一种自身免疫性疾病,其特征是血小板数量极低并伴有过度出血。原发性ITP是一种排除性诊断,在检查过程中必须排除ITP的继发性病因,包括淋巴增殖性疾病、药物和某些感染。这是第一份强调围手术期出现术中ITP或类似ITP的新型变体导致出血增加的报告。对该患者的全面检查未发现任何继发性致病因素。ITP的临床表现是短暂的。她接受了氨甲环酸(TXA)、静脉注射类固醇和静脉注射免疫球蛋白(IVIG)治疗,康复且无并发症。本病例报告探讨了手术患者术中及术后出血的一个可能未被充分报道的原因。