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Low levels of platelets in turn may lead to prolonged or excessive bleeding. It is the most common coagulation disorder among intensive care patients and is seen in a fifth of medical patients and a third of surgical patients. [3] A normal human platelet count ranges from 150,000 to 450,000 platelets/microliter (μL) of blood. [4]
Macrocytic anemias have several causes but with the implementation of folic acid fortification in North America, folate deficiency has become a rare cause of megaloblastic macrocytic anemia in that part of the world. [2] In this region, Vitamin B 12 deficiency is a far more common cause of megaloblastic macrocytic anemia. [2]
Methotrexate was originally developed and continues to be used for chemotherapy, either alone or in combination with other agents.It is effective for the treatment of several cancers, including solid tumours of breast, head and neck, lung, bladder, as well as acute lymphocytic leukemias, non-Hodgkin's lymphoma, osteosarcoma, and choriocarcinoma and other trophoblastic neoplasms.
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The anticonvulsant drug, lamotrigine, has been associated with a decrease in white blood cell count. [2] The FDA monograph for metronidazole states that this medication can also cause leukopenia, and the prescriber information suggests a complete blood count, including differential cell count, before and after, in particular, high-dose therapy. [3]
Methotrexate can also lead to pulmonary toxicity (lung damage), although this is fairly uncommon and more commonly it can confound the leukopenia caused by sarcoidosis. [19] Due to these safety concerns it is often recommended that methotrexate is combined with folic acid in order to prevent toxicity. [ 19 ]
A low level of blood Vitamin B 12 is a finding that normally can and should be treated by injections, supplementation, or dietary or lifestyle advice, but it is not a diagnosis. Hypovitaminosis B 12 can result from a number of mechanisms, including those listed above. For determination of cause, further patient history, testing, and empirical ...
Mild joint involvement can be effectively treated with NSAIDs, hydroxychloroquine, and oral prednisone. [71] [44] [25] Methotrexate has been observed to be useful in more severe cases. [72] If methotrexate is contraindicated, alternative disease-modifying medications for RA, such as leflunomide or azathioprine, may be used. [68]
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