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Drug-induced thrombocytopenic purpura is a skin condition result from a low platelet count due to drug-induced anti-platelet antibodies caused by drugs such as heparin, sulfonamides, digoxin, quinine, and quinidine. [1]: 821
Treatment is guided by the severity and specific cause of the disease. Treatment focuses on eliminating the underlying problem, whether that means discontinuing drugs suspected to cause it or treating underlying sepsis. Diagnosis and treatment of serious thrombocytopenia is usually directed by a hematologist.
The 4T score for heparin-induced thrombocytopenia [9] [10] Thrombocytopenia 2 points if the fall in platelet count is >50% of the previous value, AND the lowest count (nadir) is 20–100 × 10 9 /liter 1 point if the fall is 30–50% or the nadir is 10–19 × 10 9 /liter No points if the fall is less than 30% or the nadir is <10 × 10 9 /liter ...
Other causes of thrombocytopenia which may occur in pregnancy, such as drug induced thrombocytopenia, hereditary thrombocytopenia and pseudothrombocytopenia should also be ruled out. [63] ITP can be difficult to distinguish from gestational thrombocytopenia (which is by far the most common cause of thrombocytopenia in pregnancy). Unlike ITP ...
Thrombotic thrombocytopenic purpura (TTP) initially presents with a range of symptoms that may include severe thrombocytopenia (platelet count usually < 30,000/mm³), microangiopathic hemolytic anemia (evidenced by schistocytes in the blood smear), and various clinical signs such as petechiae, purpura, neurologic symptoms, myocardial ischemia ...
The specific cause is dependent of the type of TMA that is presented, but the two main pathways that lead to TMA are external triggers of vascular injury, such as viruses, bacterial Shiga toxins or endotoxins, antibodies, and drugs; and congenital predisposing conditions, including decreased levels of tissue factors necessary for the coagulation cascade.
By tradition, the term idiopathic thrombocytopenic purpura is used when the cause is idiopathic, or unknown. However, most cases are now considered to be immune-mediated. [citation needed] Another form is thrombotic thrombocytopenic purpura. [citation needed]
Heparin is contraindicated for suspected cases of vaccine-induced pro-thrombotic immune thrombocytopenia (VIPIT) secondary to SARS-CoV-2 vaccination, as heparin may further increase the risk of bleeding in an anti-PF4/heparin complex autoimmune manner, in favor of alternative anticoagulant medications (such as argatroban or danaparoid). [7] [8] [9]
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