COAGULOPATHY
Q1. What are the most likely causes of this patient’s thrombocytopenia and lack of response to platelets transfusion?
The possible cause for the patient’s condition is the administration of cephalosporin antibiotics after the surgery exercise. A high concentration of cephalosporin adversely affects proteins amalgamation hence resulting in low counts of platelets in the human body. Since the functioning of platelets is affected by the introduction of cephalosporin, the count is relatively small than usual. After the transfusion, the patient does not respond to the platelets since the antibiotic inhibits most enzymes present in the blood. The patient therefore continues to have a low count even after receiving transfused platelets.
Q2. What is the appropriate laboratory evaluation to confirm the diagnosis?
When confirming the diagnosis, the patient is subjected to a blood test to count the number of blood platelets in a sample blood. Adults normally contain between 150,000 to 450,000 platelets in every one microliter of blood hence a lower value confirms the condition. Additionally, the doctor may physically examine the patient’s skin and abdomen and obtain information about medical history.
Q3. What is the appropriate therapy?
The most preferred therapy for this condition requires treatment of the cause of thrombocytopenia. The doctor will change the prescription of cephalosporin antibiotics to enable the patient to regain her platelet count. Alternatively, the doctor may perform another blood transfusion to introduce new platelets in the woman’s body.
Case 1-11
Q1. Can the petechiae be explained by the platelet count alone?
No. In this case, the petechiae develop due to both the low platelets count and the noninfectious condition myeloid leukemia. Since further evaluation revealed the presence of the acute leukemia-M2 condition, then the petechiae are caused by both the low platelet countdown and leukemia.
Q2. What explains the bleeding tendency?
The persistent bleeding is as a result of low platelets counts in the blood. The absence of enough platelets renders the body vulnerable to form clots, thus causing petechiae. Moreover, bleeding can occur due to the presence of blasts in the blood.
Q3. What other acquired disorders produce bleeding by a similar mechanism?
Other disorders that possess similar bleeding characteristics include the Von Willebrand disease, sickle-cell disease, and hemophilia.
Q4. What is the appropriate therapy?
The most preferred therapy for this condition involves administering medications that increase the number of blood cells in the body, stimulate maturity of blood cells, suppress the patient’s immune system. The doctor can also prescribe antibiotics that treat the infections.