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This results in platelet activation and the formation of platelet microparticles, which initiate the formation of blood clots; the platelet count falls as a result, leading to thrombocytopenia. [1] [7] In addition, the reticuloendothelial system (mostly the spleen) removes the antibody-coated platelets, further contributing to the thrombocytopenia.
Higher platelet transfusion thresholds have been used in premature neonates, but this has been based on limited evidence. [19] There is now evidence that using a high platelet count threshold (50 x 10 9 /L) increases the risk of death or bleeding compared to a lower platelet count threshold (25 x 10 9 /L) in premature neonates. [20]
Most patients will be able to self-administer the drug after appropriate training. Patients with severe renal impairment should receive only 25 μg/kg daily. The first dose should be given 6 to 24 hours after completion of chemotherapy. Dosing should be continued until platelet counts reach at least 50,000 cells.
Platelet count increase as well as platelet survival after transfusion is related to the dose of platelets infused and to the patient's body surface area (BSA). Usually these values are less than what would be expected. Corrected platelet count increment (CCI) = platelet increment at one hr x BSA (m 2) / # platelets infused x 10 11
A normal human platelet count ranges from 150,000 to 450,000 platelets/microliter (μL) of blood. [4] Values outside this range do not necessarily indicate disease. One common definition of thrombocytopenia requiring emergency treatment is a platelet count below 50,000/μL. [ 5 ]
EDTA-dependent agglutination. In some individuals, clinically insignificant antibodies may cause in vitro agglutination of platelets. As a result of platelet clumping, platelet counts reported by automated counters may be much lower than the actual count in the blood because these devices cannot differentiate platelet clumps from individual cells.
Symptoms of ITP include abnormal bleeding and bruising due to the reduction in platelet count. [20] Rh o (D) Immune Globulin Intravenous [Human; Anti-D] is indicated for use in non-splenectomized, Rh o (D)-positive children with chronic or acute ITP, adults with chronic ITP, and children and adults with ITP secondary to HIV infection. Anti-D ...
Indications for treatment of pregnant people with ITP include the presence of bleeding, platelet counts less than 20-30,000, planned procedures (such as an amniocentesis), and raising platelet levels prior to delivery (the minimum platelet level for a vaginal delivery is 30,000 and for a cesarean section is 50,000). [63]
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