Oral Healthcare and Idiopathic Thrombocytopenic Purpura: Early Recognition, Dental Management and Case Report

A 47-year-old Caucasian man, in good general, oral and periodontal health, presented with a non-bleeding bluish lesion on the back of his tongue, presumably due to an ecchymotic area of traumatic origin which was left untreated. The day after, other ecchymotic-type lesions on the mucous membranes of the cheeks and the upper lip, a bleeding lesion at the apex of the tongue and gingivorrhagia, along with petechiae on the back, scalp, lower limbs and feet, occurred, with rapid clinical deterioration, requiring immediate hospitalization. Oral, dermatological, and hematological evaluations lead to idiopathic thrombocytopenic purpura (ITP) diagnosis and hydrocortisone prescription, with a complete recovery in the next few days.The presented case of ITP, with early intra-oral manifestations,aimed both to emphasize the role of oral healthcare workers in theearly recognition of ITP, which may be especially relevant for those cases with extremely fast platelet depletion, high risk of internal bleeding and consequent potentially fatal complications, and in the differential diagnosis of the diseasethat may be aided by the diagnostic protocol described, and to provide dentists with recommendations on oral care management of cases ofITP, both in dental and multi-disciplinary settings.

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Chronic subdural hematoma associated with idiopathic thrombocytopenic purpura in an elderly female: A rare case report

Romanian Neurosurgery ◽

10.1515/romneu-2016-0065 ◽

2016 ◽

Vol 30 (3) ◽

pp. 419-424

Author(s):

Sachin Chhabra ◽

Ashok Gupta

Keyword(s):

Idiopathic Thrombocytopenic Purpura ◽

Rare Case ◽

Chronic Subdural Hematoma ◽

Lower Limbs ◽

Fatal Complication ◽

Thrombocytopenic Purpura ◽

Young Females ◽

Elderly Female ◽

Surgical Evacuation ◽

Rare Case Report

Abstract Intracranial hemorrhage is the most fatal complication of idiopathic thrombocytopenic purpura(ITP) and is very rare(<1%) mostly in young females and intraparenchymal or subarachnoid in most of the cases. We report a case of 63 years of female presented with acute SDH with petechiae in both lower limbs and headache. After ruling out all causes patient was diagnosed as having idiopathic thrombocytopenic purpura(ITP).Considering her haematological and neurological profile patient was kept conservatively. Platelets and steroids were given to the patient following which platelet counts improved but patient deteriorated clinically. Hence patient was operated and surgical evacuation of SDH was done through burr hole. Although some studies have shown disappearance of chronic SDH with medical management, but it failed in our case and so surgical evacuation was done.

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Advances in the diagnosis of idiopathic thrombocytopenic purpura

Seminars in Hematology ◽

10.1053/shem.2000.8956 ◽

2000 ◽

Vol 37 (3) ◽

pp. 249-260 ◽

Cited By ~ 4

Author(s):

Beng H. Chong ◽

Tee Beng Keng

Keyword(s):

Idiopathic Thrombocytopenic Purpura ◽

Thrombocytopenic Purpura

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PAICA: A Method for Characterizing Platelet-Associated Antibodies - Its Application to the Study of Idiopathic Thrombocytopenic Purpura and to the Detection of Platelet-bound c7E3

Thrombosis and Haemostasis ◽

10.1055/s-0038-1650702 ◽

1996 ◽

Vol 76 (06) ◽

pp. 1020-1029 ◽

Cited By ~ 26

Author(s):

Laurent Macchi ◽

Gisèle Clofent-Sanchez ◽

Gérald Marit ◽

Claude Bihour ◽

Catherine Durrieu-Jais ◽

...

Keyword(s):

Monoclonal Antibody ◽

Flow Cytometry ◽

Idiopathic Thrombocytopenic Purpura ◽

Antithrombotic Therapy ◽

Membrane Glycoproteins ◽

Serum Antibodies ◽

Platelet Destruction ◽

Thrombocytopenic Purpura ◽

Capture Assay ◽

Specific Membrane

SummaryIn idiopathic thrombocytopenic purpura (ITP), autoantibodies reacting with antigens on the platelet membrane bring about accelerated platelet destruction. We now report PAICA (“Platelet-Associated IgG Characterization Assay”), a method for detecting autoantibodies bound to specific membrane glycoproteins in total platelet lysates. This monoclonal antibody (MAb) capture assay takes into account the fact that antibodies on circulating platelets may be translocated to internal pools as well as being on the surface. A total of twenty ITP patients were examined by PAICA, and the results compared with those obtained by measuring (i) serum antibodies bound to paraformaldehyde-fixed control platelets by ELISA, (ii) IgG bound to the surface of the patient’s own platelets by flow cytometry (PSIgG), (iii) total platelet-associated IgG (PAIgG) by ELISA and (iv) serum antibodies reacting with control platelets by MAIPA (“Monoclonal Antibody-specific Immobilization of Platelet Antigens”). Of twelve patients with elevated PAIgG, nine had increased PSIgG yet eleven reacted positively in PAICA. Of these, eight possessed antibodies directed against GP Ilb-IIIa, two against GP Ib-IX and one patient possessed antibodies directed against GP Ilb-IIIa and GP Ia-IIa respectively. Only seven of the patients possessed serum antibodies detectable by MAIPA. PAICA was also able to detect platelet-associated c7E3 (the chimeric form of Fab fragments of the MAb 7E3) following its infusion during antithrombotic therapy, when it proved more sensitive over a seven-day period than a MAIPA assay adapted for assessing surface-bound antibody. We propose that PAICA provides added sensitivity to the detection of platelet-associated antibodies in immune thrombocytopenias or following therapy with humanized MAbs.

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Pregnancy & Oral Health and Dental Management in Pregnant Patient

Journal of Current Medical Research and Opinion ◽

10.15520/jcmro.v3i11.360 ◽

2020 ◽

Vol 3 (11) ◽

Author(s):

Dr. Vishal Thakur ◽

Dr. Reetika Thakur ◽

Dr. Manpreet Kaur ◽

Dr. Jasleen Kaur ◽

Dr. Atul Kumar ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Oral Health ◽

Human Body ◽

Oral Hygiene ◽

Pregnancy Outcomes ◽

Oral Care ◽

Pregnant Patient ◽

Dental Management ◽

Exciting Time

Pregnancy is a unique, exciting time in a woman's life, and there are so many changes going on in human body during pregnancy and mouth is no exception , so good oral hygiene is extremely important during pregnancy . Usually oral health is often the most neglected form of health during all stages of life & the most important cause for this neglection is lack of awareness among people & this problems also increases when a lady is pregnant because of mis-perceptions and mis-leading information in the society or due to lack of knowledge. But the fact is during pregnancy many complex physiologic changes occur in the women’s body, which can adversely affect oral health and in turn those oral health problems may lead to pregnancy outcomes like preterm birth or low birth weight. Proper oral care is of utmost importance during pregnancy to avoid these complications. Avoiding foods that may cause oral problems, proper brushing and flossing and having dental consultations on a regular basis are steps to ensure good oral health during pregnancy.

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