Idiopathic Thrombocytopenic Purpura in Post COVID-19 Condition: Case Study

A 50 years old woman was referred to hospital with complaints of bluish black discoloration of skin or multiple ecchymosis since 6 days and skin rashes, pink changes or petechiae changes since 1 week, dark color stools since 3 days. She had a history of COVID-19 positive on past ‘‘3 months’’ back and she received the corticosteroids, antiviral drugs, broad spectrum antibiotics, anticoagulants, and vitamin B and C supplements. Now patient is admitted and investigated for further management. Her bone marrow examination reveals marrow cytological features are compatible with immune thrombocytopenic Purpura and peripheral examination reveals red cells are microcytic hypochromic with elongation forms, platelets are markedly reduced and elevation of CRP, reduction of the Hb, PCV, MCH, MCV, MCHC, APTT, Serum vitamin B12, Lymphocytes and her HRCT-Chest shows CORADS 5, Rapid antigen test shows positive. A review on introduction of the disease, etiology, pathogenesis, pathophysiology, mechanism of thrombocytopenia in COVID-19 patients and grading is explained in literature review.

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DIAGNOSIS AND TREATMENT: MANAGEMENT OF IDIOPATHIC THROMBOCYTOPENIC PURPURA

PEDIATRICS ◽

10.1542/peds.33.6.979 ◽

1964 ◽

Vol 33 (6) ◽

pp. 979-980

Author(s):

Irving Schulman

Keyword(s):

Idiopathic Thrombocytopenic Purpura ◽

Systemic Disease ◽

Purpura Fulminans ◽

Systemic Infection ◽

Bone Marrow Examination ◽

Rational Approach ◽

Thrombocytopenic Purpura ◽

Disease States ◽

History Of ◽

Acute Itp

THE TERM idiopathic thrombocytopenic purpura (ITP) should be reserved for that hemorrhagic disorder characterized by a subnormal platelet count (usually below 50,000/cu mm) in the presence of a normal marrow containing normal or increased megakaryocytes and the absence of systemic disease capable of inducing thrombopenia. Bone marrow examination is mandatory to rule out leukemia, other infiltrative disorders, and hypoplastic and aplastic states; an L.E. preparation is indicated as are the careful search for systemic infection and renal disease and the detailed inquiry concerning drug ingestion. Although no specific antecedent event can be identified in most cases of ITP, it is recognized that some of the common childhood exanthemata may occasionally be followed by thrombocytopenic purpura (e.g., rubella, rubeola, varicella). The rational approach to treatment must be based upon understanding of the natural history of the disease. Acute ITP has an excellent prognosis and approximately 80% affected children will make a complete and permanent recovery without specific therapy. Of these, three-quarters will recover within 3 months of onset, most within 4 to 6 weeks. Approximately 20% of cases will persist longer than 6 months and are then usually designated as chronic. The mortality rate in acute ITP is extremely low and most of the urgency for treatment stems from concern over central nervous system hemorrhage. It seems clear that the incidence of CNS bleeding is no greater than 2-4% and that in most series reporting a greater incidence cases were not limited to ITP but included instances of thrombotic thrombocytopenic purpura and purpura fulminans, i.e., disease states associated with vasculitis.

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Relation between serum vitamin B12 level and duration of treatment with carbamazepine in epilepsy patients

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v9i4.30371 ◽

2016 ◽

Vol 9 (4) ◽

pp. 223

Author(s):

Mohammad Tariqul Islam ◽

Khair M. Sobhan ◽

Mahjabin Rahman Shawly ◽

Shafiqur Saleheen ◽

Mohammad Masum Emran ◽

...

Keyword(s):

Correlation Coefficient ◽

Pearson Correlation ◽

Serum Vitamin ◽

Vitamin B ◽

Pearson Correlation Coefficient ◽

Duration Of Treatment ◽

Epileptic Patients ◽

History Of ◽

The Mean

Vitamin B12 levels in the serum of 58 epileptic patients receiving only carbamazepine for at least 6 months were measured. Same number of epilepsy patients with no history of taking antiepileptic medicine were taken as control. The mean level of vitamin B12 in carbamazepine-treated epileptic patients was 265.5 pg/mL whereas it was 478.3 pg/mL in control. Increased duration of treatment of carbamazepine in epilepsy caused significantly decreased level of serum vitamin B12 (Pearson correlation coefficient, r = -0.9, p<0.0001). In conclusion, serum vitamin B12 level significantly decreased in relation to duration of carbamazepine treatment in epileptic patients.

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Cecal Vitamin Bezoar Formation Inducing Abdominal Discomfort

Annals of Pharmacotherapy ◽

10.1177/106002809202600405 ◽

1992 ◽

Vol 26 (4) ◽

pp. 485-487 ◽

Cited By ~ 5

Author(s):

Ann K. Hunt-Fugate ◽

Harry J. Schmidt

Keyword(s):

Treatment Options ◽

Chief Complaint ◽

Abdominal Discomfort ◽

Vitamin B ◽

Magnesium Citrate ◽

X Ray ◽

History Of ◽

Community Teaching

OBJECTIVE: To document a case of cecal lecithin-vitamin B12 bezoar formation inducing abdominal discomfort. DESIGN: Case study. SETTING: 500-bed, community teaching hospital PATIENT: 81-year-old man with a history of multiple abdominal surgeries who presented with a chief complaint of abdominal pain. Flat plate X-ray of the abdomen revealed multiple capsule-shaped objects lodged in the cecum. INTERVENTIONS: Catharsis with bisacodyl, magnesium citrate, NaCl 0.9%; dissolution with heated, dilute barium administered rectally in conjunction with external manipulation; laparotomy. MAIN OUTCOME MEASURES: None planned; dissolution or transit of bezoar through gastrointestinal tract desired outcome. RESULTS/DISCUSSION: Classification of bezoars and treatment discussed in relation to this case report. CONCLUSIONS: Medicinal agents have been implicated in bezoar formation. Treatment options have included: cathartics, heated solvent enemas, and external manipulation and surgery.

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Nutritional B12 Deficiency in Infants of Vitamin B12-Deficient Mothers

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000080 ◽

2011 ◽

Vol 81 (5) ◽

pp. 328-334 ◽

Cited By ~ 6

Author(s):

Oya Halicioglu ◽

Sezin Asik Akman ◽

Sumer Sutcuoglu ◽

Berna Atabay ◽

Meral Turker ◽

...

Keyword(s):

Megaloblastic Anemia ◽

Maternal Diet ◽

Clinical Manifestations ◽

Serum Vitamin ◽

Failure To Thrive ◽

Clinical Findings ◽

Vitamin B ◽

Animal Products ◽

Hematological Evaluation ◽

Nutritional Vitamin

Aim: Nutritional vitamin B12 deficiency in infants may occur because the maternal diet contains inadequate animal products. Clinical presentations of the infants who had nutritional vitamin B12 deficiency were analyzed in this study. Subjects and Methods: Patients with nutritional vitamin B12 deficiency were enrolled in the study between 2003 and 2010. The diagnosis was based on a nutritional history of mothers and infants, clinical findings, hematological evaluation, and low level of serum vitamin B12. Results: Thirty children aged 1 - 21 months constituted the study group. Poverty was the main cause of inadequate consumption of animal products of the mothers. All infants had predominantly breastfed. The most common symptoms were developmental delay, paleness, apathy, lethargy, anorexia, and failure to thrive. Hematological findings were megaloblastic anemia (83.3 %), thrombocytopenia (30 %), and severe anemia (13.3 %). All of the mothers had low serum B12 levels; eight of them had megaloblastic anemia. Conclusion: The unusual clinical manifestations of vitamin B12 deficiency may also be seen apart from neurological and hematological findings. Nutritional vitamin B12 deficiency due to maternal deficiency might be a serious health problem in infants. Therefore, screening and supplementation of pregnant and lactating women to prevent infantile vitamin B12 deficiency should be considered.

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Serum Vitamin B12 Concentrations among Mothers and Newborns and Follow-up Study to Assess Implication on the Growth Velocity and the Urinary Methylmalonic Acid Excretion

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.79.56.297 ◽

2009 ◽

Vol 79 (56) ◽

pp. 297-307 ◽

Cited By ~ 3

Author(s):

Laila Hussein ◽

Sahar Abdel Aziz ◽

Salwa Tapouzada ◽

Boehles

Keyword(s):

Early Diagnosis ◽

Growth Velocity ◽

Methylmalonic Acid ◽

Post Partum ◽

Serum Vitamin ◽

Vitamin B ◽

Postnatal Life ◽

Negative Consequences ◽

Metabolic Marker ◽

Biochemical Measurement

Objective:Cobalamin (B12) deficiency has been reported in infants born to mothers with low cobalamin intake. Early diagnosis of vitamin B12 deficiency in infants is critical for the prevention of neurobehavioral disorders. We investigated the relationship between serum vitamin B12 level in newborns and in their healthy mothers who consumed an omnivorous diet. Anthropometry was studied longitudinally to assess the growth velocity of the infants. Urinary methylmalonic acid (MMA) excretion of 6-month old infants was compared retrospectively as the biomarker correlated with the initial serum vitamin B12 concentrations. Methods: Serum cobalamin and blood hemoglobin were determined in 84 pairs of newborns and their mothers. Urinary MMA excretion was measured in the same subjects during the first 6 months of the post partum period. Results: At birth, median serum cobalamin levels were 152.0 pmol/L in the mothers and 296.6 pmol/L in the newborns. Maternal and neonatal serum cobalamin levels had no effect on growth velocity during the first six months of postnatal life. Serum maternal and neonatal cobalamin levels were inversely associated with urinary MMA excretion. Conclusion: Early diagnosis of vitamin B12 status in neonates and infants is crucial, particularly in nutritionally deprived areas. Biochemical measurement of plasma cobalamin or its metabolic marker MMA is highly recommended. Urinary MMA measurement in cobalamin diagnostics provides an advantage in that blood sampling is not required. A vitamin B12 taskforce should be created to alleviate vitamin deficiency and its negative consequences.

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Press Propaganda and Subaltern Agents of Pan-Islamic Networks in the Muslim Mediterranean World prior to World War I

10.3366/edinburgh/9781474430616.003.0006 ◽

2018 ◽

Author(s):

Odile Moreau

Keyword(s):

Middle East ◽

World War I ◽

North Africa ◽

World War ◽

Subaltern Studies ◽

Resistance Movements ◽

The Press ◽

Mediterranean World ◽

History Of

This chapter explores movement and circulation across the Mediterranean and seeks to contribute to a history of proto-nationalism in the Maghrib and the Middle East at a particular moment prior to World War I. The discussion is particularly concerned with the interface of two Mediterranean spaces: the Middle East (Egypt, Ottoman Empire) and North Africa (Morocco), where the latter is viewed as a case study where resistance movements sought external allies as a way of compensating for their internal weakness. Applying methods developed by Subaltern Studies, and linking macro-historical approaches, namely of a translocal movement in the Muslim Mediterranean, it explores how the Egypt-based society, al-Ittihad al-Maghribi, through its agent, Aref Taher, used the press as an instrument for political propaganda, promoting its Pan-Islamic programme and its goal of uniting North Africa.

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Turning Aliens into Socialists

International Journal for the Study of New Religions ◽

10.1558/ijsnr.v1i1.75 ◽

2010 ◽

Vol 1 (1) ◽

pp. 75-93

Author(s):

Jessica Moberg

Keyword(s):

Outer Space ◽

The United States ◽

Second World War ◽

World War ◽

History Of ◽

Swedish History ◽

Second World ◽

The Universe ◽

Highly Evolved

Immediately after the Second World War Sweden was struck by a wave of sightings of strange flying objects. In some cases these mass sightings resulted in panic, particularly after authorities failed to identify them. Decades later, these phenomena were interpreted by two members of the Swedish UFO movement, Erland Sandqvist and Gösta Rehn, as alien spaceships, or UFOs. Rehn argued that ‘[t]here is nothing so dramatic in the Swedish history of UFOs as this invasion of alien fly-things’ (Rehn 1969: 50). In this article the interpretation of such sightings proposed by these authors, namely that we are visited by extraterrestrials from outer space, is approached from the perspective of myth theory. According to this mythical theme, not only are we are not alone in the universe, but also the history of humankind has been shaped by encounters with more highly-evolved alien beings. In their modern day form, these kinds of ideas about aliens and UFOs originated in the United States. The reasoning of Sandqvist and Rehn exemplifies the localization process that took place as members of the Swedish UFO movement began to produce their own narratives about aliens and UFOs. The question I will address is: in what ways do these stories change in new contexts? Texts produced by the Swedish UFO movement are analyzed as a case study of this process.

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