Thrombocytopenia natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2], Farbod Zahedi Tajrishi, M.D. [2]
Overview
Natural History
Studies on the natural history of thrombocytopenia are limited and the natural history itself depends enormously on the underlying cause of thrombocytopenia. In one study on 217 asymptomatic individuals with mild thrombocytopenia, the following results were reported at six month of observation:[1]
- 23 (11 percent) improved and had normal platelet counts
- two developed MDS
- one patient developed SLE.
- Low platelet count persisted in the remainder of participants (191 individuals; 88 percent), but they didn't develop any symptoms.
After five years of follow-up, the majority of participants (64 percent) either experienced:
- spontaneous resolution of thrombocytopenia, or
- persistent mild thrombocytopenia without development of an associated condition, suggesting a diagnosis of ITP.
Complications
Prognosis
Generally, the prognosis of thrombocytopenia depends on its underlying cause. In acute coronary syndrome trials and ST elevation MI trials, thrombocytopenia has been associated with an increase risk of major bleeding, transfusion, recurrent MI, stroke and both in-hosptial and 30 day mortality. [2][3][4][5]
References
- ↑ Stasi R, Amadori S, Osborn J, Newland AC, Provan D (2006). "Long-term outcome of otherwise healthy individuals with incidentally discovered borderline thrombocytopenia". PLoS Med. 3 (3): e24. doi:10.1371/journal.pmed.0030024. PMC 1326262. PMID 16401142.
- ↑ Gore JM, Spencer FA, Gurfinkel EP, López-Sendón J, Steg PG, Granger CB, FitzGerald G, Agnelli G (2009). "Thrombocytopenia in patients with an acute coronary syndrome (from the Global Registry of Acute Coronary Events [GRACE])". The American Journal of Cardiology. 103 (2): 175–80. doi:10.1016/j.amjcard.2008.08.055. PMID 19121432. Retrieved 2010-06-30. Unknown parameter
|month=ignored (help) - ↑ Merlini PA, Rossi M, Menozzi A, Buratti S, Brennan DM, Moliterno DJ, Topol EJ, Ardissino D (2004). "Thrombocytopenia caused by abciximab or tirofiban and its association with clinical outcome in patients undergoing coronary stenting". Circulation. 109 (18): 2203–6. doi:10.1161/01.CIR.0000127867.41621.85. PMID 15117843. Retrieved 2010-06-30. Unknown parameter
|month=ignored (help) - ↑ Nikolsky E, Sadeghi HM, Effron MB, Mehran R, Lansky AJ, Na Y, Cox DA, Garcia E, Tcheng JE, Griffin JJ, Stuckey TD, Turco M, Carroll JD, Grines CL, Stone GW (2005). "Impact of in-hospital acquired thrombocytopenia in patients undergoing primary angioplasty for acute myocardial infarction". The American Journal of Cardiology. 96 (4): 474–81. doi:10.1016/j.amjcard.2005.04.005. PMID 16098296. Retrieved 2010-06-30. Unknown parameter
|month=ignored (help) - ↑ Wang TY, Ou FS, Roe MT, Harrington RA, Ohman EM, Gibler WB, Peterson ED (2009). "Incidence and prognostic significance of thrombocytopenia developed during acute coronary syndrome in contemporary clinical practice". Circulation. 119 (18): 2454–62. doi:10.1161/CIRCULATIONAHA.108.827162. PMID 19398666. Retrieved 2010-06-30. Unknown parameter
|month=ignored (help)