Case study of immune thrombocytopenia diagnosis (ITP
The case study presents a 14-year-old girl accompanied by her mother to seek medical interventions after she developed an increased number of abnormal bruises, including various red splotches that are easily noticed in her leg. The paper’s main purpose is to elaborate on the need to engage in splenectomy after immune thrombocytopenia diagnosis (ITP).
The scenario presented by the case study proves the existence of a bleeding disorder that may be caused by immune thrombocytopenia (ITP). ITP is a medical issue that leads a patient to bleed and bruise excessively. The disorder is autoimmune since autoantibodies decrease platelet production and increases platelet destruction. Worrest et al. (2020) postulate that the poor immune system portrayed by the case study patient is mainly attributed to or prompted by the immune thrombocytopenia platelets. That happens especially when the platelet levels decrease since these platelet cells help the individual body towards blood clotting.
Splenectomy works toward autoantibody production and removing the platelet’s primary site clearance. According to Kochhar and Neunert (2021), splenectomy is more effective than other ITP therapies. Before the development and introduction of drug therapy, splenectomy was mainly used as the main ITP treatment, and still, it stands as the common treatment for patients with chronic ITP (Chaturvedi et al., 2018). The health specialists need to intervene in the case study’s patient condition by removing the spleen through a laparoscopic procedure or open surgery depending on the patient’s condition to prevent further damage to the platelets by the spleen, thus increasing these platelets’ body circulation. The advantage of engaging the laparoscopic procedure known as keyhole surgery is that the patient will always have fewer days in hospitalization and recover much quicker than when the surgeon conducts an open surgery (Kuriyama et al., 2022). However, the condition that may require the engagement of open surgery is if the patient’s spleen is large or presence of other complications that may interfere with the procedure. In conclusion, healthcare providers must effectively assess the patient’s conditions to determine the most appropriate ITP procedure.
Chaturvedi, S., Arnold, D. M., & McCrae, K. R. (2018). Splenectomy for immune thrombocytopenia: down but not out. Blood, The Journal of the American Society of Hematology, 131(11), 1172-1182. https://doi.org/10.1182/blood-2017-09-742353
Kochhar, M., & Neunert, C. (2021). Immune thrombocytopenia: A review of upfront treatment strategies. Blood Reviews, 49, 100822. https://doi.org/10.1016/j.blre.2021.100822
Kuriyama, N., Maeda, K., Komatsubara, H., Shinkai, T., Noguchi, D., Gyoten, K., … & Mizuno, S. (2022). The usefulness of modified splenic hilum hanging maneuver in laparoscopic splenectomy, especially for patients with huge spleen: a case-control study with propensity score matching. Surgical Endoscopy, 36(2), 911-919. https://doi.org/10.1007/s00464-021-08348-7
Worrest, T., Cunningham, A., Dewey, E., Deloughery, T. G., Gilbert, E., Sheppard, B. C., & Fischer, L. E. (2020). Immune thrombocytopenic purpura splenectomy in the context of new medical therapies. Journal of Surgical Research, 245, 643-648. https://doi.org/10.1016/j.jss.2019.06.092
In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (not all may apply to each scenario):
The factors that affect fertility (STDs).
Why inflammatory markers rise in STD/PID.
Why prostatitis and infection happens. Also explain the causes of systemic reaction.
Why a patient would need a splenectomy after a diagnosis of ITP.
Anemia and the different kinds of anemia (i.e., micro and macrocytic).
A 14-year-old female is brought to the urgent care by her mother, who states that the girl has had an abnormal number of bruises and “funny looking red splotches” on her legs. These bruises were first noticed about 2 weeks ago and are not related to trauma. PMH not remarkable and she takes no medications. The mother does state the girl is recovering from a “bad case of mono” and was on bedrest at home for the past 3 weeks. The girl noticed that her gums were slightly bleeding when she brushed her teeth that morning.
Labs at urgent care demonstrated normal hgb and hct with normal WBC differential. Platelet count of 100,000/mm3 was the only abnormal finding. The staff also noticed that the venipuncture site oozed for a few minutes after pressure was released. The doctor at urgent care referred the patient and her mother to the ED for a complete work-up of the low platelet count, including a peripheral blood smear for suspected immune thrombocytopenia purpura.