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Thrombocytopenia is one of the most common hematologic disorders, characterized by an abnormally low number of platelets from multiple causes. The normal count of thrombocytes (platelets) is between 150,000 and 450,000 per microliter. The clinical expression of thrombocytopenia has broad variation from asymptomatic to life-threatening bleeding. Var...
Citations
... Chemotherapy often damages normal cells and leads to thrombocytopenia and leukopenia, which limit the doses of cancer therapeutic drugs (4). The primary treatment for this disease is generally corticosteroids, which are recurrent and reversible in most cases (5). Another treatment is intravenous immunoglobulin (IVIG), which unreliably increases the platelets, has transient effects, and requires repeated administration (6). ...
... In this regard, urgent treatments such as platelet reception are generally not a long-term therapeutic option. In addition, it is not appropriate for some types of diseases due to heparin (5). Indeed, bone marrow suppression has been a common side effect of chemotherapy (7). ...
Background: Due to the toxicity of chemotherapy drugs in cancer patients, thrombocytopenia can lead to bleeding. Trifolium pratense L. is traditionally used as an anti-inflammatory compound for the treatment of various diseases. The aim of the present study was to evaluate the effect of T. pratense (red clover) extract (TPE) on thrombocytopenia and the related factors in a rat model of chemotherapy. Materials and Methods: In this experimental in vivo study, 28 rats were randomly divided into four groups of seven members (four males and three females) including Group1 as the control subjects, Group2 as thrombocytopenia cases, and Groups 3 and 4 with thrombocytopenic animals receiving TPE (100 and 200 mg/kg). Thrombocytopenia was induced by intraperitoneal injection of cyclophosphamide (CP) on three consecutive days. Then, the TPE was fed to rats for 14 days. At the end of the study, the rats' weight was measured. Blood samples were collected, complete blood count (CBC) was performed, and PF4 and clotting time were measured. After the dissection of the animals, the bone marrow and spleen were separated, and hisopathological changes were determined. The data were analyzed by one-way ANOVA and a post-hoc Tukey test. Results: Cyclophosphamide decreased the platelets and the white blood cells (WBCs) and increased PF4 and the clotting time significantly (P < 0.05). Also, TPE significantly increased the platelets and the WBC counts but decreased the time of clotting and the PF4 factor (P < 0.05). TPE increased megakaryocyte (P < 0.001) and enhanced the bone marrow and spleen cellularity. Conclusion: T. pratense can increase the number of platelets and WBCs and improve thrombocytopenia and bone marrow cellularity induced by chemotherapy.
... Thrombocytopenia may result from medications that interfere with platelet functions, or any underlying disease/infection [7]. Dengue, malaria, aplastic anemia, hypersplenism, and chikungunya are a few diseases that result in thrombocytopenia [8][9][10]. ...
Drug-induced thrombocytopenia (DIT) is a disorder where platelet count declines as an adverse effect of therapeutic drugs. Plant extract of C. papaya Caripill™ is known to elevate platelet count under thrombocytopenic conditions. To evaluate the contribution of supplements with antioxidant potential to treat DIT, the comparative study of Caripill™, vanillic acid L-carnitine effect on platelet count and indices of oxidative stress in a model of rat thrombocytopenia induced through oral administration of hydroxyurea was performed. Wistar rats were grouped into four categories with five animals in each group: control (without any treatment); control + antioxidants; thrombocytopenia; thrombocytopenia + antioxidants. The above-mentioned antioxidants were supplemented orally at 50 mg/kg for 7 days. The level of lipid peroxidation products, superoxides, protein carbonyls and sulfhydryls, SOD and CAT activity in isolated platelets as oxidative stress markers, and indices of platelets aggregation and ATP secretion as functional markers were used. Vanillic acid was shown to be beneficial, similar to Caripill™, during hydroxyurea-induced thrombocytopenia by maintaining platelet functions, enhancing both the antioxidant capacity of platelets and its number. L-carnitine efficiently up-regulated the enzymatic antioxidants, maintained platelet functions and protected lipids and proteins from oxidation in thrombocytopenic rats, however, it could not improve the platelet count. These findings open new avenues for employing the studied antioxidants as supplements for therapeutic purposes.
... During malaria infections, host response against the Plasmodium parasite builds up a balance of inflammation, tissue damage, and immune-mediated events that are targeted toward controlling further parasite growth [9]. Hematological abnormalities consistently accompany malaria infections, with the patient presenting with anemia, thrombocytopenia, splenomegaly, mild-to-moderate atypical lymphocytosis, and rarely disseminated intravascular coagulation [11]. Binding platelets to the RBCs releases an anti-microbial protein referred to as platelet factor 4 (PF4), this protein accumulates in the RBCs and subsequently lysis the food vacuole of the parasite [9]. ...
The study attempted to identify possible overlap between serum cell-reactive proteins (C-rp) and hematological indices as predictors of comorbidity of malaria and septicemia among children attending primary healthcare facilities in Ilorin, Nigeria.
One hundred and ninety-three children (aged: ≤ 1–15 years) presenting with symptoms suggestive of malaria were enrolled. Blood specimens were collected and screened for: Romanowsky, culture, serum C-RP and hematological indices.
One hundred and fifteen (59.6%) children had Plasmodium falciparum infections (female 69.0% and male 34.1%). Septicemia was common among 52 (26.9%), but malaria and septicemia co-infection was 42 (36.5%). C-rp levels were low (< 10 mg/L) in 41 (35.7%, OR 4.594, CI 2.463–8.571) and high (> 10 mg/L) in 74 (64.3%, OR 2.519, CI 1.681–3.775) among the malaria positives (p < 0.05). Children with low C-rp, 8 (15.4%, OR 9.413, CI 4.116–21.531) were positive for septicemia and high C-RP 44 (84.6%, OR 1.694, CI 1.396–2.055), but without malaria, respectively. Similarly, increased C-rp levels were significantly associated with clinical malaria; > 10,000 parasites/μL (OR 1.486, CI 1.076–2.054, P < 0.001). Malaria-positive versus negative showed that PCV, C-rp, hemoglobin, platelet, WBC, and neutrophil were statistically significant (P < 0.05). Two bacteria species were identified, viz; Staphylococcus aureus 39 (54.9%) and Escherichia coli 32 (45.1%). The trade-off between sensitivity and specificity occurred at 16.475 cut-off using C-rp and degree of malaria severity as the standard for AUROC.
C-rp are inflammatory markers, though non-specificity may be associated with malaria prognosis and severity during malaria–septicemia co-infection.
... This observation was also valid for the levels lymphocytes and monocytes compared to negative control. A significant decrease was recorded for platelets in treated rats compared to negative control suggested the administered aqueous extract from R. sese ripe dried fruits could precipitate thrombocytopenia that was one of the common hematological disorders, characterized by an abnormally high number of number of platelets from multiple causes(Izak and Brussel, 2014). www.wjpps.com ...
The present study was initiated in the evaluation of antioxidant activity of extracts and soluble fractions from Raphia sese ripe dried fruits in vitro against 5 selected reactive oxygen species, (ROS) and acute and subacute toxicity of aqueous extract in vivo. Results revealed that aqueous and methanol extracts from R. sese ripe dried fruits and chloroform, ethylacetate, n-butanol and residual soluble fractions exhibited pronounced antioxidant activity by producing IC 50 values < 10 µg/ml against all selected ROS, excepted chloroform soluble fractions showing moderate activity against hydrogen peroxide radical. In acute and subacute toxicity, aqueous extract did not influence the levels of hematological and biochemical parameters of treated rats since all reported values were found to be in acceptable physiological limits. In addition, it did not induce mortality of treated rats since its LD50 was estimated to be greater than 5000 mg/kg bw and did not significantly modify the vital organ weights and electrolytes levels of treated animal. Aqueous extract was considered as practically non-toxic per os supporting its use for a lo time without the occurring of side effects.
... The normal count of PLTs is 150-450 × 10 3 per mm 3 . Thrombocytopenia is defined as a PLT count below 150 × 10 3 /mm 3 (21). Host and viral factors evaluated included gender, weight, age, age at infection, duration of infection, viral load, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, prothrombin time (PT), PLT count, AST-to-PLT ratio index (APRI = [AST/upper limit of normal] × [100/PLTs, × 10 9 /L]), albumin, fast blood sugar (FBS), triglycerides (TG), cholesterol & body mass index [(BMI); weight/height squared (kg/m2)]. ...
Polymorphism in human platelet antigen (HPA)-1 and HPA-3 (GPIIb/IIIa), HPA-2 (GPIb/IX), HPA-4 (GPIIIa), HPA-5 (GPIa/IIa), & HPA-15 (CD109) was investigated in 86 Covid-19-infected patients with thrombocytopenia (Group A) and 136 Covid-19-infected patients without thrombocytopenia (Group B). HPA genotyping was done by the sequence-specific primers PCR method. Lower HPA-3a and higher HPA-3b (P=0.028) allele frequencies were seen in Group A than in Group B, and homozygosity for HPA 3b (P=0.038) alleles was more prevalent in Group A than in Group B. The allele and genotype distributions of the other HPA polymorphic variants were similar between the two groups. Univariate analysis identified the CCGGGC (P = 0.016) combined genotype to be negatively associated & the TCGGGC (P=0.003) and CCGGGC (P=0.003) to be positively associated with thrombocytopenia. The frequency of anti-HPA-1a and anti-HPA-3a antibodies was significantly higher in all patients compared to other anti-HPAs antibodies (P < 0.05). These results highlight the role of HPAs in the thrombocytopenia of Covid-19 infected patients. This is the first evidence demonstrating the differential association of the six common HPA gene variants and specific HPA genotype combinations with thrombocytopenia in Covid-19-infected patients.
... The normal count of PLTs is 150-450 × 10 3 per mm 3 . Thrombocytopenia is defined as a PLT count below 150 × 10 3 /mm 3 (21). Host and viral factors evaluated included gender, weight, age, age at infection, duration of infection, viral load, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, prothrombin time (PT), PLT count, AST-to-PLT ratio index (APRI = [AST/upper limit of normal] × [100/PLTs, × 10 9 /L]), albumin, fast blood sugar (FBS), triglycerides (TG), cholesterol & body mass index [(BMI); weight/height squared (kg/m2)]. ...
Polymorphism in human platelet antigen (HPA)-1 and HPA-3 (GPIIb/IIIa), HPA-2 (GPIb/IX), HPA-4 (GPIIIa), HPA-5 (GPIa/IIa), & HPA-15 (CD109) was investigated in 86 COVID-19-infected patients with thrombocytopenia (Group A) and 136 COVID-19-infected patients without thrombocytopenia (Group B). HPA genotyping was done by the sequence-specific primers PCR method. Lower HPA-3a and higher HPA-3b (P = 0.028) allele frequencies were seen in Group A than in Group B, and homozygosity for HPA 3b (P = 0.038) alleles was more prevalent in Group A than in Group B. The allele and genotype distributions of the other HPA polymorphic variants were similar between the two groups. Univariate analysis identified the CCGGGC (P = 0.016) combined genotype to be negatively associated & the TCGGGC (P = 0.003) and CCGGGC (P = 0.003) to be positively associated with thrombocytopenia. The frequency of anti-HPA1a and anti-HPA-3a antibodies was significantly higher in all patients compared to other anti-HPAs antibodies (P < 0.05). These results highlight the role of HPAs in the thrombocytopenia of COVID-19 infected patients. This is the first evidence demonstrating the differential association of the six common HPA gene variants and specific HPA genotype combinations with thrombocytopenia in COVID-19-infected patients.
... 12,13,15,[17][18][19][20][21][22] Approach to the Clients A previous study regarding the management of thrombocytopenia suggested performing a detailed history taking, including a family history of thrombocytopenia, medical history (recent viral and bacterial infections, vaccinations, malignancies, recent travels, and recent transfusions), and concomitant medications (heparin), in order to find causes and treat appropriately. 29 In particular COVID-19 vaccination, there are several aspects to consider VITT. ...
... General physical examination, including inspection, palpation, percussion, and auscultation, was indicated in previous management of thrombocytopenia. 29 Moreover, special attention for the physical examination can be performed based on different embolisms and/or thrombotic event(s) resulting from different clinical presentations and coexisting conditions. Although not all the included studies specify clinical presentations and coexisting conditions, some specific incidents can be discussed based on the data available. ...
... The previous management of thrombocytopenia indicated that one treatment approach is removing the potential cause of thrombocytopenia, such as discontinuing medication and treating infection. 29 This is consistent with the review's findings that management from included studies did not continue the second dose of COVID-19 vaccination. 13,[15][16][17][18][19]21,22 In addition, there was evidence of positive COVID-19 cases following 14-27 days after the first dose of the COVID-19 vaccine, which is difficult to determine if they were infected prior to vaccination. ...
This scoping review aims to 1) identify characteristics of participants who developed embolism and/or thrombotic event(s) after COVID-19 vaccination and 2) review the management during the new vaccine development of the unexpected event(s). This review was conducted following PRISMA for scoping review guidelines. Peer-reviewed articles were searched for studies involving participants with embolism and/or thrombotic event(s) after COVID-19 vaccination with the management described during the early phase after the approval of vaccines. The 12 studies involving 63 participants were included in this review. The majority of participants’ ages ranged from 22 to 49 years. The embolism and/or thrombotic event(s) often occur within 30 days post-vaccination. Five of the included studies reported the event after receiving viral vector vaccines and suggested a vaccine-induced immune thrombotic thrombocytopenia as a plausible mechanism. Cerebral venous sinus thrombosis was the most frequently reported post-vaccination thrombosis complication. In summary, the most frequently reported characteristics and management from this review were consistent with international guidelines. Future studies are recommended to further investigate the incidence and additional potential complications to warrant the benefit and safety after receiving COVID-19 vaccine and other newly developed vaccines.
... Thrombocytopenia was defined as platelet count <150 k/μL (Izak and Bussel, 2014). The odds ratios (ORs) with 95% confidence intervals (CI) were measured by applying binary logistic regression analysis for estimating the occurrence for clinical symptoms as outcomes and thrombocytopenia as a predictor. ...
... All the patients were diagnosed between 5 th to 9 th days of the onset of dengue symptoms. Normal platelet count of the human body is 150-400 K/µL of total blood volume (Izak and Bussel, 2014). ...
This study was performed to figure out the prevalence and pattern of the symptoms and diagnosis of patients during a dengue outbreak at Rajshahi metropolitan city in Bangladesh and to assess the significance of biochemical profiles and physiological complications of dengue patients. In this cross-sectional survey, a set of questionnaires was used for 150 randomly selected dengue patients in Rajshahi metropolitan city. An excess of male patients (80.66%) was found among reported dengue cases, comparing to females (19.33%). Thirty-five (23.33%) of infected patients were from the city of Rajshahi whereas 115 (76.67%) patients were from outside. Less than 7% patients had positive IgG or IgM values and only 6% had both. Out of 150, 94 patients (62.67%) had platelet counts lower than 150 k/μL. All patients had fever and over 90% patients had nausea, vomiting and pain in muscle and lower abdomen. Joint pain (74%), dark urine (64%) and bloody diarrhea (12.66%) were also reported but no patient experienced skin rash. Two patients (1.33%) suffered from acute pancreatitis as well as dementia and paralysis. Platelet count of patients displayed notable association with hypotension, bloody diarrhea and hydration status. Though Bangladesh is facing dengue outbreaks for over fifty years, the current situation is exacerbated by the rising number of deaths. Public health management needs to be enhanced and better organized to cope up with the dengue situation in Bangladesh.
... Thrombocytopenia is one of the most common hematological conditions, manifested by an unnaturally low platelet count due to several reasons [102]. Thrombocytopenia is linked to multiple syndromes and diseases and can be an early indicator of hematologic malignancies, thrombotic microangiopathies, infectious diseases, and autoimmune disorders, as well as a common adverse effect of numerous medications [103]. Megakaryocytes (MKs) are a type of functional hematopoietic stem cells; by differentiating and maturing MKs, it is possible to treat thrombocytopenia-related diseases [104]. ...
Abstract: Fruits and vegetables are used not only for nutritional purposes but also as therapeutics to treat various diseases and ailments. These food items are prominent sources of phytochemicals that exhibit chemopreventive and therapeutic effects against several diseases. Hirsutine (HSN) is a naturally occurring indole alkaloid found in various Uncaria species and has a multitude of therapeutic benefits. It is found in foodstuffs such as fish, seafood, meat, poultry, dairy, and some grain products among other things. In addition, it is present in fruits and vegetables including corn, cauliflower, mushrooms, potatoes, bamboo shoots, bananas, cantaloupe, and citrus fruits. The primary emphasis of this study is to summarize the pharmacological activities and the underlying mechanisms of HSN against different diseases, as well as the biopharmaceutical features. For this, data were collected (up to date as of 1 July 2023) from various reliable and authentic literature by searching different academic search engines, including PubMed, Springer Link, Scopus, Wiley Online, Web of Science, ScienceDirect, and Google Scholar. Findings indicated that HSN exerts several effects in various preclinical and pharmacological experimental systems. It exhibits anti-inflammatory, antiviral, anti-diabetic, and antioxidant activities with beneficial effects in neurological and cardiovascular diseases. Our findings also indicate that HSN exerts promising anticancer potentials via several molecular mechanisms, including apoptotic cell death, induction of oxidative stress, cytotoxic effect, anti-proliferative effect, genotoxic effect, and inhibition of cancer cell migration and invasion against various cancers such as lung, breast, and antitumor effects in human T-cell leukemia. Taken all together, findings from this study show that HSN can be a promising therapeutic agent to treat various diseases including cancer.
... We categorized each parameter into three groups according to commonly used lower and upper reference values. [17][18][19] Haemoglobin was classified into normal (≥130 g/L for men and ≥120 g/L for women), mild to moderate anaemia (80-130 g/L for men and 80-120 g/L for women), and severe anaemia (<80 g/L). Platelets were categorized into normal (150-450 × 10 9 /L), thrombopaenia (<150 × 10 9 /L), and thrombocytosis (>450 × 10 9 /L). ...
Background:
Perioperative myocardial infarction/injury (PMI) is a surprisingly common, yet difficult to predict cardiac complication in patients undergoing non-cardiac surgery. We aimed to assess the incremental value of preoperative cardiac troponin (cTn) concentration in the prediction of PMI.
Methods:
Among prospectively recruited patients at high cardiovascular risk (age >65 years OR >45 years with pre-existing cardiovascular disease), PMI was defined as an absolute increase in high-sensitivity cTnT (hs-cTnT) concentration of ≥14ng/L (the 99th percentile) above the preoperative concentration. PMI was centrally adjudicated by two independent cardiologists using serial measurements of hs-cTnT. Using logistic regression, three models were derived: Model 1 included patient- and procedure-related information, Model 2 adding routinely available laboratory values, and Model 3 further adding preoperative hs-cTnT concentration. Models were compared also versus preoperative hs-cTnT alone. Findings were validated in two independent cohorts.
Results:
Among 6'944 patients, PMI occurred in 1058 patients (15.2%). The predictive accuracy as quantified by the area under the receiver-operating characteristic curve was 0.73 (95%CI 0.71-0.74) for Model 1, 0.75 (95%CI 0.74-0.77) for Model 2, 0.79 (95%CI 0.77-0.80) for Model 3, and 0.74 for hs-cTnT alone. Model 3 included 10 preoperative variables: age, body-mass-index, known coronary artery disease, metabolic equivalent >4, risk of surgery, emergency surgery, planned duration of surgery, haemoglobin, platelet count and hs-cTnT. These findings were confirmed in both independent validation cohorts (n=722, n=966).
Conclusions:
Preoperative cTn adds incremental value above patient- and procedure-related variables as well as routine laboratory in the prediction of PMI.
