Primary immune thrombocytopenia in a 60-year-old patient in the canton of Loja in the province of Loja.

Abstract

Abstract

The case of a 60-year-old patient with a clinical history of Type 2 Diabetes Mellitus and Arterial Hypertension is presented, who attends a medical consultation with a specialist at the San Gregorio Clinic in the city of Loja, due to presenting a clinical picture characterized by: proctorrhagia , epistaxis and generalized petechiae, where they decided to be admitted for management by the Hematology and Observation Service. Paraclinical studies were carried out where hematological alterations suggestive of Primary Immune Thrombocytopenia were evidenced.

The medical indications for the patient's recovery on the first day of hospitalization were: nothing by mouth, relative rest, methylprednisolone, hemoblock, enoxaparin, platelet concentrates. The next day, the patient was kept on a tranexamic acid pump, which reduced the bleeding episodes.

On her third day of hospitalization, the patient is hemodynamically stable, she has not presented nose or mouth bleeding. The first dose of

immunoglobulin G was administered. On his fourth day of hospitalization, the patient manifested epistaxis after changes in position, which is why strict absolute bed rest, a second dose of immunoglobulin G, and an additional transfusion of platelet concentrates were indicated.

Patient evolves favorably during his hospital stay and on the last day of hospitalization, vital signs within normal parameters. In this pathology, the correction of platelets is essential to avoid possible complications that may even cause the death of the patient.

Treatment with methylprednisolone and immunoglobulin G has been shown to have relevant clinical efficacy in these cases. We also assess the risk-benefit ratio of enoxaparin in cases such as IPT