Acute myocardial infarction and renal dysfunction due to chronic extreme anemia (hemoglobin 2.5 g/dL) in immune thrombocytopenia

Abstract

Immune thrombocytopenic purpura (ITP) is an acquired thrombocytopenia where autoantibodies are generated against platelet antigens. Primary ITP is often idiopathic, whereas secondary ITP has many potential causes, including drug induced, infection related (human immunodeficiency virus, hepatitis C), leukemias, or autoimmune such as systemic lupus erythematosus. ITP is a common cause of thrombocytopenia in asymptomatic individuals, where evidence of bleeding may be minor or absent. Chronic silent bleeding leading to extreme anemia in patients with ITP is rare, and evidence of multiorgan damage is even rarer; hence the relevance of this case report. Here we describe a case of primary ITP with severe chronic blood loss leading to profound anemia causing renal failure and a type II non-ST elevation myocardial infarction. Our patient underwent extensive workup for the etiology of both thrombocytopenia and anemia and was eventually treated with packed red blood cell and platelet transfusions, along with intravenous steroids and immunoglobulin therapy.

Endothelial Activation and Immune Thrombocytopenia: An Engagement Waiting for Consolidation

“…The study of Muenchrath et al in 2018 19 concluded that patients had anemia attributed to sustained slow bleeding secondary to profound thrombocytopenia In this study, there was no statistically significant difference between studied patients' platelets count as regards to age and sex which was demonstrated also in the study of Bonaccio et al 2016. 21 There was no statistically significant difference between studied patients' platelet counts as regards to Hb and WBCs.…”

“…Muenchrath et al 2018 19 reported that patients had anemia due to bleeding secondary to profound thrombocytopenia. This was demonstrated also in Trotter and Hill 2018 20 study where they identified significant morbidity in patients with ITP, including fatigue, anemia, fear of bleeding which critically affect patients’ health-related quality of life (HRQoL).…”

“…The study of Muenchrath et al in 2018 19 concluded that patients had anemia attributed to sustained slow bleeding secondary to profound thrombocytopenia…”