She was referred to Dr. Uttam Nath [haematologist] the same day. He sure 3 days of broad(prenominal) dose Methylprednisone and platelet transfusion in view of progressive bleed.
The next day [04/07/2012] she was infused 45gm IVIg [ intravenous immunoglobulin ] and tablet azathioprine was started .This dose was repeated on 08/07/2012.
She was noted to have disseminated herpetic lesions for which she was apt(p) Valganciclovir.which was stopped few days later for suspected operating system marrow suppression.
Her haemoglobin had vanishped multiple times mainly cod to menorrhagia and severe malena. Periods had been suppressed with Progesterone .For malena she received Pantoprazole infusion, Tranexamic dosage infusion.
For her ITP, other therapies that she received [all in consultation with and as advised by Dr.
Uttam Nath] are
* ELTROMBOPAG OLAMINE tablets [from 09/07/2012]
* RITUXIMAB iv once weekly [on 14/07/2012]
* VINCRISTINE iv once weekly [on 17/07/2012]
She was intubated and ventilate for hypovolemic impingement on 19/07/2012. She had also been presumptuousness Desmopressin spray for active bleed.She also received Noradrenaline infusion.
A bone marrow aspiration study was undertaken on 13/07/2012, which showed MEGAKARYOCYTIC THROMBOCYTOPENIA.
On 20/07/2012she became hypothermic with a drop in Hb to 5.3g/dl [one of multiple episodes in the preceding(a) few days]. She was resuscitated with packed RBC concentrate ,started on noradrenaline infusion , pan-cultures sent [ to exclude septic shock ] and she was started on broad spectrum antibiotics. Hemoglobin was stablilised [21/07/2012] and noradrenaline tapered.Platelet counts improved to 90000/microl.If you essential to get a full essay, order it on our website: Orderessay
If you want to get a full essay, wisit our page: write my essay .
No comments:
Post a Comment