Haematology
Marital Status Cohabiting Sex Male3/52 hx of epistaxis, oral mucosal bleeding and purpura over the feet and shins.JM was diagnosed with idiopathic autoimmune thrombocytopenia purpura in 1996. He suffered from epistaxis, bleeding gums and purpura and his platelet level at this time was found to be 2 x 109g/L. Treated with corticosteroids, but refractory to therapy, JM underwent a splenectomy with good resolution. He was gradually weaned off prednisolone and followed up in the haematology clinic in 1999. The patient has been asymptomatic until this recent presentation to his GP, who referred him to the haematology unit at the Western General Hospital.1994 - Autoimmune haemolytic anaemia diagnosed. Treated with corticosteroids."aasthma, "aepilepsy, "ajaundice, "aDM, "aMI, "aCVA, "aTB, "aHT, "aRF
The strong immuno-suppressive effect of the combination of CyA and corticosteroids is potentially very effective in arresting the immune response. In chronic ITP, autoantibodies directed against platelet membrane antigens are detectable in 80% of patients. He feels that being chronically ill will impair his ability to look after his wife and young child. The majority of patients experienced side effects and discontinuation of treatment was deemed necessary in six. I have learned to ask open questions and not to believe that silences are to be avoided at all costs. His platelet count is very low at 7 x 109/L. 3) Try with prednisolone, 1mg/kg/day for 3 weeks. Patients may be asymptomatic or have insidious onset bleeding problems due to their decreased platelets. Life Cycle Patient-centered medicine requires integration of the concepts of disease and illness with an understanding of the whole person, including an awareness of the patient's position in the life cycle and his or her life context. Twenty patients were divided into two groups of ten, those refractory to prednisolone (group 1) and those refractory to at least prednisolone and splenectomy (group 2). How will his illness affect his own life and his ability to continue to access the world he enjoys? Would he be in hospital at critical times for his partner and child and would this affect his relationship with them? Understanding the whole person can deepen the doctor's knowledge of the human condition; especially the nature of suffering and the responses of persons to sickness, allowing better care to be achieved. Treatment of patients unresponsive to corticosteroid therapy and splenectomy is to keep the patient free of symptoms.
Common topics in this essay:
Cycle Patient-centered,
Syndrome JM,
Medicine Patients,
Chronic ITP,
Sequestration Eg,
Enquiry JM,
Management Plan,
Complaint JM,
Expectations JM,
CNS Grossly,
platelet count,
chronic itp,
3/52 hx,
life cycle,
purpura feet,
corticosteroid therapy,
feet extending shins,
intravenous immunoglobulin,
partner child,
corticosteroids splenectomy,
refractory corticosteroids,
position life cycle,
refractory corticosteroids splenectomy,
raise platelet count,
repeated infusions intravenous,
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