Immune Thrombocytopenic Purpura and Gastritis by H. pylori Associated With Type 1 Diabetes Mellitus
| Autor: | Christian R Mejia, Igor Flores-Guevara, Ricardo G. Correa, Carlos Culquichicón-Sánchez, Frank Espinoza Morales |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Ecchymosis Every Eight Hours peru 030209 endocrinology & metabolism Gastroenterology Pediatrics inmune thrombocytopenic purpura 03 medical and health sciences 0302 clinical medicine América Latina Internal medicine medicine 030212 general & internal medicine Type 1 diabetes medicine.diagnostic_test Insulin glargine business.industry Diabetes General Engineering Endocrinology/Diabetes/Metabolism Enfermedades gastrointestinales latin america medicine.disease Thrombocytopenic purpura Surgery idiophatic thrombocytopenic purpura Sitagliptin Diabetes & Endocrinology medicine.symptom business Tranexamic acid type 1 diabetes mellitus medicine.drug Partial thromboplastin time |
| Zdroj: | Cureus Universidad Continental Repositorio Institucional-Continental CONTINENTAL-Institucional instacron:CONTINENTAL |
| ISSN: | 2168-8184 |
| Popis: | We present the 15th case reported worldwide and 3rd case reported in Latin America of immune thrombocytopenic purpura associated with Type 1 diabetes mellitus in Scopus, MEDLINE, and SciELO. An 11-year-old male patient of mixed ethnicity with immune thrombocytopenic purpura, Type 1 diabetes mellitus, and gastritis due to H. pylori presented to the emergency room with petechiae, ecchymosis, and gingival and conjunctival bleeding that had been worsening for the past three months. The patient had a body mass index of 18.85 kg/m2 (P75). A biochemical analysis showed 1×109 platelets/L, increased prothrombin time, increased partial thromboplastin time, and an HbA1C of 7.84% on admission. He was prescribed a single dose of intravenous methylprednisolone 750 mg in 100 mL of NaCl and daily oral 50 mg prednisolone, with intravenous 250 mg tranexamic acid every eight hours. The patient’s glycemic control was continued with the administration of insulin glargine (30 units every 24 hours) and prandial insulin glulisine (five to eight units per meal). Before admission, the patient was on a prescribed treatment of sitagliptin 50 mg and metformin 850 mg, but this was suspended in the emergency room. For the eradication of H. pylori he was prescribed amoxicillin 500 mg every eight hours, oral clarithromycin 335 mg every 12 hours, and IV omeprazole 40 mg. After 15 days, he showed disease resolution and he was discharged to his home with orders to follow-up with pediatrics, hematology, and endocrinology services. The first-line treatment for immune thrombocytopenic purpura patients with active bleeding and a platelet count < 30,000 platelets/μl is the administration of corticosteroids and inmunoglobulin. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|