Etiological Profile, Morbidity and Mortality In Adult Thrombocytopenia Cases: A Study from Central India
Etiological Profile, Morbidity and Mortality In Adult Thrombocytopenia Cases: A Study from Central India
DOI:
https://doi.org/10.70284/njirm.v8i6.1333Keywords:
bleeding manifestation, chronic liver disease, megaloblastic anaemia, mortality, septicaemia, ThrombocytopeniaAbstract
Background: Thrombocytopenia is known since ages causing major catastrophes to human being. Researchers are always conducted in thrombocytopenic for better diagnosis, treatment and prognosis. Platelet counts in peripheral blood below 1 lac /μL termed as thrombocytopenia. Aims: To explore etiologies of thrombocytopenia in adults and to find incidence of morbidity, pattern of bleeding diathesis and mortality along with its association to severity of thrombocytopenia. Methods: It was a cross-sectional study done over a period of one year among 252 indoor cases of thrombocytopenia. Diagnosis was made with the help of clinical data and investigations performed. Bleeding manifestations and mortality were recorded and correlated with severity of thrombocytopenia. Results: The most common cause of thrombocytopenia was Septicaemia (24.21%) followed by megaloblastic anaemia (13.10%). Other causes included alcoholic liver disease, non-alcoholic liver disease and malignancies. Where 41 (16.27%) cases presented with bleeding manifestations. Incidence of bleeding manifestation was found highest that is 27.27% (P=0.008) in severe and least 9.44% in mild thrombocytopenia. Overall mortality rate was 19.84%, where 29.54%, 22.22% & 14.96% cases died with severe, moderate and mild thrombocytopenia respectively. Septicaemia (40%) was the most common cause of death followed by alcoholic liver disease (14%) and non-alcoholic liver disease (12%). Despite of being second most common etiology of thrombocytopenia, megaloblastic anemia showed only 8% mortality. Conclusion: Septicemia is leading cause of thrombocytopenia followed by megaloblastic anemia in Malwa region of Madhya Pradesh. Commonest bleeding manifestation in these cases is petechial hemorrhages seen more frequent in severe thrombocytopenia. More than half of the deaths in thrombocytopenic patients is attributed to septicemia and chronic liver disease. [Yadav S NJIRM 2017; 8(6):60-65]
References
2. Greinacher A, Selleng K. Thrombocytopenia in the Intensive Care Unit Patient. Hematology. 2010;1:135-143.
3. Kumar P, Chandra K. A Clinical study of febrile thrombocytopenia: A hospital-based retrospective study. Indian Journal of Clinical Practice. 2014; 24(10):952-957.
4. Bhalara SK, Shah S, Goswami H, Gonsai RN. Clinical and etiological profile of thrombocytopenia in adults: A tertiary-care hospital based cross-sectional study. Int J Med Sci Public Health. 2015;4:7-10.
5. Nair PS, Jain A, Khanduri U, Kumar V. A Study of Fever-associated Thrombocytopenias. JAPI.2003;(51): 1173.
6. Gandhi AA, Akholkar PJ. Clinical and laboratory evaluation of patients with febrile thrombocytopenia. National J of Medical Research. 2015; 5(1):43-46.
7. Patil P, Solanke P, Harshe G. To study clinical evaluation and outcome of patients with febrile thrombocytopenia. Int J of Scentific and Research Publications. 2014;4(10):1-3.
8. Dash HS, Ravikiran P, Swarnalatha G. A study of clinical and laboratory profile of fever with thrombocytopenia and its outcome during hospital stay. International J Scientific Research. 2013 Nov; 2 (11): 445-447.
9. Joshi P, Joseph D, Bajpai P, Manoria P, Joshi P, Yadav V, Dagore H, Jha R.K. Prevalence of anemia among the general population of malwa (m.p), India. J Evaluation of Med and Dental Sciences. 2013;2(1):46-51.
10. Weksler BB. Review article: the pathophysiology of thrombocytopenia in hepatitis C virus infection and chronic liver disease. Aliment Pharmacol Ther 2007;3(2):217-25.
11. Poordad F. Review article: thrombocytopenia in chronic liver disease. Alimentary Pharmacology & Therapeutics. 2007;26(1):5–11.
12. Lohitashwa SB, Vishwanath BM, Srinivas G. Clinical and Lab Profile of Fever with Thrombocytopenia. Abstract Free Paper Oral Presentation - APICON, 2008. Available at: http://www.japi.org/march_2009/oral_presentation.
13. Malik S, Sarwar I, Mehmood T, Naz F. Aetiological considerations of acquired aplastic anaemia. J Ayub Med Coll Abbottabad. 2009;21(3):127-130.
