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Báo cáo y học: "Treatment of stasis dermatitis using aminaphtone: Management of aplastic anemia in a woman during pregnancy: a case repor"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Treatment of stasis dermatitis using aminaphtone: Management of aplastic anemia in a woman during pregnancy: a case report. | Stibbe et al. Journal of Medical Case Reports 2011 5 66 http www.jmedicalcasereports.eom content 5 1 66 JOURNALOF medical case reports CASE REPORT Open Access Management of aplastic anemia in a woman during pregnancy a case report Krista JM Stibbe1 Hajo IJ Wildschut2 Pieternella J Lugtenburg3 Abstract Introduction Aplastic anemia is a rare disease caused by destruction of pluripotent stem cells in bone marrow. During pregnancy it could be life-threatening for both mother and child. The only causal therapy for aplastic anemia is bone marrow transplantation which is contraindicated during pregnancy because of potential embryo toxicity. Treatment options are erythrocytes and platelet transfusions and immunosuppressive therapy. There is however no agreement about the optimal supportive care and treatment regime for this disorder during pregnancy. Case Presentation A 26-year-old nulliparous Asian woman with an uneventful medical history was admitted to the hospital at 14 weeks gestation because of excessive vomiting. Routine laboratory tests showed pancytopenia Hb 3.5 mmol L leukocytes 3.5 109 L platelets 45 109L . A bone marrow biopsy confirmed aplastic anemia. Methylprednisolon cyclosporine A packed cells and platelet transfusions were initiated. At 33 weeks she developed neutropenia 0.1 109 L for which oral colistin and tobramycin were given prophylactically. At 35 weeks labor was induced during which she developed a fever of 38.2 C. She gave birth spontaneously to a healthy son weighing 2415 grams who had no signs of pancytopenia. After delivery the blood count of the patient did not recover and did not respond to medication. Eighteen weeks after delivery she died of sepsis complicated by cerebral bleeding and infarction due to severe thrombocytopenia and neutropenia despite optimal supportive treatment. Conclusion This potential life-threatening disease has a relatively good prognosis for both mother and child after optimal treatment. Transfusion during pregnancy .