Case 7 – update 6

Unfortunately on day four of PEX the platelet count falls to 19, LDH rises and he spikes a temperature.  Antibiotics for presumed sepsis are started.  PEX is increased to BD with no improvement in platelet count and he starts to become confused again.  Steroids are re-started and PEX is continued BD.

Questions:

Rituximab has been mentioned by the team.  Is this everyone’s first line?  What abor ciclosporin or vincristine?

Please reply on Twitter and always include #teamhaem to allow others to follow your comments. Please join in the debate and learn about haematological emergencies along the way. The case will continue to  evolve over the coming week so keep checking #teamhaem for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

TeamHaem are not a position of authority.  It is an educational platform to allow discussion

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Online education and discussion about all things haematological
This entry was posted in Acquired bleeding, Anaemia, Platelet disorders and tagged , , , . Bookmark the permalink.

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