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Topics:
Pediatric Hematology/Oncology • Internal Medicine • Rheumatology • Hematology • Pediatric Hematology • Antiphospholipid Syndrome • Benign Hematology
How would you manage a patient with antiphospholipid syndrome in the setting of severe steroid-refractory thrombocytopenia?
Especially in a triple-positive patient with an acute ischemic stroke who may have urgency for anticoagulation with high bleeding risk and severe thrombocytopenia (< 50K)
Answer from: at Academic Institution
Dr. @Keith McCrae answered the question of severe thrombocytopenia in a patient with APS and an acute thrombotic stroke. I agree with his approach. However, this “between a rock and a hard place” clinical scenario does also appear not infrequently during the chronic management of patient...
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Answer from: at Community Practice
I would like some more information on the patient, such as age, bleeding history/risk, other cardiometabolic risk factors, other meds, etc. But in general, I agree with anticoagulation. Clearly, it would be helpful to get the platelet count up quickly--though even at 50,000 I would not hold anticoag...