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An uncommon cause of gastrointestinal bleeding in an 84-year-old female
Suartcha Prueksaritanond1, Aram Barbaryan, Alaa M Ali
1Saint Joseph Hospital/University of Illinois at Chicago, Department of Internal Medicine, 2900 N. Lake Shore, Chicago, IL 60657, USA.
Abstract:
The estimated annual incidence for drug-induced thrombocytopenia is 10 per million. Although fatal consequences are uncommon, life-threatening hemorrhage can occur due to spontaneous bleeding. We report a case of 84-year-old Caucasian female who presented to the emergency department with multiple episodes of bloody bowel movements. One week prior to this admission, she was started on trimethoprim-sulfamethoxazole for the treatment of skin abscess. On admission laboratory results showed platelet count of 4 × 10(3)/mm(3) and hemoglobin of 10.2 g/dL. Because of unstable vital signs, the patient was transferred to the intensive care unit where she received multiple units of platelet and blood transfusion. Drug-induced thrombocytopenia due to TMP/SMX was suspected. Intravenous methylprednisolone was started as well as immune globulin with good clinical response.
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