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Jazeer M, Garusinghe C. Occurrence of Immune Thrombocytopenic Purpura Following Enucleation of a Neuroendocrine Tumor of the Head of the Pancreas. Cureus 2023; 15:e47109. [PMID: 38022022 PMCID: PMC10646959 DOI: 10.7759/cureus.47109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Neuroendocrine tumors are growths occurring in various organs including the pancreas which contain endocrine tissue. Pancreatic neuroendocrine tumors are rare in occurrence with an incidence of <1 per 100,000 individuals. But the incidence is rising and the said tumors are becoming more common in the world. Herein we report a case of a 49-year-old female with a background history of poorly controlled type 2 diabetes mellitus for 7 years, dyslipidemia, and bronchial asthma for 19 years on regular inhaler therapy presenting with a history of back pain for 3 months duration. With serial investigations, she was found to have a neuroendocrine tumor involving the head of the pancreas with no local infiltration and distant metastases. Whipple's procedure was performed after which she developed thrombocytopenia from post-operative day 1 itself. Following this, she was diagnosed as having immune thrombocytopenic purpura and being managed with oral corticosteroids, after which she made a successful recovery from the acute condition but with multiple relapses from time to time.
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Affiliation(s)
- Mohamed Jazeer
- Internal Medicine, Teaching Hospital, Batticaloa, Batticaloa, LKA
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Zhou L, Zhang LZ, Wang JY, Li YW, Hu HD, Peng XM, Zhao Y, Wang XM, Xie H, Liu CZ, Wang HM. Perioperative safety analysis of transcatheter arterial chemoembolization for hepatocellular carcinoma patients with preprocedural leukopenia or thrombocytopenia. Mol Clin Oncol 2017; 7:435-442. [PMID: 28811901 DOI: 10.3892/mco.2017.1345] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 07/22/2017] [Indexed: 01/05/2023] Open
Abstract
Patients with hepatocellular carcinoma (HCC) exhibit a high incidence of concomitant cirrhosis with leukopenia and/or thrombocytopenia. In the present study, perioperative changes in the white blood cell (WBC) and platelet (PLT) counts and associated complications were investigated to assess the safety of transcatheter arterial chemoembolization (TACE) for HCC patients with preprocedural leukopenia or thrombocytopenia. The records of 1,461 HCC patients who received TACE between January 2012 and December 2013 were retrospectively reviewed. The incidence of complications during the perioperative period and changes in the WBC and PLT counts were recorded. A Chi-squared test was used to evaluate the associations between postoperative infection and preprocedural WBC count and between bleeding at the puncture site and preprocedural PLT count. The WBC count of the majority of the patients increased within 3 days and returned to the preprocedural level within 30 days after TACE. The PLT count decreased within 3 days and returned to the preprocedural level within 30 days after TACE. The major complications were liver decompensation (n=66), puncture site bleeding (n=45), infection (n=33), severe thrombocytopenia (n=8), upper gastrointestinal bleeding (n=6), tumor bleeding (n=4) and agranulocytosis (n=3). A Chi-squared test revealed that postoperative infection was not associated with preprocedural WBC count and puncture site bleeding was not associated with decreased PLT count due to hypersplenism. Therefore, TACE was found to be safe for HCC patients with preprocedural thrombocytopenia or leukopenia due to hypersplenism, with a low incidence of major complications during the perioperative period.
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Affiliation(s)
- Lin Zhou
- Department of Interventional Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
| | - Lin-Zhi Zhang
- Department of Interventional Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
| | - Jing-Yan Wang
- Department of Interventional Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
| | - Yong-Wu Li
- Department of Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
| | - Hai-Dong Hu
- Department of Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
| | - Xiao-Ming Peng
- Department of Interventional Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
| | - Yun Zhao
- Department of Interventional Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
| | - Xi-Ming Wang
- Department of Interventional Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
| | - Hui Xie
- Department of Interventional Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
| | - Chun-Zi Liu
- Department of Interventional Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
| | - Hua-Ming Wang
- Department of Interventional Radiology, Beijing 302 Hospital, Beijing 100039, P.R. China
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