Trombositopeni ve Çoklu Organ Yetersizliği: İkisi Arasında Bağlantı Var mı?

Abstract

Çoklu organ yetersizliği, kritik hastalarda görülen en ciddi komplikasyonlardandır. Çoklu organ yetersizliği ile yaygın sistemik tromboz arasında ilişki olduğu gösterilmiştir. Bu ilişkiye dayanarak son yıllarda trombositopeni ilişkili çoklu organ yetersizliği kavramı kullanılmaya başlamıştır. Trombositopeni ilişkili çoklu organ yetersizliği trombotik trombositopenik purpura, ikincil trombotik mikroanjiyopa- ti ve dissemine intravasküler koagülasyonu kapsayan patoloji spektrumlarıdır. Bu makalemizde trombositopeni ile başvuran ve çoklu organ yetersizliği gelişen bir vaka sunulmaktadır

Keywords

• Çoklu organ yetersizliği,trombositopeni,trombositopeni ilişkili çoklu organ yetersizliği,trombotik trombositopenik purpura,trombotik mikroanjiyopati,dissemine intravasküler koagulasyon

Thrombocytopenia and Multiple Organ Failure: Is There an Association?

Abstract

Multiple organ failure is one of the most severe complica- tions of the critically ill patients. The contributing role of the systemic thrombosis and related organ dysfunction is clearly demonstrated. According to this relationship thrombocytopenia-associated multiple organ failure is a recently defined syndrome. Thrombocytopenia-associated multiple organ failure is a thrombotic microangiopathic syndrome that can be defined by a spectrum of pathologies that includes thrombotic thrombocytopenic purpura, secon- dary thrombotic microangiopathy, and disseminated intra- vascular coagulation. In this paper we described a patient who has a thrombocytopenia and multiple organ failure

Keywords

• Multiple organ failure,thrombocytopenia,thrombocytopenia-associated multiple organ failure,thrombotic thrombocytopenic purpura,thrombotic microangiopathy,disseminated intravascular coagulation

References

1. 1. Wilkinson JD, Pollack MM, Ruttiman UE, et al. Outcome of pediatric patients with multiple organ system failure. Crit Care Med 1986; 14:271-4.
2. 2. Proulx F, Gauthier M, Nadeau D, et al. Timing and predictors of death in pediatric patinets with multiple organ system failure. Crit Care Med 1994; 22:1025-31.
3. 3. Tantalean JA, Leon JR, Santos AA, et al. Multiple organ dysfunction syndrome in children. Pediatr Crit Care Med 1999; 4:181-5.
4. 4. Wilkinson JD, Pollack MM, Glass NL, et al. Mortality associated with multiple organ system failure and sepsis in pediatric intensive care unit. J Pediatr 1987; 111:324-8.
5. 5. Neely WA, Berry DW, Rushton FW, et al. Septic shock: Clinical, physiological, and pathological survey of 244 autopsies. Ann Surg 1971; 173:657-67.
6. 6. Amoo-Lamptey A, Carcillo JA. Comparative pathology of children with sepsis, isolated pneumonia, and organ failure without infection. Pediatr Res 2001; 49:46A, 251.
7. 7. Baughman RP, Lower EE, Flessa HC, Tollerus DJ. Thrombocytopenia in the intensive care unit. Chest 1993; 104:1243-7.
8. 8. Stephan F, Hollanda J, Richand O, et al. Thrombocytopenia in a surgical ICU. Chest 1999; 115:1363-70.

9. 9. Nguyen TC, Han YY, Watson S, et al. Thrombocytopenia is associated with multiple organ failure and death in children. Crit Care Med 2000; 28(Suppl):A50
10. 10. Nguyen T, Hall M, Han Y, et al. Microvascular thrombosis in pediatric multiple organ failure:is it a therapeutic target. Pediatr Crit Care Med 2001; 2:187-96.
11. 11. Nguyen TC, Carcillo JA. Bench-to-bedside review: thrombocytopenia-associated multiple organ failure-a newly appreciated syndrome in the critically ill. Crit Care 2006; 10:235-44.
12. 12. Nabhan C, Kwaan HC. Current concepts in the diagnosis and management of thrombotic thrombocytopenic purpura.
13. 13. Bianchi V, Robles R, Alberio L, Furlan M, Lämmle B. VonWillebrand factor-cleaving protease (ADAMTS-13) in thrombocytopenic disorders: a severely deficient acitivity is specific for thrombotic thrombocytopenic purpura. Blood 2002; 100:710-3.
14. 14. Arya M, Anvari B, Romo GM, et al. Ultralarge multimers of von Willebrand factor form spontaneous high-strength bonds with the platelet glycoprotein Ib-IX complex: studies using optical tweezers. Blood 2002; 99:3971-7.
15. 15. Peyvandi F, Ferrari S, Lavoretano S, Canciani MT, Mannucci PM. von Willebrand factor cleaving protease (ADAMTS-13) and ADAMTS-13 neutralizing autoantibodies in 100 patients with thrombotic thrombocytopenic purpura. Br J Haematol 2004; 127:433-9.