Acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report

APDE is an acquired, transient bleeding disorder characterised by normal platelet counts with marked eosinophilia. It was previously known as ‘nonthrombocytopenic purpura with eosinophilia’. We report a case of a 3-year-old boy with prolonged history of spontaneous unexplained bruising which was ini...

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Main Authors:	Anuar, Muhamad Azamin, A. Talib, Norlelawati, Misaridin, Nur Farah Izzati, Mohamed, Mossad Abdelhak Shaban, Hasan, Taufiq Hidayat
Format:	Conference or Workshop Item
Language:	English English
Published:	2019
Subjects:	RJ101 Child Health. Child health services
Online Access:	http://irep.iium.edu.my/75191/ http://irep.iium.edu.my/75191/7/Muhamad%20Azamin%20Anuar%20-%20PP110.pdf http://irep.iium.edu.my/75191/13/ADPE%20mimick%20NAI%20poster%20-%2075191.pdf

id	iium-75191
recordtype	eprints
spelling	iium-751912020-02-26T07:03:57Z http://irep.iium.edu.my/75191/ Acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report Anuar, Muhamad Azamin A. Talib, Norlelawati Misaridin, Nur Farah Izzati Mohamed, Mossad Abdelhak Shaban Hasan, Taufiq Hidayat RJ101 Child Health. Child health services APDE is an acquired, transient bleeding disorder characterised by normal platelet counts with marked eosinophilia. It was previously known as ‘nonthrombocytopenic purpura with eosinophilia’. We report a case of a 3-year-old boy with prolonged history of spontaneous unexplained bruising which was initially investigated by Suspected Child Abuse and Neglect (SCAN) team for suspected non-accidental injury (NAI). Case summary: A 3-year-old boy attended the paediatric clinic with a 4-month history of recurrent spontaneous bruising. Parents were unsure of preceded illness, but he remained well with no history of trauma. His past medical history was unremarkable and father is a thalassaemia carrier. Upon assessment in clinic, he was subsequently referred for suspected NAI and an assessment by the SCAN team led to a police report with a plan to review in 2-months. Parents later decided to bring the child for further medical assessments which revealed multiple bruises over both thighs, back of shoulder, loin and trunk with varying sizes and ages. They were all non-tender on palpation with no recognisable shapes or patterns. Blood results showed normal liver functions with slightly prolonged APTT 39.8 secs. He has normal platelet count with significant eosinophilia 2.2 x 10^9/L (approximately 15%) and occasional reactive lymphocytes. Reflecting this result, plan for platelet functions and von Willebrand tests were made. However, due to costs, we decided to treat the child with anti-helminthic agent for possible parasitic infestation. He had 3 days course of albendazole and no further bruises appeared after 5 days of completing treatment. Discussion: Unexplained bruises are significant in children in view of possible sinister causes. Idiopathic thrombocytopenic purpura (ITP) remains the most common cause of acquired bleeding disorder in children and the diagnosis is usually straightforward based on cardinal clinical and laboratorial characteristics. The clinical presentation of APDE can mimic ITP in many ways yet normal platelet counts often leads to a delay in diagnosis. Reassuringly, the course of APDE is benign and no treatment is often required. Investigations however are costly, therefore treatment with anti-helminthic agent would be an alternative option in providing assurance to family and medical practitioners dealing with suspected cases. 2019 Conference or Workshop Item NonPeerReviewed application/pdf en http://irep.iium.edu.my/75191/7/Muhamad%20Azamin%20Anuar%20-%20PP110.pdf application/pdf en http://irep.iium.edu.my/75191/13/ADPE%20mimick%20NAI%20poster%20-%2075191.pdf Anuar, Muhamad Azamin and A. Talib, Norlelawati and Misaridin, Nur Farah Izzati and Mohamed, Mossad Abdelhak Shaban and Hasan, Taufiq Hidayat (2019) Acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report. In: 15th Asian Oceanian Congress of Child Neurology in conjunction with the 41st Malaysian Paediatric Association Annual Congress 2019 “Synergy to Challenge Boundaries in Child Neurology”, 19th-22nd September 2019, Kuala Lumpur. (Unpublished)
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English
topic	RJ101 Child Health. Child health services
spellingShingle	RJ101 Child Health. Child health services Anuar, Muhamad Azamin A. Talib, Norlelawati Misaridin, Nur Farah Izzati Mohamed, Mossad Abdelhak Shaban Hasan, Taufiq Hidayat Acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report
description	APDE is an acquired, transient bleeding disorder characterised by normal platelet counts with marked eosinophilia. It was previously known as ‘nonthrombocytopenic purpura with eosinophilia’. We report a case of a 3-year-old boy with prolonged history of spontaneous unexplained bruising which was initially investigated by Suspected Child Abuse and Neglect (SCAN) team for suspected non-accidental injury (NAI). Case summary: A 3-year-old boy attended the paediatric clinic with a 4-month history of recurrent spontaneous bruising. Parents were unsure of preceded illness, but he remained well with no history of trauma. His past medical history was unremarkable and father is a thalassaemia carrier. Upon assessment in clinic, he was subsequently referred for suspected NAI and an assessment by the SCAN team led to a police report with a plan to review in 2-months. Parents later decided to bring the child for further medical assessments which revealed multiple bruises over both thighs, back of shoulder, loin and trunk with varying sizes and ages. They were all non-tender on palpation with no recognisable shapes or patterns. Blood results showed normal liver functions with slightly prolonged APTT 39.8 secs. He has normal platelet count with significant eosinophilia 2.2 x 10^9/L (approximately 15%) and occasional reactive lymphocytes. Reflecting this result, plan for platelet functions and von Willebrand tests were made. However, due to costs, we decided to treat the child with anti-helminthic agent for possible parasitic infestation. He had 3 days course of albendazole and no further bruises appeared after 5 days of completing treatment. Discussion: Unexplained bruises are significant in children in view of possible sinister causes. Idiopathic thrombocytopenic purpura (ITP) remains the most common cause of acquired bleeding disorder in children and the diagnosis is usually straightforward based on cardinal clinical and laboratorial characteristics. The clinical presentation of APDE can mimic ITP in many ways yet normal platelet counts often leads to a delay in diagnosis. Reassuringly, the course of APDE is benign and no treatment is often required. Investigations however are costly, therefore treatment with anti-helminthic agent would be an alternative option in providing assurance to family and medical practitioners dealing with suspected cases.
format	Conference or Workshop Item
author	Anuar, Muhamad Azamin A. Talib, Norlelawati Misaridin, Nur Farah Izzati Mohamed, Mossad Abdelhak Shaban Hasan, Taufiq Hidayat
author_facet	Anuar, Muhamad Azamin A. Talib, Norlelawati Misaridin, Nur Farah Izzati Mohamed, Mossad Abdelhak Shaban Hasan, Taufiq Hidayat
author_sort	Anuar, Muhamad Azamin
title	Acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report
title_short	Acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report
title_full	Acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report
title_fullStr	Acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report
title_full_unstemmed	Acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report
title_sort	acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report
publishDate	2019
url	http://irep.iium.edu.my/75191/ http://irep.iium.edu.my/75191/7/Muhamad%20Azamin%20Anuar%20-%20PP110.pdf http://irep.iium.edu.my/75191/13/ADPE%20mimick%20NAI%20poster%20-%2075191.pdf
first_indexed	2023-09-18T21:46:23Z
last_indexed	2023-09-18T21:46:23Z
_version_	1777413477754732544

Acquired platelet dysfunction with eosinophilia mimicks non-accidental injury: a case report

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