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Epidural anesthesia for labor and delivery in a patient with May-Hegglin anomaly: a case report
We report a case of May-Hegglin anomaly (MHA) in a woman who had a successful labor and delivery under epidural anesthesia. MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essen...
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Published in: | Local and regional anesthesia 2017-01, Vol.10, p.53-58 |
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container_title | Local and regional anesthesia |
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creator | Muzannar, Annas Muhammad Al Harbi, Mohammed Rathore, Raza Tawfeeq, Nasser Wambi, Freddie Mahmood, Nasir Albrechtova, Sonia Dimitriou, Vassilios |
description | We report a case of May-Hegglin anomaly (MHA) in a woman who had a successful labor and delivery under epidural anesthesia. MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essential for optimal maternal and neonatal delivery outcome. Additionally, it can avoid unnecessary diagnostic studies, such as bone marrow aspiration and biopsy, and even harmful therapies with corticosteroids, immunosuppressive agents, and splenectomy. Consequently, the most serious impacts of this disease are iatrogenic managements due to misdiagnosis. It seems that in patients with MHA, adequate clinical coagulation is far more dependent on adequate platelet function than any particular platelet count. The diagnosis of MHA may pose a challenge for clinicians managing pregnant women with thrombocytopenia. |
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MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essential for optimal maternal and neonatal delivery outcome. Additionally, it can avoid unnecessary diagnostic studies, such as bone marrow aspiration and biopsy, and even harmful therapies with corticosteroids, immunosuppressive agents, and splenectomy. Consequently, the most serious impacts of this disease are iatrogenic managements due to misdiagnosis. It seems that in patients with MHA, adequate clinical coagulation is far more dependent on adequate platelet function than any particular platelet count. The diagnosis of MHA may pose a challenge for clinicians managing pregnant women with thrombocytopenia.</description><identifier>ISSN: 1178-7112</identifier><identifier>EISSN: 1178-7112</identifier><identifier>DOI: 10.2147/LRA.S125811</identifier><identifier>PMID: 28496360</identifier><language>eng</language><publisher>New Zealand: Dove Medical Press Limited</publisher><subject>Anesthesia ; Biopsy ; Blood platelets ; Bone marrow ; Care and treatment ; Case Report ; Case reports ; Cesarean section ; Childbirth & labor ; Epidural anesthesia ; Granulocytes ; Health aspects ; Hematology ; Immunoglobulins ; Inherited thrombocytopaenias ; Leukocyte disorders ; May-Hegglin anomaly ; Mutation ; Obstetrics ; Patients ; Pregnancy ; Pregnant women</subject><ispartof>Local and regional anesthesia, 2017-01, Vol.10, p.53-58</ispartof><rights>COPYRIGHT 2017 Dove Medical Press Limited</rights><rights>2017. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Muzannara et al. This work is published and licensed by Dove Medical Press Limited 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-39d63679115c03fd52e2c413f5856de0057baa4abeeefb3891c29d5cc8ef89b03</citedby><orcidid>0000-0002-2143-8058 ; 0000-0002-6207-3577 ; 0000-0001-7018-064X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2229350730/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2229350730?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28496360$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Muzannar, Annas Muhammad</creatorcontrib><creatorcontrib>Al Harbi, Mohammed</creatorcontrib><creatorcontrib>Rathore, Raza</creatorcontrib><creatorcontrib>Tawfeeq, Nasser</creatorcontrib><creatorcontrib>Wambi, Freddie</creatorcontrib><creatorcontrib>Mahmood, Nasir</creatorcontrib><creatorcontrib>Albrechtova, Sonia</creatorcontrib><creatorcontrib>Dimitriou, Vassilios</creatorcontrib><title>Epidural anesthesia for labor and delivery in a patient with May-Hegglin anomaly: a case report</title><title>Local and regional anesthesia</title><addtitle>Local Reg Anesth</addtitle><description>We report a case of May-Hegglin anomaly (MHA) in a woman who had a successful labor and delivery under epidural anesthesia. MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essential for optimal maternal and neonatal delivery outcome. Additionally, it can avoid unnecessary diagnostic studies, such as bone marrow aspiration and biopsy, and even harmful therapies with corticosteroids, immunosuppressive agents, and splenectomy. Consequently, the most serious impacts of this disease are iatrogenic managements due to misdiagnosis. It seems that in patients with MHA, adequate clinical coagulation is far more dependent on adequate platelet function than any particular platelet count. 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MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essential for optimal maternal and neonatal delivery outcome. Additionally, it can avoid unnecessary diagnostic studies, such as bone marrow aspiration and biopsy, and even harmful therapies with corticosteroids, immunosuppressive agents, and splenectomy. Consequently, the most serious impacts of this disease are iatrogenic managements due to misdiagnosis. It seems that in patients with MHA, adequate clinical coagulation is far more dependent on adequate platelet function than any particular platelet count. 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subjects | Anesthesia Biopsy Blood platelets Bone marrow Care and treatment Case Report Case reports Cesarean section Childbirth & labor Epidural anesthesia Granulocytes Health aspects Hematology Immunoglobulins Inherited thrombocytopaenias Leukocyte disorders May-Hegglin anomaly Mutation Obstetrics Patients Pregnancy Pregnant women |
title | Epidural anesthesia for labor and delivery in a patient with May-Hegglin anomaly: a case report |
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