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Carry on doctor
We report the case of a 13-year-old girl with tuberculosis who developed persistent symptomatic thrombocytopenia whilst being treated with rifampicin and isoniazid. There was widespread agreement that rifampicin was the likely cause of the thrombocytopenia. After discussion with the family we electe...
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Published in: | Archives of disease in childhood 2009-09, Vol.94 (9), p.734-735 |
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description | We report the case of a 13-year-old girl with tuberculosis who developed persistent symptomatic thrombocytopenia whilst being treated with rifampicin and isoniazid. There was widespread agreement that rifampicin was the likely cause of the thrombocytopenia. After discussion with the family we elected to continue treatment as we believed that the potential benefits of continuing treatment outweighed the risks of thrombocytopenia. Despite continued treatment the platelet count returned to normal after a few weeks. We found that thrombocytopaenia may be transient even when therapy is continued and would recommend a watchful waiting strategy to others faced with a similar clinical dilemma. |
doi_str_mv | 10.1136/adc.2008.156299 |
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There was widespread agreement that rifampicin was the likely cause of the thrombocytopenia. After discussion with the family we elected to continue treatment as we believed that the potential benefits of continuing treatment outweighed the risks of thrombocytopenia. Despite continued treatment the platelet count returned to normal after a few weeks. We found that thrombocytopaenia may be transient even when therapy is continued and would recommend a watchful waiting strategy to others faced with a similar clinical dilemma.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/adc.2008.156299</identifier><identifier>PMID: 19700428</identifier><identifier>CODEN: ADCHAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher><subject>Adolescent ; Antibiotics, Antitubercular - adverse effects ; Antibiotics, Antitubercular - therapeutic use ; Biological and medical sciences ; Blood platelets ; Case studies ; Complications and side effects ; Demographic aspects ; Diagnosis ; Drug dosages ; Drug therapy ; Families & family life ; Female ; General aspects ; Grade 2 ; Health participants ; Hematology ; Humans ; Immunoglobulins ; Isoniazid ; Isoniazid - therapeutic use ; Literature Reviews ; Lung - diagnostic imaging ; Medical sciences ; Medical Services ; Miscellaneous ; Narcotics ; Prevention and actions ; Public health. 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Hygiene-occupational medicine ; Radiography ; Rifampin ; Rifampin - adverse effects ; Rifampin - therapeutic use ; Thrombocytopenia ; Thrombocytopenia - chemically induced ; Thrombocytopenia - diagnostic imaging ; Treatment Outcome ; Tuberculosis ; Tuberculosis, Pulmonary - diagnostic imaging ; Tuberculosis, Pulmonary - drug therapy ; Visual Acuity</subject><ispartof>Archives of disease in childhood, 2009-09, Vol.94 (9), p.734-735</ispartof><rights>BMJ Publishing Group Ltdand Royal College of Paediatrics and Child Health.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright: 2009 BMJ Publishing Group Ltdand Royal College of Paediatrics and Child Health.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b502t-c6efcd79301345510e8f9560b72d9bbe66c6790fa5f8f29c93383760e74c0ad63</citedby><cites>FETCH-LOGICAL-b502t-c6efcd79301345510e8f9560b72d9bbe66c6790fa5f8f29c93383760e74c0ad63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1828678884/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1828678884?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,21359,21375,27903,27904,33590,33856,43712,43859,73967,74143</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21830546$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19700428$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nair, S</creatorcontrib><creatorcontrib>Carroll, W D</creatorcontrib><title>Carry on doctor</title><title>Archives of disease in childhood</title><addtitle>Arch Dis Child</addtitle><description>We report the case of a 13-year-old girl with tuberculosis who developed persistent symptomatic thrombocytopenia whilst being treated with rifampicin and isoniazid. There was widespread agreement that rifampicin was the likely cause of the thrombocytopenia. After discussion with the family we elected to continue treatment as we believed that the potential benefits of continuing treatment outweighed the risks of thrombocytopenia. Despite continued treatment the platelet count returned to normal after a few weeks. We found that thrombocytopaenia may be transient even when therapy is continued and would recommend a watchful waiting strategy to others faced with a similar clinical dilemma.</description><subject>Adolescent</subject><subject>Antibiotics, Antitubercular - adverse effects</subject><subject>Antibiotics, Antitubercular - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood platelets</subject><subject>Case studies</subject><subject>Complications and side effects</subject><subject>Demographic aspects</subject><subject>Diagnosis</subject><subject>Drug dosages</subject><subject>Drug therapy</subject><subject>Families & family life</subject><subject>Female</subject><subject>General aspects</subject><subject>Grade 2</subject><subject>Health participants</subject><subject>Hematology</subject><subject>Humans</subject><subject>Immunoglobulins</subject><subject>Isoniazid</subject><subject>Isoniazid - therapeutic use</subject><subject>Literature Reviews</subject><subject>Lung - diagnostic imaging</subject><subject>Medical sciences</subject><subject>Medical Services</subject><subject>Miscellaneous</subject><subject>Narcotics</subject><subject>Prevention and actions</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Radiography</subject><subject>Rifampin</subject><subject>Rifampin - adverse effects</subject><subject>Rifampin - therapeutic use</subject><subject>Thrombocytopenia</subject><subject>Thrombocytopenia - chemically induced</subject><subject>Thrombocytopenia - diagnostic imaging</subject><subject>Treatment Outcome</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Pulmonary - diagnostic imaging</subject><subject>Tuberculosis, Pulmonary - drug therapy</subject><subject>Visual Acuity</subject><issn>0003-9888</issn><issn>1468-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>ALSLI</sourceid><sourceid>CJNVE</sourceid><sourceid>M0P</sourceid><recordid>eNqNkM9LHDEUgEOp1K1Kj72VBelFmN2X3y9HGWwVFj24ireQyWRkt7Mz22QW9L83Mose9fQO70vex0fITwozSrmau9rPGADOqFTMmC9kQoXCgoEQX8kEAHhhEPGQfE9pDUAZIv9GDqnRAILhhPwoXYzP076b1r0f-nhMDhrXpnCyn0fk7s_FsrwsFjd_r8rzRVFJYEPhVWh8rQ0HyoWUFAI2RiqoNKtNVQWlvNIGGicbbJjxhnPkWkHQwoOrFT8ip-O_29j_34U02HW_i10-aSkyVDpbi0wVI_Xo2mBXne-7ITwNvm_b8BhsNipv7DmjIt9GrT_NU0ApKGR-PvI-9inF0NhtXG1cfLYU7GtgmwPb18B2DJxf_Np776pNqN_5fdEM_N4DLnnXNtF1fpXeOEaRgxTqXXWVsuLb3sV_Vmmupb2-Ly3ePiyWhl_b28yfjXy1WX9o-QIMw5mg</recordid><startdate>20090901</startdate><enddate>20090901</enddate><creator>Nair, S</creator><creator>Carroll, W D</creator><general>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88I</scope><scope>8A4</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>20090901</creationdate><title>Carry on doctor</title><author>Nair, S ; Carroll, W D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b502t-c6efcd79301345510e8f9560b72d9bbe66c6790fa5f8f29c93383760e74c0ad63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Antibiotics, Antitubercular - adverse effects</topic><topic>Antibiotics, Antitubercular - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Blood platelets</topic><topic>Case studies</topic><topic>Complications and side effects</topic><topic>Demographic aspects</topic><topic>Diagnosis</topic><topic>Drug dosages</topic><topic>Drug therapy</topic><topic>Families & family life</topic><topic>Female</topic><topic>General aspects</topic><topic>Grade 2</topic><topic>Health participants</topic><topic>Hematology</topic><topic>Humans</topic><topic>Immunoglobulins</topic><topic>Isoniazid</topic><topic>Isoniazid - therapeutic use</topic><topic>Literature Reviews</topic><topic>Lung - diagnostic imaging</topic><topic>Medical sciences</topic><topic>Medical Services</topic><topic>Miscellaneous</topic><topic>Narcotics</topic><topic>Prevention and actions</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Radiography</topic><topic>Rifampin</topic><topic>Rifampin - adverse effects</topic><topic>Rifampin - therapeutic use</topic><topic>Thrombocytopenia</topic><topic>Thrombocytopenia - chemically induced</topic><topic>Thrombocytopenia - diagnostic imaging</topic><topic>Treatment Outcome</topic><topic>Tuberculosis</topic><topic>Tuberculosis, Pulmonary - diagnostic imaging</topic><topic>Tuberculosis, Pulmonary - drug therapy</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nair, S</creatorcontrib><creatorcontrib>Carroll, W D</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection【Remote access available】</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>Education Periodicals</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>Social Science Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Education Collection</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>Education Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><jtitle>Archives of disease in childhood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nair, S</au><au>Carroll, W D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carry on doctor</atitle><jtitle>Archives of disease in childhood</jtitle><addtitle>Arch Dis Child</addtitle><date>2009-09-01</date><risdate>2009</risdate><volume>94</volume><issue>9</issue><spage>734</spage><epage>735</epage><pages>734-735</pages><issn>0003-9888</issn><eissn>1468-2044</eissn><coden>ADCHAK</coden><abstract>We report the case of a 13-year-old girl with tuberculosis who developed persistent symptomatic thrombocytopenia whilst being treated with rifampicin and isoniazid. There was widespread agreement that rifampicin was the likely cause of the thrombocytopenia. After discussion with the family we elected to continue treatment as we believed that the potential benefits of continuing treatment outweighed the risks of thrombocytopenia. Despite continued treatment the platelet count returned to normal after a few weeks. We found that thrombocytopaenia may be transient even when therapy is continued and would recommend a watchful waiting strategy to others faced with a similar clinical dilemma.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</pub><pmid>19700428</pmid><doi>10.1136/adc.2008.156299</doi><tpages>2</tpages></addata></record> |
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subjects | Adolescent Antibiotics, Antitubercular - adverse effects Antibiotics, Antitubercular - therapeutic use Biological and medical sciences Blood platelets Case studies Complications and side effects Demographic aspects Diagnosis Drug dosages Drug therapy Families & family life Female General aspects Grade 2 Health participants Hematology Humans Immunoglobulins Isoniazid Isoniazid - therapeutic use Literature Reviews Lung - diagnostic imaging Medical sciences Medical Services Miscellaneous Narcotics Prevention and actions Public health. Hygiene Public health. Hygiene-occupational medicine Radiography Rifampin Rifampin - adverse effects Rifampin - therapeutic use Thrombocytopenia Thrombocytopenia - chemically induced Thrombocytopenia - diagnostic imaging Treatment Outcome Tuberculosis Tuberculosis, Pulmonary - diagnostic imaging Tuberculosis, Pulmonary - drug therapy Visual Acuity |
title | Carry on doctor |
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