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Haemodialysis-associated thrombocytopenia: interactions among the immune system, membranes and sterilisation methods.

Felipe BataliniGabriel Francisco AleixoAsaf MaozShayna Sarosiek
Published in: BMJ case reports (2019)
We present a case of a 47-year-old man with severe thrombocytopenia. The differential diagnosis for thrombocytopenia is wide. The assessment includes an evaluation for falsely low platelet counts (pseudothrombocytopenia), immune-mediated platelet destruction, bone marrow dysfunction, or increased consumption and sequestration. After extensive and systematic workup, we found a relationship of his thrombocytopenia with haemodialysis. Although not widely recognised by clinicians, partly due to an incomplete understanding of its pathophysiology, haemodialysis is also a potential cause of thrombocytopenia. His platelet counts completely normalised after the substitution of his haemodialysis membrane. We concluded that our patient had haemodialysis-induced thrombocytopenia, most likely secondary to electron-beam sterilisation.
Keyphrases
  • end stage renal disease
  • peritoneal dialysis
  • bone marrow
  • chronic kidney disease
  • palliative care
  • oxidative stress
  • case report
  • peripheral blood
  • high glucose
  • endothelial cells