• A & A case reports · Oct 2013

    Dental extraction in a child with chronic idiopathic thrombocytopenia purpura: are preoperative platelet transfusions necessary?

    • Stanley Tay, Ferenc Szabo, and Brian Spain.
    • From the Departments of *Anesthesia and †Hematology, Royal Darwin Hospital, Darwin, Australia.
    • A A Case Rep. 2013 Oct 1;1(1):3-4.

    AbstractThresholds for platelet counts in patients at risk for bleeding are often used before surgery. We present a case report of a 13-year-old female with chronic idiopathic thrombocytopenia purpura for dental extraction with a platelet count of 4 × 10 L. Usually, therapies including platelet infusions, IV immunoglobulin, or corticosteroids would be used to increase platelet numbers. In this patient, rather than using any of these prophylactic therapies preoperatively, we used a "watchful waiting" strategy with a multidisciplinary team, the use of tranexamic acid and the aforementioned therapies available only as "rescue" agents.

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