Pulmonary Endarterectomy in a Patient with Immune Thrombocyt
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Introduction
Immune thrombocytopenic purpura is a common hematological disorder which involves immune mediated platelet destruction and impaired platelet production. It is characterized by isolated thrombocytopenia in the absence of other causes or disorders that may be associated with thrombocytopenia. The association of ITP and chronic thromboembolic pulmonary hypertension represents a complex therapeutic challenge. To our knowledge, no case was reported to describe management of patients with ITP undergoing pulmonary endarterectomy. We describe our experience of perioperative management in a patient of ITP who underwent surgery.

Case Report
A 69-year-old female with shortness of breath (New York Heart Association Class IV) and CTEPH for a 1-year period was referred for PEA. Her medical history revealed that she had hypertension, regulated with oral antihypertensive drugs, and type II diabetes mellitus. Routine hematological examination was normal with a platelet count of 228,000/mm3. Her hematologic investigations showed a provisional diagnosis of ITP for 12 years with history of splenectomy 10 years ago. The patient was on chronic corticosteroid and azathioprine therapy on admission....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454759/
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