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Case report
Haemodialysis-associated thrombocytopenia: interactions among the immune system, membranes and sterilisation methods
  1. Felipe Batalini1,2,
  2. Gabriel Francisco Aleixo3,
  3. Asaf Maoz4 and
  4. Shayna Sarosiek5
  1. 1 Division of Hematology and Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  2. 2 Harvard Medical School, Boston, Massachusetts, USA
  3. 3 Universidade do Oeste Paulista Faculdade de Medicina, Presidente Prudente, Brazil
  4. 4 Boston University School of Medicine, Boston, Massachusetts, USA
  5. 5 Section of Hematology Oncology & Women’s Health Unit, Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr Felipe Batalini, fbatalin{at}bidmc.harvard.edu

Abstract

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.

  • chronic renal failure
  • dialysis
  • haematology (incl blood transfusion)
  • immunology
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Footnotes

  • Contributors FB took personal care of this patient, conceptualised and planned the report. FB, GFA and AM conducted the report. FB and AM acquired the data. Design, analysis and interpretation were performed by all authors, and lead by SS. FB drafted the article. All authors revised the article. All authors approved the version published. All agree to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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