Pulmonary Thromboembolism in Immune Thrombocytopenia: A Report of Five Cases and a Review of the Literature

Figures & data

Table 1 Main Clinical Features of 5 Patients

Cases	Gender	Age	PLT When Diagnosed with PTE(×10^9/L)	Time from ITP to PTE (Month)	Complication	Treatment	Prognosis
1	M	80	22.0	10	Hypertension, DM, History of prostate surgery	Hormone/No anticoagulant therapy	Favourable
2	F	77	58.0	5	Hypertension, DM, History of gallbladder surgery	Hormone/Anticoagulant therapy	Favourable
3	F	68	63.0	5	None	Hormone/Anticoagulant therapy	Favourable
4	M	88	43.0	24	None	Anticoagulant therapy	Worse
5	M	80	35.0	20	COPD, RF	Anticoagulant therapy	Worse

Abbreviations: DM, diabetes mellitus; COPD, chronic obstructive pulmonary disease; RF, respiratory failure.

Table 2 Results of Hematology and Coagulation Indexes in 5 Patients

Cases	Hb (g/L)	WBC (×10^9/L)	PLT (×10^9/L)	D-D (ug/L)	PT (s)	APTT (s)	TT (s)	AT (%)	Fb (g/L)	INR	CRP (mg/L)
1	128.0	3.7	10.0	540.0	12.8	31.2	17.8	69.3	2.5	1.09	23.8
2	114.0	11.2	70.0	14,110.0	13.8	29.0	19.6	61.4	2.5	1.18	14.0
3	122.0	10.8	80.0	18,989.0	12.7	29.2	19.0	94.1	3.4	1.08	28.6
4	87.0	6.6	43.0	5318.0	20.6	29.2	15.7	62.6	3.4	1.75	24.5
5	127.0	5.2	38.0	18,734.0	15.1	28.0	25.4	41.4	2.1	1.30	64.8

Notes: Normal ranges for the parameters: Hb 120–160 g/L (male) and 110–150g/L (female), WBC 4–10×10⁹/L, PLT 100–300×10⁹/L, D-D 0–550 ug/L, PT 9.6–14.3 second, APTT 23.3–32.5 second, TT 14.0–21.0 second, AT 75.0%-130.0%, Fb 1.7–4.1 second, INR 0.85–1.25, CRP 1–10 mg/L.

Abbreviations: Hb, hemoglobin; WBC, white blood cell; PLT, platelet; D-D, D dimer; PT, prothrombin time; APTT, activated partial thromboplastin time; TT, thrombin time; AT, antithrombin; Fb, fibrinogen; INR, International normalized ratio; CRP, C-reactive protein.

Table 3 The Results of All Indexes Compared Between the Case Group and the Normal Control

Item	Case Group(n=5)	Control Group(n=18)	t-value
Hb(g/L)	115.60±16.92	138.28±6.82	3.8304**
WBC(×10^9/L)	7.50±3.36	5.68±1.54	1.7281
PLT(×10^9/L)	48.20±27.73	237.55±66.22	10.1033**
D-D(ug/L)	11,538.20±8269.82	294.38±114.48	5.7815**
PT(s)	15.00±3.27	11.41±8.15	0.9468
APTT(s)	29.32±1.16	27.86±2.03	1.5148
TT(s)	19.50±3.62	17.61±0.57	2.1274*
AT(%)	65.76±18.96	99.75±12.75	4.6449**
Fb(g/L)	2.78±0.59	2.54±0.49	0.9139
INR	1.16±0.28	0.98±0.04	1.8644
CRP(mg/l)	31.14±19.57	1.00±0.01	6.5530**

Notes: *P < 0.05, **P < 0.01, and the rest were all P > 0.05.

Abbreviations: Hb, hemoglobin; WBC, white blood cell; PLT, platelet; D-D, D dimer; PT, prothrombin time; APTT, activated partial thromboplastin time; TT, thrombin time; AT, antithrombin; Fb, fibrinogen; INR, International normalized ratio; CRP, C-reactive protein.