Thresholds 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 × 109 L−1. 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.
From the Departments of *Anesthesia and †Hematology, Royal Darwin Hospital, Darwin, Australia.
Accepted for publication January 10, 2013
The authors declare no conflicts of interest.
Reprints will not be available from the authors.
Address correspondence to Stanley Tay, MBBS, BMedSc, Department of Anesthesia, Royal Darwin Hospital, Rocklands Drive, Tiwi, Darwin, Northern Territory, Australia. Address e-mail to firstname.lastname@example.org.