Browsing by Author "Nitish Kumar Patel"

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Clinical Dilemma, Bernard Soulier Syndrome versus Immune Thrombocy-topenic Purpura: A Case Report
(Bentham Science Publishers, 2023) J. Bhavya; Nitish Kumar Patel; Nilesh Kumar; Jitendra Singh; Kailash Kumar
Background: Bernard Soulier Syndrome (BSS) is a rare autosomal recessive disorder due to deficiency or dysfunction of the glycoprotein GPIb-V-IX complex on the platelet surface. It is also known as hemorrhagiparous thrombocytic dystrophy or congenital hemorrhagiparous thrombo-cytic dystrophy. The patient usually presents with severe and prolonged bleeding along with charac-teristics of giant blood platelets and low platelet counts. Manifestations of BSS include epistaxis, gum bleeding, purpuric rashes, menorrhagia, rarely melena, and hematemesis. On the other hand, immune thrombocytopenic purpura (ITP) is an acquired autoimmune disorder in which there is ac-celerated platelet destruction and reduced platelet production. Isolated thrombocytopenia without fever, lymphadenopathy, and organomegaly usually lead to the diagnosis of immune thrombocyto-penia. Case Presentation: A 20 years old female presented with complaints of recurrent episodes of epi-staxis since childhood and menorrhagia during menarche. She was misdiagnosed as ITP elsewhere. Later, based on thorough clinical examination and investigation, the diagnosis was confirmed as BSS. Conclusion: BSS should always be taken in the differential diagnosis of ITP, especially when per-sistent, refractory, and treated unsuccessfully with steroids or splenectomy. © 2023 Bentham Science Publishers.
Disseminated Tuberculosis in an Immunocompetent State: A Case Report
(Bentham Science Publishers, 2023) Jitendra Singh; Anju Dinkar; Nitish Kumar Patel; J. Bhavya; Ankita Dewangan; Nilesh Kumar; Kalish Kumar
Background: Tuberculosis is one of the major infectious diseases of mankind and remains a significant health concern, especially in developing countries. Clinical manifestations of TB are broad and sometimes very challenging for clinicians to diagnose early. Tuberculous psoas abscess was gen-erally secondary to spinal tuberculosis or direct extension from adjacent structures in immunocompro-mised individuals, but tuberculous psoas abscess in the immunocompetent state is very infrequent. In addition, pancytopenia and new onset neck swelling simultaneously make this presentation a very unu-sual clinical entity in tuberculosis. Case Presentation: We now present a case of a 21-years-old, unmarried, otherwise healthy girl pre-sented with fever, lower abdominal pain and weight loss for two months. She also noticed painless neck swelling for 15 days. She later had a tuberculous left sided psoas abscess with pancytopenia and a cold abscess on the left side of the neck with no sign of any other apparent focus, according to the evi-dence. Diagnosis of disseminated TB without lung involvement was established and ATT was started. The outcome was successful on follow up. Conclusion: Among the broad spectrum of atypical manifestations of TB, this case report draws atten-tion to its rarity, diagnostic challenge and awareness of the clinical spectrum, especially in developing countries. © 2023 Bentham Science Publishers.