Nontraumatic subperiosteal orbital hemorrhage in a laboring patient with gestational immune thrombocytopenic purpura
Purpose: To describe a case of nontraumatic subperiosteal orbital hemorrhage (NTSOH) in a laboring patient with gestational immune thrombocytopenic purpura. Observations: A 28-year-old G3P2 laboring patient was urgently evaluated by our ophthalmology unit after she developed sudden onset left eye pr...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-12-01
|
| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993620303017 |
| _version_ | 1818921297109843968 |
|---|---|
| author | Carl Shen Siddharth Nath |
| author_facet | Carl Shen Siddharth Nath |
| author_sort | Carl Shen |
| collection | DOAJ |
| description | Purpose: To describe a case of nontraumatic subperiosteal orbital hemorrhage (NTSOH) in a laboring patient with gestational immune thrombocytopenic purpura. Observations: A 28-year-old G3P2 laboring patient was urgently evaluated by our ophthalmology unit after she developed sudden onset left eye proptosis, headache, and diplopia in the final hour of pushing. The patient's platelet count was markedly decreased at 45,000 and subsequent work-up established a diagnosis of gestational immune thrombocytopenic purpura. On examination, visual acuity was 20/25 bilaterally and there was a minus two restriction in upgaze in the left eye and a left hypotropia in primary position. Computed tomography demonstrated an elliptical, hyperdense collection at the left orbital roof consistent with NTSOH. The patient was deemed clinically stable through serial examinations and symptoms resolved with conservative management. Conclusions and Importance: NTSOH is a rare, potentially sight-threatening condition that requires timely ophthalmological evaluation. To our knowledge, this is the first report in the literature of NTSOH in a laboring patient with gestational immune thrombocytopenic purpura. Consideration of the possibility of NTSOH as a complication in this population may allow for appropriate diagnosis, monitoring, and treatment when indicated. |
| first_indexed | 2024-12-20T01:35:24Z |
| format | Article |
| id | doaj.art-a1cad904ed7e415e95c6af6adfcd8d14 |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-12-20T01:35:24Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-a1cad904ed7e415e95c6af6adfcd8d142022-12-21T19:58:01ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362020-12-0120100986Nontraumatic subperiosteal orbital hemorrhage in a laboring patient with gestational immune thrombocytopenic purpuraCarl Shen0Siddharth Nath1Division of Ophthalmology, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Corresponding author. Hamilton Regional Eye Institute, Division of Ophthalmology, Department of Surgery, Faculty of Health Sciences, McMaster University, 2757 King Street East, Hamilton, ON L8G 5E4, Canada.Division of Ophthalmology, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; MD/PhD Program, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, CanadaPurpose: To describe a case of nontraumatic subperiosteal orbital hemorrhage (NTSOH) in a laboring patient with gestational immune thrombocytopenic purpura. Observations: A 28-year-old G3P2 laboring patient was urgently evaluated by our ophthalmology unit after she developed sudden onset left eye proptosis, headache, and diplopia in the final hour of pushing. The patient's platelet count was markedly decreased at 45,000 and subsequent work-up established a diagnosis of gestational immune thrombocytopenic purpura. On examination, visual acuity was 20/25 bilaterally and there was a minus two restriction in upgaze in the left eye and a left hypotropia in primary position. Computed tomography demonstrated an elliptical, hyperdense collection at the left orbital roof consistent with NTSOH. The patient was deemed clinically stable through serial examinations and symptoms resolved with conservative management. Conclusions and Importance: NTSOH is a rare, potentially sight-threatening condition that requires timely ophthalmological evaluation. To our knowledge, this is the first report in the literature of NTSOH in a laboring patient with gestational immune thrombocytopenic purpura. Consideration of the possibility of NTSOH as a complication in this population may allow for appropriate diagnosis, monitoring, and treatment when indicated.http://www.sciencedirect.com/science/article/pii/S2451993620303017Subperiosteal hemorrhageLaborImmune thrombocytopenic purpura |
| spellingShingle | Carl Shen Siddharth Nath Nontraumatic subperiosteal orbital hemorrhage in a laboring patient with gestational immune thrombocytopenic purpura American Journal of Ophthalmology Case Reports Subperiosteal hemorrhage Labor Immune thrombocytopenic purpura |
| title | Nontraumatic subperiosteal orbital hemorrhage in a laboring patient with gestational immune thrombocytopenic purpura |
| title_full | Nontraumatic subperiosteal orbital hemorrhage in a laboring patient with gestational immune thrombocytopenic purpura |
| title_fullStr | Nontraumatic subperiosteal orbital hemorrhage in a laboring patient with gestational immune thrombocytopenic purpura |
| title_full_unstemmed | Nontraumatic subperiosteal orbital hemorrhage in a laboring patient with gestational immune thrombocytopenic purpura |
| title_short | Nontraumatic subperiosteal orbital hemorrhage in a laboring patient with gestational immune thrombocytopenic purpura |
| title_sort | nontraumatic subperiosteal orbital hemorrhage in a laboring patient with gestational immune thrombocytopenic purpura |
| topic | Subperiosteal hemorrhage Labor Immune thrombocytopenic purpura |
| url | http://www.sciencedirect.com/science/article/pii/S2451993620303017 |
| work_keys_str_mv | AT carlshen nontraumaticsubperiostealorbitalhemorrhageinalaboringpatientwithgestationalimmunethrombocytopenicpurpura AT siddharthnath nontraumaticsubperiostealorbitalhemorrhageinalaboringpatientwithgestationalimmunethrombocytopenicpurpura |