Mild to serious bleeding can occur as the major signs and symptoms of thrombocytopenia. Bleeding can be internal or external. Signs and symptoms can appear suddenly or over time. Mild thrombocytopenia often has no signs or symptoms. Severe thrombocytopenia can cause bleeding in almost any part of the body. External bleeding usually is the first sign of a low platelet count. Extrinsic compression due to hematoma, intraneural bleed, and immune-mediated nerve injury has been reported in the literature as mechanisms of neuropathy. Neuropathy due to thrombocytopenia is a rare complication with challenging manifestations. We report a case series of patients with dengue hemorrhagic fever (DHF) and idiopathic thrombocytopenic purpura (ITP) who had difficulty in standing and walking. One of the patients regained his muscle strength following the treatment and his quality of life was improved significantly.
Ganeshwaran Y, Seneviratne SM, Jayamaha R, et al. Dengue fever associated with a hematoma of the rectus abdominis muscle. Ceylon Med J 2001;46(3):105–106. DOI: 10.4038/cmj.v46i3.8139.
Ammer AM, Arachichi WK, Jayasingha PA. Psoas hematoma complicating dengue hemorrhagic fever: a case report. Galle Med J 2009;14(1):83–84. DOI: 10.4038/gmj.v14i1.1188.
Ganu S, Mehta Y. Femoral compressive neuropathy from iliopsoas hematoma complicating dengue haemorrhagic fever. Asian Pac J Trop Med 2013;6(5):419–420. DOI: 10.1016/S1995-7645(13)60052-8.
Goodfellow J, Fearn CB, Matthews JM. Iliacus haematoma. A common complication of haemophilia. J Bone Joint Surg Br 1967;49(4):748–756. DOI: 10.1302/0301-620X.49B4.748.
Miyao S, Takano A, Teramoto J. Oculomotor nerve palsy due to intraneural hemorrhage in idiopathic thrombocytopenic purpura: a case report. Eur Neurol 1993;33(1):20–22. DOI: 10.1159/000116893.
Bax L, Staes F, Verhagen A. Does neuromuscular electrical stimulation strengthen the quadriceps femoris? a systematic review of randomised controlled trials. Sports Med 2005;35(3):191–212. DOI: 10.2165/00007256-200535030-00002.
Carraro U, Rossini K, Mayr W. Muscle fiber regeneration in human permanent lower motoneuron denervation: relevance to safety and effectiveness of FES-training, which induces muscle recovery in SCI subjects. Artif Organs 2005;29(3):187–191. DOI: 10.1111/j.1525-1594.2005.29032.x.
Kern H, Salmons S, Mayr W. Recovery of long-term denervated human muscles induced by electrical stimulation. Muscle Nerve 2005;31(1):98–101. DOI: 10.1002/mus.20149.
