Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Thrombocytopenia is a lower than normal number of
platelets in the blood.
Platelets are one of the components of the blood along with white and red
blood cells. Platelets play an important role in clotting and bleeding.
Platelets are made in the bone marrow similar to other cells in the blood such
as, white blood cells and red blood cells.
Platelets originate from megakaryocytes which are large cells found in the bone
marrow. The fragments of
these megakaryocytes are platelets that are released into the blood stream. The
circulating platelets make up about two third of the platelets that are released
from the bone marrow. The other one third is typically stored (sequestered) in
the spleen.
Platelets, in general, have a brief 7 to 10 days life in
the blood, after which they are removed from the blood circulation. The number of platelets in
the blood is referred to as the platelet count and is
normally between 150,000 to 450,000 per micro liter (one millionth of a liter) of blood. Platelet counts
less than 150,000 are termed thrombocytopenia. Platelet counts greater that
450,000 are called thrombocytosis.
The function of platelets is very important in the
clotting system. Platelets are a part of a very complicated pathway. They
circulate in the blood vessels and become activated if there is any bleeding or
injury in the body.
Certain chemicals are released from the injured blood vessels or other structures
that signal platelets to become activated and join the other components of the
system to stop the bleeding. When activated, the platelets become sticky and
adhere to one another and to the blood vessel wall at the site of the injury to
slow down and stop the bleeding by plugging up the damaged blood vessel or
tissue (hemostasis).
It is important to note that, even though, the platelet numbers are decreased
in thrombocytopenia, their function usually remains completely intact. Other
disorders exist that can cause impaired platelet function despite normal
platelet count.
Low platelet count in severe cases may result in spontaneous bleeding or may
cause delay in the normal process of clotting. In mild thrombocytopenia, there
may be no adverse effects in the clotting or bleeding pathways.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
Leukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
Blood clots can occur in the venous and arterial vascular system. Blood clots can form in the heart, legs, arteries, veins, bladder, urinary tract and uterus. Risk factors for blood clots include high blood pressure and cholesterol, diabetes, smoking, and family history. Symptoms of a blood clot depend on the location of the clot. Some blood clots are a medical emergency. Blood clots are treated depending upon the cause of the clot. Blood clots can be prevented by lowering the risk factors for developing blood clots.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Non-Hodgkin's lymphoma is cancer of the lymphatic system, a vital part of the body's immune system. Symptoms include swollen lymph nodes, fever, night sweats, coughing, weakness, chest pain, unexplained weight loss, and abdominal pain. Treatment depends on which type of non-Hodgkin's lymphoma you have, the stage of the cancer, your age, how fast the cancer is growing, and whether you have other health problems.
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by
blood transfusion, hemodialysis, and needle sticks, especially with intravenous
drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
A hematoma is a collection of blood that is outside a blood vessel. There are different areas where hematomas occur including the inside the skull, scalp, ear, septum, bones, finger and toenails, and intra-abdominal. Treatment for hematomas depend on the type and location of the hematoma.
The hepatitis B virus is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
The spleen enlarges if it is asked to do excessive work in filtering or manufacturing blood cells, if there is abnormal blood flow to it, or if it is invaded with abnormal cells or deposits. Symptoms of an enlarged spleen may include weakness and fatigue, easy bleeding, and poor white blood cell function. Treatment of an enlarged spleen is focused toward the cause of the splenomegaly. Surgery may be required to remove the spleen.
Pernicious anemia is a blood disorder in which the body does not make enough red blood cells due to a lack of vitamin B12 in the blood. Pernicious anemia can develop from a lack of a protein that helps the body absorb vitamin B12, not getting enough B12 in the diet, and certain intestinal conditions that interfere with the absorption of vitamin B12 such as Crohn's disease, celiac sprue, or ulcerative colitis. There is no cure for pernicious anemia, thus treatment is life-long.
Vasculitis is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.
Fifth disease (Erythema infectiosum) is caused by a virus known as parvovirus B 19. Symptoms include low-grade fever, fatigue, a "rash," and a rash over the whole body. The name fifth disease reflects the historical belief that it was one of the five diseases that produced a rash in children.
There are many types of E. Coli (Escherichia coli ). Pathogenic E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburger or raw milk or dairy products.
Mumps is an acute viral illness caused by the mumps virus. Symptoms of mumps include fever, headache, muscle aches, tiredness, and loss of appetite; followed by swelling of the salivary glands.
Idiopathic means that the cause of the condition isn't known. Thrombocytopenic means there's a lower than normal number of platelets in the blood. Purpura refers to purple bruises caused by bleeding under the skin. Idiopathic thrombocytopenic purpura (ITP) is a bleeding condition in which the blood doesn't clot as it should. This is due to a low number of blood cell fragments called platelets.
German measles is a disease that's caused by a virus. Symptoms include rash and fever for two to three days. The MMR (measles, mumps, and rubella) vaccine prevents this disease.
The spleen is an organ located in the upper left quadrant of the abdomen just
below the diaphragm and protected under the lower left ribs.
The spleen has a couple of important functions involving blood cells within
the body.
It filters blood and removes old and damaged red blood cells,
bacteria, and other particles as they pass through the maze of blood vessels
within the spleen.
It produces lymphocytes, a type of white
blood cell that produces antibodies and assists immune system.
The
filtration system is part of the red pulp while the white pulp of the spleen
contains the immune functioning cells
Normally, the spleen is a small organ about the size of a small fist or
orange. Splenomegaly describes the situation where the spleen enlarges in size
(spleen+megaly=enlargement).
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