Sjofjan, Syahirah Ayu and Saharudin, Shahida and Majiran, Nur Rahman and Md Supian, Badrul Hisham (2025) Diversity in clinical challenges of aplastic anemia: ethical reflections on hidden thrombosis risk. In: 1st Asean Conference on Shariah-Compliant Healthcare (ASCOCH2025), 13th November 2025, Kuantan, Pahang, Malaysia.
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Abstract
Introduction: Aplastic anaemia is predominantly managed with concerns over bleeding and infection, while thrombotic complications such as venous thromboembolism (VTE) remain under-recognised. This case reflects the diversity of clinical manifestations in aplastic anaemia and emphasises the importance of culturally sensitive, Shariah-compliant approaches in complex decision-making. In line with hifz al-nafs (preservation of life) and harm reduction (darar), timely diagnosis is vital to ensure ethical and effective patient care. Methods: A descriptive case study design was applied, documenting the clinical presentation, bedside assessment, and ethical considerations in a patient with severe haematological disorder. Point-of-care ultrasound (POCUS) was used as the primary diagnostic modality, aligning with principles of accessibility and equity in resource-limited settings, and supporting diverse patient populations in Muslim-majority contexts. Results: A 49-year-old woman with very severe aplastic anaemia (platelet count 4 ×10⁹/L) presented with limb swelling, hypoxia, and hypotension. Despite atypical features and the absence of Virchow’s triad, POCUS confirmed femoral and popliteal deep vein thrombosis with right heart strain. Due to recent intracranial bleeding, anticoagulation was withheld. The patient was stabilised with supportive care, highlighting the clinical tension between bleeding risks and thrombotic management within diverse healthcare realities where ethical, religious, and safety considerations intersect. Conclusion: This case illustrates how assumptions of bleeding risk may overshadow the potential for thrombosis in aplastic anaemia. The integration of POCUS as a bedside diagnostic tool not only facilitates rapid and safe decision-making but also reflects Shariah-compliant principles of safeguarding life, ensuring just healthcare delivery, and embracing diversity in clinical care. Broader awareness of VTE risks in thrombocytopenic patients is essential to align practice with ethical, diverse, and Shariah-compliant healthcare frameworks.
| Item Type: | Proceeding Paper (Poster) |
|---|---|
| Additional Information: | 6428/124863 |
| Uncontrolled Keywords: | Aplastic anemia; Maqasid shariah; POCUS; thrombocytopenia; venous thromboembolism |
| Subjects: | R Medicine > R Medicine (General) |
| Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): | Kulliyyah of Medicine Kulliyyah of Medicine > Department of Basic Medical |
| Depositing User: | DR SHAHIDA SAHARUDIN |
| Date Deposited: | 03 Dec 2025 12:51 |
| Last Modified: | 03 Dec 2025 13:05 |
| Queue Number: | 2025-11-Q317 |
| URI: | http://irep.iium.edu.my/id/eprint/124863 |
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