Onyalai

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Onyalai[edit | edit source]

Onyalai skin lesions

Onyalai is a rare hematological disorder characterized by the sudden onset of thrombocytopenia and the appearance of purpura and mucosal bleeding. It is primarily observed in certain regions of Africa, particularly in the Democratic Republic of the Congo, Namibia, and Angola.

Clinical Presentation[edit | edit source]

Patients with onyalai typically present with petechiae, ecchymoses, and mucosal hemorrhages. The condition is marked by a rapid decrease in platelet count, leading to an increased risk of bleeding. The skin lesions are often the first noticeable sign, appearing as dark, bruise-like spots on the skin.

Pathophysiology[edit | edit source]

The exact cause of onyalai is not well understood, but it is believed to be an autoimmune disorder where the body's immune system mistakenly attacks and destroys its own platelets. This destruction leads to the characteristic thrombocytopenia seen in affected individuals.

Diagnosis[edit | edit source]

Diagnosis of onyalai is primarily clinical, based on the presence of purpura and mucosal bleeding in conjunction with a low platelet count. Laboratory tests are used to rule out other causes of thrombocytopenia, such as immune thrombocytopenic purpura (ITP) or thrombotic thrombocytopenic purpura (TTP).

Treatment[edit | edit source]

Treatment of onyalai focuses on managing symptoms and preventing complications. Corticosteroids are often used to suppress the immune response and increase platelet count. In severe cases, intravenous immunoglobulin (IVIG) or plasmapheresis may be employed. Avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) and other medications that can exacerbate bleeding is recommended.

Epidemiology[edit | edit source]

Onyalai is predominantly found in certain African populations, with a higher incidence reported in rural areas. The condition affects both genders equally and can occur at any age, although it is more commonly seen in young adults.

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Contributors: Prab R. Tumpati, MD