Please enable JavaScript.
Coggle requires JavaScript to display documents.
Immune thrombocytopenic purpura (ITP) (Clinical presentation (Purpura,…
Immune thrombocytopenic
purpura (ITP)
Clinical
presentation
Purpura
Bruising
Petechiae
Epistaxis
Diagnosis
Examination
Derm exam
Petechiae, purpura,
bruising, epistaxis
Investigations
Bloods
FBC (low Plt), Fe studies (normal), clotting (nil),
G+S, crossmatch (incase of major haemorrhage)
Immune screen (anti-Plt Abs +ve)
Genetic screen (haemophilia, vWF -ve)
Blood film (nil)
Bedside
Obs
History
PC/HPC
Acute onset bruising, petechiae, epistaxis
Recent viral infection 1-2wk
PMH
Growth and development
Vaccinations
Known medical conditions
DH
Meds, allergies
FH
ITP, haemophilia, vWF
SH
Living arrrangements,
nursery/school/occupation
Management
Conservative
Information, advice, support
Avoid contact sports
Monitoring (SLE)
Medical
Steroids
Indication: evidence of bleeds
E.g. PO prednisolone
IV Ig
Indication: severe bleed
Anti-D
Indication: severe bleeds
Plt transfusion
Indication: life threatening haemorrhage
MOA: raises count temporarily,
plts inevitably destroyed by Ig
Rituximab
Indication: chronic, symptomatic ITP
MOA: inhibition of B-cells producing Ab
Splenectomy
Indication: relapse, unresponsive disease
MOA: can be curative
Complications
ICH
Rare, often only if severe
and prolonged drop in Plt
Definition
Aquired haematological disorder
of reduced platelets and
bleeding tendancy
Epidemiology
Commonest cause of thrombocytopenia
in childhood
Present between 2-10y
Pathophysiology
Defect
Development of anti-platelet auto-Abs,
usually following acute viral infection (1-2wk)
May be mild, moderate or severe loss of Plt
Mechanism
Destruction of circulating Plts by IgG auto-Abs
BM may try to compensate by increasing megakaryocyte production
Prognosis
Acute, benign and
self limiting <8w in most
Chronic ITP in 20%