Immune Thrombocytopenic Purpura (ITP)
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Platelet Disorders
- Platelet Plug Formation
- Von Willebrand Disease
- Bernard-Soulier Syndrome
- Glanzmann Thrombasthenia
- Immune Thrombocytopenic Purpura (ITP)
- Thrombotic Thrombocytopenic Purpura (TTP)
- Hemolytic Uremic Syndrome (HUS)
- Disseminated Intravascular Coagulation (DIC)
Summary
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Key Points
- Immune Thrombocytopenic Purpura (ITP)
- Pathogenesis
- Destruction of normal platelets by spleen
- Usually due to anti-GpIIb/IIIa antibodies
- Splenic macrophages target and phagocytose platelets
- Idiopathic or secondary to autoimmune disorders (e.g. SLE), viral illnesses (e.g. HIV, HCV), malignancy (e.g. CLL), or drug reactions
- Destruction of normal platelets by spleen
- Presentation
- Mucocutaneous bleeding
- Gingival bleeding, menorrhagia, petechiae, epistaxis, easy bruising
- Mucocutaneous bleeding
- Diagnosis
- Decreased platelet count (thrombocytopenia)
- Quantitative defect in platelets; quality of platelets is unaffected
- Isolated thrombocytopenia is often the only symptom of disease
- Increased megakaryocytes on bone marrow biopsy
- Intact compensatory response to platelet destruction
- Increased bleeding time
- Due to decreased platelet count
- Decreased platelet count (thrombocytopenia)
- Treatment
- Steroids
- IVIG
- Rituximab
- TPO receptor antagonists (e.g. eltrombopag, romiplostim)
- Splenectomy for refractory cases
- Pathogenesis