Autoimmune conditions

Question 1

What is the most common cause of low platlets in children

Answer 1

idiopathic thrombocytopaenia

Question 2

What is ITP - idiopathic thombocytopaenia

Answer 2

Autoimmune condition characterised by reduced platelets due to increased destruction (sometimes reduced production)

Question 3

What are the secondary causes of idiopathic thrombocytopaenia

Answer 3

• viral illness - CMV, Hep, HIV, Varicella
• H. pylori
• other autoimmune conditions e.g. SLE
• medication
• lymphoproliferative disorders

Question 4

What is the most common causeIMMUNE THROMBOCYTOPENIA in chilrend

Answer 4

usually follows a viral ifnection. usually resovles in 6-7 weeks.

Question 5

What is the most common presentation of immune thrombocytoaenia

Answer 5

• petichiae and bruising
• asymptomatic
• nose bleeds

Question 6

What investigations should you do in someone with low platlets

Answer 6

• FBC
• peripherlal blood smear
• consider bone marrow if uncertain of diagnosis or atypical features present

Question 7

What is aplastic anaemia

Answer 7

bone marrow failure where the stem cells in the bone marrow don’t produce enough blood cells leading to a pancytopaenia

Question 8

How do you characterise aplastic anaemia

Answer 8

need to have 2 of the following:

• Haemoglobin <100
• Platelet < 50 x
• Neutrophil <1.5

Question 9

What are the causes of aplastic anaemia

Answer 9

• 70-80% idiopathic
• congenital - fanconis anaemia/diamond Blackfarn
• Acquired: infection - Hepatitis, HIV, EBV, parvovirus
• Drugs - diclofenac, pheytoin, carbmezapine,carbimazol
• preganancy
• sickle cell - aplastic crisis due to parvovirus

Question 10

How would you investigate aplastic anaemia

Answer 10

• FBC inc. reticulocyte count + blood film
• bone marrow aspirate
• B12 + folate
• LFTs