Haem - ITP, Aplastic Anaemia Flashcards
Immune (or idiopathic) thrombocytopenic purpura (ITP) - what is it?
Autoimmune disease of unknown cause where the number of circulating platelets is reduced
Antibodies are directed against the glycoprotein IIb/IIIa or Ib-V-IX complex
ITP - how doe sit present in children and adults?
In adults more of a chronic condition
In children - usually acute thrombocytopenia following infection or vaccination
ITP in adults - what is the clinical presentation?
Symptomatic patients:
- petichae, purpuric rash (non-blanching rash)
- bleeding (e.g. epistaxis)
- catastrophic bleeding (e.g. intracranial) - not common
Can be found incidentally on routine bloods
ITP in adults - management?
1st LINE - Oral Prednisolone
Pooled normal human immunoglobulin (IVIG) - raises platelet count faster than steroids, so use in active bleeding or urgent invasive procedure
Aplastic Anaemia - what is it?
Characterised by pancytopenia and a hypoplastic bone marrow
Aplastic Anaemia - peak age of incidence?
30 years old
Aplastic Anaemia - clinical features?
NORMOCHROMIC, NORMOCYTIC ANEMIA
leukopenia, with lymphocytes relatively spared
thrombocytopenia
may be the presenting feature acute lymphoblastic or myeloid leukaemia
a minority of patients later develop paroxysmal nocturnal haemoglobinuria or myelodysplasia1.
Aplastic Anaemia - causes?
idiopathic
drugs: cytotoxics, chloramphenicol, sulphonamides, PHENYTOIN, gold
toxins: benzene
infections: parvovirus, hepatitis
radiation
congenital: Fanconi anaemia, dyskeratosis congenita
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