Haematology

Question 1

What is Immune Thrombocytopenia?

Answer 1

Immune Thrombocytopenia is an immune-mediated reduction in platelet count, where antibodies are directed against the glycoprotein IIb/IIIa or Ib-V-IX complex

Question 2

What type of hypersensitivity reaction is Immune Thrombocytopenia?

Answer 2

type II hypersensitivity reaction

Question 3

How does Immune Thrombocytopenia typically differ in children compared to adults?

Answer 3

in children it is usually more acute and may follow an infection or vaccination.

Question 4

What are common features of Immune Thrombocytopenia in children?

Answer 4

• Bruising
• Petechial or purpuric rash
• Less common bleeding (typically epistaxis or gingival bleeding)

Question 5

What investigations are typically done for Immune Thrombocytopenia in children?

Answer 5

• FBC - isolated thrombocytopenia
• Blood film
• BM exam

Question 6

When is bone marrow biopsy done for suspected Immune Thrombocytopenia in children?

Answer 6

only if there are atypical features:
* lymph node enlargement
* splenomegaly
* abnormal white cell count
* failure to respond to treatment

Question 7

How is Immune Thrombocytopenia managed in children?

Answer 7

• usually, no treatment is required - ITP resolves in around 80% of children with 6 months
• advice to avoid activities that may result in trauma
• Treatment is indicated if the platelet count is very low (e.g., < 10 * 10⁹/L) or if there is significant bleeding
  
  • oral/IV corticosteroid
  • IV immunoglobulins
  • platelet transfusions can be used in an emergency