Immune Thrombocytic Purpura and thrombotic thrombocytic purpura (ITP and TTP)

Question 1

What are symptoms of ITP?

Answer 1

Purpuric rash (otherwise sell systemically)
Bleeds easily
Menorrhagia

Question 1

Immune Thrombocytic Purpura is…

Answer 1

autoimmune platelet destruction (IgG)

Question 2

How do you diagnose
ITP?

Answer 2

Thrombocytopenia (platelet deficiency)
Increased bone marrow megakaryoblasts (negative feedback)

Question 3

What is treatment for ITP?

Answer 3

Prednisolone (corticosteroid to suppress immune response and increase platelet production) and IV IgG (temporarily suppress immune system’s attack on platelets)
To decrease splenic platelet destruction

Then splenectomy

Question 4

Which is more common ITP or TTP?

Answer 4

ITP

Question 5

TTP is normally ____ inheritance

Answer 5

familial

Question 6

TTP is when there is a deficiency of…

Answer 6

ADAMTS13 (VWF cleaving enzyme)

Question 7

Normally, VWF are cleaved into fragments but with TTP, the VWF remain as ____ and aggregate at e_____ i____ s____

Answer 7

multimers
endothelial injury sites

Question 8

Who is at risk of TTP?

Answer 8

Adult females with a malignancy, HIV or autoimmune condition.

Question 9

What are symptoms of TTP?

Answer 9

Purpuric rash
Menorrhagia
AKI (acute kidney injury)
Fever
Haemolytic anaemia
Neurological symptoms
Not well

Question 10

How do you diagnose TTP?

Answer 10

Thrombocytopenia
Schistosytes (fragmented RBCs, microangiopathic haemolytic anaemia)
Decreased ADAMTS13 (VWF cleaving enzyme)

Question 11

How do you treat TTP?

Answer 11

Plasmapheresis (plasma exchange)
Prednisolone and rituximab (monoclonal antibody binds to protein on surface of B cells)