Immune Thrombocytopenic Purpura Flashcards

1
Q

Definition

A

Syndrome characterised by immune destruction of platelets resulting in bruising or a bleeding tendency

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2
Q

Aetiology

A
  • Often IDIOPATHIC
  • Acute ITP is often seen after viral infection in children
  • Chronic ITP is more common in adults

• Autoantibodies are generated, which bind to platelet membrane proteins (e.g. GlpIIb/IIIa) resulting in thrombocytopaenia

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3
Q

Associated with

A

o Infections (e.g. malaria, EBV, HIV)
o Autoimmune diseases (e.g. SLE, thyroid disease)
o Malignancies
o Drugs (e.g. quinine)

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4
Q

Epidemiology

A

• Acute ITP presenting CHILDREN aged 2-7 yrs

• Chronic ITP is seen in ADULTS
o 4 x more common in WOMEN

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5
Q

Presenting symptoms

A
  • Easy bruising
  • Mucosal bleeding
  • Menorrhagia
  • Epistaxis
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6
Q

Signs on physical examination

A
  • Visible petechiae and bruises

* Signs of other illness (e.g. infections, wasting, splenomegaly) would suggest that other causes

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7
Q

Investigations (exclusions)

A

Diagnosis of exclusion - exclude:
o Myelodysplasia
o Acute leukaemia
o Marrow infiltration

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8
Q

Investigations

A

• Bloods
o FBC - low platelets
o Clotting screen - normal PT, APTT and fibrinogen
o Autoantibodies (e.g. antiplatelet antibody)

• Blood Film
o To rule out pseudothrombocytopaenia (which is caused by platelets clumping together and giving falsely low counts)

• Bone Marrow
o To exclude other pathology

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