Pediatric Thrombocytopenia - Newman Flashcards
what is considered normal platelet count?
150-450k
what is considered thrombocytopenia?
<150k
what platelet count is spontaneous bleeding possible?
50k
what platelet count is life threatening hemorrhage possible?
<10k
presents after acute gastroenteritis (within 2 weeks), classic triad of:
- microangiopathic hemolytic anemia
- thrombocytopenia
- acute renal damage
HUS
- most cases caused by E.coli shiga toxin
what are the clinical manifestations of platelet disorders?
- petechiae
- purpura
- gingival bleeding
- epistaxis
- menorrhagia
- hematuria
tiny subQ micro-hemorrhages which appear as scattered discrete purple/red non-blanching pinpoint macules
diffuse petechial rash
purple/red spots on the skin, do not blanch on applying pressure, caused by bleeding underneath the skin, bigger than petechiae
purpura
MCC isolated thrombocytopenia in otherwise well children
- manifests as sudden onset of petechiae and bruising
- platelet count usually <20k (those present are large)
- PT/PTT and other cell lines normal
- often follows VIRAL illness
acute idiopathic thrombocytopenic purpura
- aka IMMUNE thrombocytopenia purpura
- overall, 20% becomes chronic
what is the tx of acute ITP?
- prednisone
- IVIG
- anti-D immunoglobulin
thrombocytopenia and hypofibrinogenemia secondary to giant hemangioma and associated intravascular coagulation
Kasabach-Merritt syndrome
- peak incidence 2-6 years
- no sex preference
- infection common 1-3 weeks before
- platelets <20k
- eosinophilia common
- duration 2-6 weeks
- spontaneous remission in 80% of cases
acute ITP
- peak incidence 20-40 years
- 3:1 F:M preference
- infection before is uncommon
- insidious onset of bleeding
- platelets 30-80k
- eosinophilia rare
- duration months-years
- spontaneous remission uncommon
chronic ITP
