Thrombocytopenia Flashcards
What is the pathophysiology of ITP?
Antibodies directed against glycoprotein IIb/IIIa or Ib-V-IX complex
What is the common presentation of ITP?
Post infection, vaccine, new drug
Petechiae, purpura
Epistaxis
What is seen on investigation with ITP?
Isolated thrombocytopenia
What is the management of ITP?
Steroids
IVIg if resistant or bleeding
What is TTP?
Thrombotic thrombocytopenia purpura
What is the pathophysiology of TTP?
Deficiency of ADAMST13, which normally cleaves large multimers of vWF. Large multimers of vWF cause platelet clumping within vessels
What is the classic presentation of TTP?
Fluctuating neurology due to micro emboli
Fever
Microangiopathic haemolytic anaemia (usually >80)
Thrombocytopenia
AKI
What are the causes of TTP?
Infection
Pregnancy
Tumours
SLE
HIV
Drugs - cyclosporin, COCP, clopidogrel, penicillin, aciclovir
What is the management of TTP?
Plasma exchange
Steroids
Immunosuppression
How is HUS differentiated from TTP?
TTP normally has fever and neurological signs as well as MAHA, AKI and thrombocytopenia
Hb usually lower (<80) in HUS
