Thrombocytopenia Flashcards
What is thrombocytopenia?
Low platelet count
Problems with Production leading to thrombocytopenia (5)
Sepsis
B12 or folic acid deficiency
Liver failure causing reduced thrombopoietin production in the liver
Leukaemia
Myelodysplastic syndrome
Problems with Destruction leading to thrombocytopenia
Haemolytic-uraemic syndrome
Immune thrombocytopenic purpura
Medications (sodium valproate, methotrexate, isotretinoin, antihistamines, proton pump inhibitors)
Alcohol
Thrombotic thrombocytopenic purpura
Heparin-induced thrombocytopenia
How does thrombocytopenia present?
Platelet counts below 50 x 109/L will result in easy or spontaneous bruising and prolonged bleeding times
Present with nosebleeds, bleeding gums, heavy periods, easy bruising or blood in the urine or stools
Platelet counts below 10 x 109/L are high risk for spontaneous bleeding. Spontaneous intracranial haemorrhage or GI bleeds are particularly concerning
Differential Diagnosis of Abnormal or Prolonged Bleeding
Thrombocytopenia (low platelets)
Haemophilia A and haemophilia B
Von Willebrand Disease
Disseminated intravascular coagulation
What is Immune Thrombocytopenic Purpura (ITP)?
Antibodies are created against platelets
Management of ITP
Prednisolone (steroids)
IV immunoglobulins
Rituximab (a monoclonal antibody against B cells)
Splenectomy
What is Thrombotic Thrombocytopenic Purpura?
Tiny blood clots develop throughout the small vessels of the body using up platelets and causing thrombocytopenia
ADAMTS13 (von Willebrand factor-cleaving protease) deficiency
von Willebrand factor overactivity
What is Heparin Induced Thrombocytopenia?
Development of antibodies against platelets in response to exposure to heparin
Patient on heparin with low platelets forms unexpected blood clots
Diagnosis is by testing for the HIT antibodies
