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10 Cards in this Set
- Front
- Back
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Immune Thrombocytopenic Purpura pathogenesis
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molecular mimicry to a viral infection - varcella?
antibodies to platelets -> destruction of platelets |
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Immune Thrombocytopenic Purpura symptoms
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very low platelet couts (< 10000)
bruising and petechiae and epistaxis often asymptomatic but can progress to mucocutaneous hemorrhage and intracranial bleeding |
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Immune Thrombocytopenic Purpura patients you worry about
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patients with trauma, especially head trauma
patients with signficant mucosal bleeding, CU tract or GI tract hemorrhage, hemoptysis |
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Immune Thrombocytopenic Purpura diagnosis
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isolated thrombocytopenia with purpura
no splenomegaly no hepatomegaly no lymphadenopathy |
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Immune Thrombocytopenic Purpura Lab findings Peripheral smear
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isolated thrombocytopenia with normal or large platelets
RBC and WBC normal rule out pseudothrombocytopenia, macrothrombocytopenia (uniformly large platelets) |
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Immune Thrombocytopenic Purpura lab findings bone marrow
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normal or increased megakaryocytes
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Immune Thrombocytopenic Purpura treatment
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corticosteroids are the first line drugs to give
IVIg - occupies Fc receptor on macrophages preventing phagocytosis of platelets IV Rh - Rh+ antibodies to RBC, macrophages eat the RBCs instead of platelets - less expensive than IVIg Rituximab - antiCD20 on B cells to reduce production of autoantibodies splenectomy |
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how does a splenectomy help in treatment of Immune Thrombocytopenic Purpura
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many B cells that make autoantibodies are in spleen
spleen is primary site of platelet destruction |
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why is thrombopoietin levels low in Immune Thrombocytopenic Purpura
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thrombopoietin binds platelets
platelets are eaten by macrophages which destroys the thrombopoietin with it |
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Amegkaryocytic thrombocytopenia
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megakaryocytes arrested development -> no platelets
see high serum thrombopoietin becuase it usually binds platelets |
