Platelet disorders encompass a range of conditions that affect the function or production of platelets, crucial components of blood responsible for clotting. These disorders can manifest in various ways, leading to abnormalbleeding or clotting tendencies, posing significant health risks. Understanding the underlying causes, recognizing symptoms, and exploring treatment options are vital for effectively managing these conditions and minimizing their impact on individuals' health and well-being. This introduction aims to provide insight into the complexities of platelet disorders, offering a foundation for further exploration and understanding.
Immune Thrombocytopenic Purpura
It is a platelet disorder in which there is isolated thrombocytopenia and the platelets are less than 1,00,000 per microliter.
Acute Immune Thrombocytopenic Purpura:
Immune Thrombocytopenic Purpura causes
Primary causes - EBV, CMV, and Rubella.
Secondary causes- Myelodysplastic syndrome, SLE, and HIV.
Clinical features of Immune Thrombocytopenic Purpura (ITP)
The patient will present with Recurrentnose bleeding.
Menorrhagia in females
Petechiae in ankles.
Purpura will occur that is non-palpable.
Spleen will remain normal but may appear palpable in rare cases of ITP.
Sometimes mucocutaneousbleeding can occur. Eg.- epistaxis, hematuria, and gastrointestinal bleeding.
Diagnosis and Workup of ITP
The platelet counts will be low and mostly these are less than 1,00,000 per microliter.
In peripheral smear, the platelet count is less and the size is relatively larger.
On bone marrow aspiration, normal or large-size megakaryocytes will be seen. The number of megakaryocytes will be high.
Treatment of Acute Immune Thrombocytopenic Purpura
Intravenous steroids like Methylprednisolone are an important line of management.
It is very important to clarify the blood group of the patient because RH-positive and RH-negative patients are treated differently.
In Rh+ patients- RhoGAMimmunoglobulin can also be given. The mechanism of action is saturation of Fc receptors. This causes inhibition of the Fc receptors function.
In Rh-ve patients- intravenous immunoglobulins are given that help in the clearance of harmful antibodies.
No platelettransfusion is recommended because it will worsen the situation.
Elective splenectomy is recommended. This can make the patient susceptible to infections, therefore vaccines against encapsulated bacteria like pneumococcus, meningococcus, and hemophilusinfluenza should be administered to the patient after splenectomy.
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