Diseases List

ID 154
Name IDIOPATHIC THROMBOCYTOPENIC PURPURA
Cause
Signs Symptoms
Diagnosis Diagnosis: 1. Bone marrow- diagnosis is established by finding severe thrombocytopenia with normal & increased number of megakaryocytes in the bone marow. 2. Blood- the platelets are remarkably diminished in number. Bleeding time is markedly prolonged with normal coagulation time and prothrombin time. 3. Demonstration of anti-platelet & anti-megakaryocyte antibodies is possible in only a few patients
Investigations
Management
Introduction Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterised by thrombocytopenia in almost all cases due to formation of an autoantibody (IgG) against platelets, or occasionally antigen-antibody immune complexes adhering to the platelets
History
Etiology
Clinical Features Clinical features: It occurs most commonly in children and young adults. Bleeding is the dominent symptom which occurs spontaneously, but usually bleeding dose not occur until the platelet falls bellow 20,000/cml, unless their function is also compromised. Purpura and spontaneous bruising is the characteristic, but there may be epistaxis, bleeding gums, hematuria, malena. Bleeding may also occur following trauma, surgical and dental procedures. Severe thrombocytopenia (platelet < 10,000/cml) may result in retinal hemorrhage and potentially fatal intracranial bleeding. Beside these, bleeding in the other internal organs is very rare.
Preventions
Treatment Treatment: 1. During acute episode of bleeding, patient should take rest in bed. 2. Fresh blood transfusion should be given. 3. Heavy dose of steroid particularly Prednisolone Img/kg/day should be given until the platelet count rises to normal. Relapse should be treated with increasing dose. 4. If a patient has two relapse it is customary to consider splenectomy. 5. If significant bleeding persist despite splenectomy then a small dose of steroid immunosupressive therapy should be considerd.
Complications
Prognosis
Types
Classification
Observation
Pathology
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