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Thrombocytopenia

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Thrombocytopenia

  1. 1. Dr. Ayaz Lone
  2. 2.  Decreased Production:  Nutritional Deficiencies  B12, Folate  Bone marrow failure  Aplastic anaemia  Bone marrow infiltrations  Leukaemia  Metastasis  Granulomatous disease
  3. 3.  Ineffective haematopoiesis  Myelodysplastic syndromes  Selective Impairment  Drud induced (alcohol, Thiazides, cytotoxic)  Infections ( Measles, HIV)  Sequestration  Hypersplenism
  4. 4.  Decreased Survival:  Immunological destruction  Primary autoimmune  Acute ITP  Chronic ITP  Secondary Autoimmune  SLE
  5. 5.  Alloimmune  Post transfusion  Neonatal  Drug associated  Quinidine, heparin, Sulfa compounds  Infections  HIV, Dengue fever, Infectious mononucleosis
  6. 6.  Nonimmunologic  DIC  TTP  Giant haemangiomas  Dilutional  Massive transfussions
  7. 7.  Autoimmune disorder in which platelet sensitization by autoantibodies takes place, leading to destruction of opsonized platelets primarily by the mononuclear phagocytic system.
  8. 8.  Primary:  Acute  Chronic  Secondary:  Lymphoproliferative disorders  SLE  HIV  Evan’s syndrome
  9. 9.  Thrombocytopenia in ITP is mediated by anti- platelet antibodies directed against the platelet specific glycoproteins (GP) IIb- IIIa, Ib-IX or Ia-IIa.  Antibodies against viral protein antigen that are cross reactive against platelet antigens.
  10. 10.  Antibody coated platelets are susceptible to phagocytosis by the cells of the mononuclear phagocytic system.  Spleen plays a crucial role for 2 reasons;  Anti-platelet antibody production site  Destruction of sensitized platelet  IgG
  11. 11.  Petechiae  Easy bruising  Epistaxis  Bleeding gums  Melena  Hematuria
  12. 12.  A diagnosis of ITP should be made only after other causes of platelet deficiences have been ruled out.  CBC:  Anaemia  Thrombocytopenia  BT  Coagulation studies
  13. 13.  Bone marrow examination:  Megakaryocytic hyperplasia with both mature and maturing forms increased.

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