Immune thrombocytopenic purpura – causes, symptoms, diagnosis, treatment, pathology

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Immune thrombocytopenic purpura. Or itp is an autoimmune condition. In which the body produces antibodies against its own thrombocytes or platelets.
Which are destroyed and this results in purpura or small bleeding spots beneath the skin normally when theres any kind of damage to the blood vessel hemostasis occurs. Which is the process that stops the bleeding and plugs the damaged vessel to limit the blood loss and there are two steps primary and secondary hemostasis during primary hemostasis platelets aggregate to form a plug at the site of the ancient blood vessel platelet aggregation is mediated by surface proteins found on platelets called gp2 b3a receptors while these platelets are aggregating secondary hemostasis kicks in secondary hemostasis. Is also called coagulation because thats when clotting factors come into play.
One. After another with the ultimate goal of cleaving fibrinogen into fibrin. Then fibrin forms of protein mesh kind of like a giant net that covers the platelet plug and stabilizes.
It now in itp. The spleen produces certain igg auto antibodies which bind to the platelet receptor gp to beat 3a and targets the platelet antibody complexes for destruction in the spleen this leads to lowering of platelet counts in the blood. Which makes it harder for bleeding to stop.
Now. Itp can be acute or chronic acute itp. Usually affects children.
A couple weeks. After a viral infection and resolves spontaneously. Within two months.
Chronic itp usually affects females of reproductive age. And persist more than six months. Chronic itp can also be primary.
When it occurs without an underlying trigger or secondary.

a nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura-0
a nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura-0

When its triggered by another condition like hepatitis c. Hiv. Or lupus.
Most of the time itp is asymptomatic in some cases. It can cause purpura which are red or purple spots on the skin measuring 03. To one centimeter in diameter in severe cases of itp when platelet levels get very low.
There may be frequent mucosal bleeding. Which most commonly presents as epistaxis meaning nosebleeds itp is a diagnosis of exclusion. So there is no specific test that confirms the diagnosis interestingly.
The cbc usually shows isolated thrombocytopenia with a normal hematocrit and leukocyte count now in some cases. If theres significant bleeding that can lead to anemia an abdominal ultrasound is often done to rule out splenomegaly and hepatitis c. Virus.
And hiv testing are done to rule out secondary itp individuals with secondary itp are treated for their underlying condition while treatment of primary itp. Depends on the platelet count and symptoms asymptomatic patients with a platelet count over 30000. Can be observed and often recover on their own patients.
With an active bleed or those with a platelet count below 30000 are usually started either on corticosteroids or intravenous immunoglobulin or ivig for short corticosteroids act as immunosuppressants and ivig has an immunomodulatory effect both of them help stop the formation of new auto antibodies in individuals who dont respond to steroids a splenectomy can be done to get rid of the splenic macrophages that are destroying the platelets finally transfusing platelets can be done when platelet count is less than 10000. All right as a quick recap itp is a condition where the spleen produces igg auto antibodies against the platelet receptor gp2 b3a. Which leads to destruction of platelets acute itp lasts for less than two months and usually affects children chronic itp lasts more than six months and usually affects females of reproductive age.
Most of the time there are no symptoms. But sometimes individuals with itp can have purpura or even nosebleeds in some severe cases in general asymptomatic itp resolves on its own. But severe cases are treated with corticosteroids or intravenous immunoglobulin.
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a nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura-1
a nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura-1

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