Immune thrombocytopenic purpura: Difference between revisions
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{{ Infobox diagnosis | |||
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| Synonyms = immune thrombocytopenia, idiopathic thrombocytopenic purpura | |||
| Micro = germinal centres in white pulp (~55% of cases), [[neutrophil]]s in the red pulp (~67% of cases), macrophages in the red pulp | |||
| Subtypes = clinical: primary, secondary | |||
| LMDDx = | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = +/-prominent white nodules (spleen), normal appearance (most common) | |||
| Grossing = [[splenectomy grossing]] | |||
| Site = systemic - see ''[[spleen]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = bleeding | |||
| Prevalence = uncommon | |||
| Bloodwork = thrombocytopenia, antiplatelet antibodies | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = dependent on underlying cause | |||
| Other = | |||
| ClinDDx = | |||
| Tx = corticosteroids, possibly splenectomy | |||
}} | |||
'''Immune thrombocytopenic purpura''', abbreviated '''ITP''', is a rare condition. | '''Immune thrombocytopenic purpura''', abbreviated '''ITP''', is a rare condition. | ||
It is also known as ''idiopathic thrombocytopenic purpura''.<ref>URL: [https://medlineplus.gov/ency/article/000535.htm https://medlineplus.gov/ency/article/000535.htm]. Accessed on: 7 September 2016.</ref> | |||
==General== | ==General== | ||
*A common non-trauma reason for [[splenectomy]].<ref name=pmid24798604>{{Cite journal | last1 = Jankulovski | first1 = N. | last2 = Antovic | first2 = S. | last3 = Kuzmanovska | first3 = B. | last4 = Mitevski | first4 = A. | title = Splenectomy for haematological disorders. | journal = Pril (Makedon Akad Nauk Umet Odd Med Nauki) | volume = 35 | issue = 1 | pages = 181-7 | month = | year = 2014 | doi = | PMID = 24798604 }}</ref> | |||
Presentation: | Presentation: | ||
*Bleeding - usually.<ref name=pmid23714309>{{cite journal |author=Kistangari G, McCrae KR |title=Immune thrombocytopenia |journal=Hematol. Oncol. Clin. North Am. |volume=27 |issue=3 |pages=495–520 |year=2013 |month=June |pmid=23714309 |doi=10.1016/j.hoc.2013.03.001 |url=}}</ref> | *Bleeding - usually.<ref name=pmid23714309>{{cite journal |author=Kistangari G, McCrae KR |title=Immune thrombocytopenia |journal=Hematol. Oncol. Clin. North Am. |volume=27 |issue=3 |pages=495–520 |year=2013 |month=June |pmid=23714309 |doi=10.1016/j.hoc.2013.03.001 |url=}}</ref> | ||
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***[[Systemic lupus erythematosus]].<ref>{{cite journal |author=Cines DB, Liebman H, Stasi R |title=Pathobiology of secondary immune thrombocytopenia |journal=Semin. Hematol. |volume=46 |issue=1 Suppl 2 |pages=S2–14 |year=2009 |month=January |pmid=19245930 |pmc=2682438 |doi=10.1053/j.seminhematol.2008.12.005 |url=}}</ref> | ***[[Systemic lupus erythematosus]].<ref>{{cite journal |author=Cines DB, Liebman H, Stasi R |title=Pathobiology of secondary immune thrombocytopenia |journal=Semin. Hematol. |volume=46 |issue=1 Suppl 2 |pages=S2–14 |year=2009 |month=January |pmid=19245930 |pmc=2682438 |doi=10.1053/j.seminhematol.2008.12.005 |url=}}</ref> | ||
**Viral. | **Viral. | ||
**Bacterial - possibly [[Helicobacter pylori]].<ref>{{cite journal |author=Kuwana M |title=Helicobacter pylori-associated immune thrombocytopenia: clinical features and pathogenic mechanisms |journal=World J. Gastroenterol. |volume=20 |issue=3 |pages=714–23 |year=2014 |month=January |pmid=24574745 |pmc=3921481 |doi=10.3748/wjg.v20.i3.714 |url=}}</ref> | **Bacterial - possibly [[Helicobacter pylori]].<ref name=pmid24574745>{{cite journal |author=Kuwana M |title=Helicobacter pylori-associated immune thrombocytopenia: clinical features and pathogenic mechanisms |journal=World J. Gastroenterol. |volume=20 |issue=3 |pages=714–23 |year=2014 |month=January |pmid=24574745 |pmc=3921481 |doi=10.3748/wjg.v20.i3.714 |url=}}</ref><ref name=pmid25728540>{{Cite journal | last1 = Frydman | first1 = GH. | last2 = Davis | first2 = N. | last3 = Beck | first3 = PL. | last4 = Fox | first4 = JG. | title = Helicobacter pylori Eradication in Patients with Immune Thrombocytopenic Purpura: A Review and the Role of Biogeography. | journal = Helicobacter | volume = 20 | issue = 4 | pages = 239-51 | month = Aug | year = 2015 | doi = 10.1111/hel.12200 | PMID = 25728540 }}</ref> | ||
==Gross== | ==Gross== | ||
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*[http://www.webpathology.com/image.asp?case=376&n=2 ITP spleen (webpathology.com)]. | *[http://www.webpathology.com/image.asp?case=376&n=2 ITP spleen (webpathology.com)]. | ||
*[http://www.pathpedia.com/education/eatlas/histopathology/spleen/immune_thrombocytopenic_purpura_(itp).aspx ITP spleen (pathpedia.com)]. | *[http://www.pathpedia.com/education/eatlas/histopathology/spleen/immune_thrombocytopenic_purpura_(itp).aspx ITP spleen (pathpedia.com)]. | ||
==Sign out== | |||
<pre> | |||
Spleen, Splenetectomy: | |||
- Spleen with prominent red pulp macrophages and expanded germinal | |||
centres, pending hematopathology consult. | |||
</pre> | |||
===Block letters=== | |||
<pre> | |||
SPLEEN, SPLENECTOMY: | |||
- SPLEEN WITH CHANGES COMPATIBLE WITH IMMUNE THROMBOCYTOPENIC PURPURA. | |||
</pre> | |||
===Micro=== | |||
The sections show spleen with increased numbers of red pulp macrophages and siderophages. Rare scattered red pulp neutrophils are seen. Rare plasma cells are seen in the red pulp. Lymphoid follicles do not show significant expansion. | |||
==See also== | ==See also== | ||