Immune thrombocytopenic purpura

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Immune thrombocytopenic purpura, abbreviated ITP, is a rare condition.

General

Presentation:

  • Bleeding - usually.[1]

Treatment:

  • Usually treated with corticosteroids.[1]
    • Possibly retuximab.[2]
  • Refractory cases get a splenectomy.

Prevalence:

  • Uncommon.

Classification

Gross

Features:[4]

  • Typically ~ 100 grams.
  • +/-Prominent white nodules (AKA Malpighian corpuscles) - uncommon.

Microscopic

Features:[4]

  • Germinal centres in white pulp (~55% of cases)
    • Classically described as "proliferative".
  • Neutrophils in the red pulp (~67% of cases).
  • Macrophages in the red pulp (~25% of cases). †

Notes:

  • Changes not dependent on titre of antiplatelet antibodies.[4]
  • † May be a finding associated with treatment.[4]
  • The classic changes are proliferation of lymphoid germinal centres and red pulp PMNs.

Images

See also

References

  1. ↑ 1.0 1.1 Kistangari G, McCrae KR (June 2013). "Immune thrombocytopenia". Hematol. Oncol. Clin. North Am. 27 (3): 495–520. doi:10.1016/j.hoc.2013.03.001. PMID 23714309.
  2. ↑ Zhang, C.; Liu, HF.; Chen, XH.; Gao, L.; Gao, L.; Liu, Y.; Kong, PY.; Sun, AH. et al. (Mar 2014). "Is splenectomy necessary for immune thrombocytopenic purpura? The role of rituximab in patients with corticosteroid resistance in a single-center experience.". Clin Ther 36 (3): 385-8. doi:10.1016/j.clinthera.2014.01.017. PMID 24594069.
  3. ↑ Kuwana M (January 2014). "Helicobacter pylori-associated immune thrombocytopenia: clinical features and pathogenic mechanisms". World J. Gastroenterol. 20 (3): 714–23. doi:10.3748/wjg.v20.i3.714. PMC 3921481. PMID 24574745. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921481/.
  4. ↑ 4.0 4.1 4.2 4.3 Hayes MM, Jacobs P, Wood L, Dent DM (September 1985). "Splenic pathology in immune thrombocytopenia". J. Clin. Pathol. 38 (9): 985–8. PMC 499346. PMID 4044880. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC499346/.