Immune thrombocytopenic purpura
Immune thrombocytopenic purpura, abbreviated ITP, is a rare condition.
| Immune thrombocytopenic purpura | |
|---|---|
| Diagnosis in short | |
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| |
| Synonyms | immune thrombocytopenia |
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| LM | germinal centres in white pulp (~55% of cases), neutrophils in the red pulp (~67% of cases), macrophages in the red pulp |
| Subtypes | clinical: primary, secondary |
| Gross | +/-prominent white nodules (spleen), normal appearance (most common) |
| Site | systemic - see spleen |
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| Symptoms | bleeding |
| Prevalence | uncommon |
| Blood work | thrombocytopenia, antiplatelet antibodies |
| Prognosis | dependent on underlying cause |
| Treatment | corticosteroids, possibly splenectomy |
General
Presentation:
- Bleeding - usually.[1]
Blood work:
- Thrombocytopenia.
- Antiplatelet antibodies.
Treatment:
Prevalence:
- Uncommon.
Classification
- Primary - diagnosis of exclusion.
- Secondary.
- Autoimmune.
- Viral.
- Bacterial - possibly Helicobacter pylori.[4]
Gross
Features:[5]
- Typically ~ 100 grams.
- +/-Prominent white nodules (AKA Malpighian corpuscles) - uncommon.
Microscopic
Features:[5]
- 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.[5]
- † May be a finding associated with treatment.[5]
- The classic changes are proliferation of lymphoid germinal centres and red pulp PMNs.
Images
See also
References
- ↑ 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.
- ↑ 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.
- ↑ Cines DB, Liebman H, Stasi R (January 2009). "Pathobiology of secondary immune thrombocytopenia". Semin. Hematol. 46 (1 Suppl 2): S2–14. doi:10.1053/j.seminhematol.2008.12.005. PMC 2682438. PMID 19245930. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682438/.
- ↑ 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/.
- ↑ 5.0 5.1 5.2 5.3 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/.