SlideShare a Scribd company logo
1 of 16
Causes of
Thrombocytopenia
in pediatrics other
than ITPPrepared by:-
Asmaa Rabie Abdel Monem
A 5th grade med student
Alexandria University Faculty of Medicine
Causes of thrombocytopenia
increased destruction
 Immune mechanism
 Iodopathic (ITP)
 Secodary to infection, drugs, SLE
 Non-immune mechanism
 platelet consumption
 DIC ,HUS
 microangiopathic hemolytic
anemia
 platelet destruction
 Hypersplenism , drugs
 Prothetic heart valve
 sequesteration
 Large spleen
Decreased production
 Bone marrow depression
 Hereditary
 Fanconi anemia
 TAR syndrome
 Acquired
 Drugs , chemotherapy
 Inefction, hepatitis ,HIV
,EBV
 Bone marrow infiltration
 Leukemia ,neuroblastoma
 Storage disease
Secondary immune mechanism
Drug-Induced Thrombocytopenia
•A number of drugs are associated
with immune thrombocytopenia as
the result of either an immune
process or a megakaryocyte injury.
Heparin-induced hrombocytopenia (and rarely thrombosis) is seldom seen in
pediatrics but occurs when, after exposure to heparin, the patient develops
an antibody directed against the heparin/ platelet factor IV complex.
Non immune Platelet Destruction
increase platelet consumption
DIC
hemolytic-uremic syndrome
thrombotic
thrombocytopenic purpura
The syndromes of DIC, hemolytic-uremic syndrome, and thrombotic
thrombocytopenic purpura share the hematologic picture of
The microangiopathic hemolytic anemia is characterized by the
presence of RBC fragments, including helmet
cells, schistocytes, spherocytes, and burr cells.
Hemolytic-Uremic Syndrome (HUS)
Abnormal red cell morphology
Normal numbers of
megakaryocytes.
Combined Platelet and Fibrinogen Consumption Syndromes
Kasabach-Merritt Syndrome
Hemangioma
platelet trapping and activation of
coagulation with fibrinogen
consumption and generation of
fibrin(ogen)
Non immune Platelet Destruction
Sequestration
•Individuals with massive splenomegaly
develop thrombocytopenia, since the
spleen acts as a sponge for platelets
and sequesters large numbers.
•Most such patients will also have mild
leukopenia and anemia on the CBC.
Individuals who have
thrombocytopenia caused by splenic
sequestration should undergo a work-
up to diagnose the etiology of
splenomegaly, including
infectious, infiltrative, neoplastic, obstr
uctive, and hemolytic causes.
Thrombocytopenia - Underproduction
Marrow failure: myelodysplasia, aplastic
anemia, vitamin deficiencies.
Marrow infiltration: tumor, granulomatous
diseases, fibrosis, leukemias, lymphomas
Marrow toxins: drugs, radiation, infections
(CMV, HIV), alcohol.
Congenital Thrombocytopenic
Syndromes
Congenital Amegakaryocytic
thrombocytopenia
Bone marrow transplant is
curative.
Bone marrow failure
absence of megakaryocytes in
bone marrow examination.
Thrombocytopenia–absent radius
(TAR)
The thrombocytopenia of TAR
syndrome frequently remits
over the first few years of life.
Fanconi anemia
Aplastic anemia not present
at birth, develops about 6
yr of age; fatal without
bone marrow transplant;
chromosomal breakage
challenge test available for
early diagnosis.
Wiskott-Aldrich syndrome (WAS)
Microthrombocytopenia
Eczema
Recurrent infections
X-linked
Normal number of
megakaryocytes
Successful bone
marrow
transplantation cures
WAS.
Microthrombocytes
Refrences
1. Nelson textbook of pediatrics 19th edition,
Chapter 476.
2. Dan L. Longo, HARRISON’S Hematology and
Oncology;
3. Childhood idiopathic thrombocytopenic purpura
(itp): over 40 year of experiences; Medical
Journal of Islamic World Academy of Sciences
19:4, 151-160, 2011.
-http://www.uptodate.com/contents/clinical.4
-of-evaluation-and-manifestations
children-in-thrombocytopenia
Causes of Thrombocytopenia in pediatrics other than ITP

More Related Content

What's hot

Thrombotic Thrombocytopenic Purpura
Thrombotic Thrombocytopenic PurpuraThrombotic Thrombocytopenic Purpura
Thrombotic Thrombocytopenic Purpura
Shakeel Arif
 
Thrombocytopenia
ThrombocytopeniaThrombocytopenia
Thrombocytopenia
fitango
 
Hemolytic uremic syndrome
Hemolytic uremic syndromeHemolytic uremic syndrome
Hemolytic uremic syndrome
Najib Suhrabi
 
Approach to hemolytic anemia
Approach to hemolytic anemiaApproach to hemolytic anemia
Approach to hemolytic anemia
Sarath Menon
 

What's hot (20)

Thrombotic Thrombocytopenic Purpura
Thrombotic Thrombocytopenic PurpuraThrombotic Thrombocytopenic Purpura
Thrombotic Thrombocytopenic Purpura
 
Bone marrow failure syndromes.ppt
Bone marrow failure syndromes.pptBone marrow failure syndromes.ppt
Bone marrow failure syndromes.ppt
 
Thrombocytopenia
ThrombocytopeniaThrombocytopenia
Thrombocytopenia
 
Aplastic anemia
Aplastic anemiaAplastic anemia
Aplastic anemia
 
Haemolytic anemia
Haemolytic anemia Haemolytic anemia
Haemolytic anemia
 
Thrombocytopenia
ThrombocytopeniaThrombocytopenia
Thrombocytopenia
 
Thrombocytopenia
ThrombocytopeniaThrombocytopenia
Thrombocytopenia
 
Thrombocytopenia
Thrombocytopenia Thrombocytopenia
Thrombocytopenia
 
Idiopathic (autoimmune) Thrombocytopenic Purpura
Idiopathic (autoimmune) Thrombocytopenic PurpuraIdiopathic (autoimmune) Thrombocytopenic Purpura
Idiopathic (autoimmune) Thrombocytopenic Purpura
 
Fulminant hepatic failure (fhf)
Fulminant hepatic failure (fhf)Fulminant hepatic failure (fhf)
Fulminant hepatic failure (fhf)
 
Pancytopenia
PancytopeniaPancytopenia
Pancytopenia
 
Essential thrombocytosis
Essential thrombocytosisEssential thrombocytosis
Essential thrombocytosis
 
Thrombocytopenia
ThrombocytopeniaThrombocytopenia
Thrombocytopenia
 
Aplastic anemia pediatrics
Aplastic anemia pediatricsAplastic anemia pediatrics
Aplastic anemia pediatrics
 
leukemoid reaction and leukemia
leukemoid reaction and leukemialeukemoid reaction and leukemia
leukemoid reaction and leukemia
 
Hemolytic uremic syndrome
Hemolytic uremic syndromeHemolytic uremic syndrome
Hemolytic uremic syndrome
 
Polycythemia
PolycythemiaPolycythemia
Polycythemia
 
Approach to hemolytic anemia
Approach to hemolytic anemiaApproach to hemolytic anemia
Approach to hemolytic anemia
 
Essential thrombocythemia (2019) by Dr Shami Bhagat SKIMS
Essential thrombocythemia (2019) by Dr Shami Bhagat SKIMSEssential thrombocythemia (2019) by Dr Shami Bhagat SKIMS
Essential thrombocythemia (2019) by Dr Shami Bhagat SKIMS
 
Anemia of chronic disease
Anemia of chronic diseaseAnemia of chronic disease
Anemia of chronic disease
 

Similar to Causes of Thrombocytopenia in pediatrics other than ITP

Medicine.Bleeding disorders.(dr.sabir)
Medicine.Bleeding disorders.(dr.sabir)Medicine.Bleeding disorders.(dr.sabir)
Medicine.Bleeding disorders.(dr.sabir)
student
 
medicine.Bleeding disorders.(dr.sabir) (new powerpoint)
medicine.Bleeding disorders.(dr.sabir) (new powerpoint)medicine.Bleeding disorders.(dr.sabir) (new powerpoint)
medicine.Bleeding disorders.(dr.sabir) (new powerpoint)
student
 
Hemostastis Pada Anak
Hemostastis Pada AnakHemostastis Pada Anak
Hemostastis Pada Anak
Daniel Lukman
 
thromboticdisorders-150818135124-lva1-app6892.pdf
thromboticdisorders-150818135124-lva1-app6892.pdfthromboticdisorders-150818135124-lva1-app6892.pdf
thromboticdisorders-150818135124-lva1-app6892.pdf
mergawekwaya
 
Leukaemia i
Leukaemia iLeukaemia i
Leukaemia i
mhrhbsri
 
medicine.Acute leukemias.(dr.sabir)
medicine.Acute leukemias.(dr.sabir)medicine.Acute leukemias.(dr.sabir)
medicine.Acute leukemias.(dr.sabir)
student
 

Similar to Causes of Thrombocytopenia in pediatrics other than ITP (20)

Medicine.Bleeding disorders.(dr.sabir)
Medicine.Bleeding disorders.(dr.sabir)Medicine.Bleeding disorders.(dr.sabir)
Medicine.Bleeding disorders.(dr.sabir)
 
medicine.Bleeding disorders.(dr.sabir) (new powerpoint)
medicine.Bleeding disorders.(dr.sabir) (new powerpoint)medicine.Bleeding disorders.(dr.sabir) (new powerpoint)
medicine.Bleeding disorders.(dr.sabir) (new powerpoint)
 
PLATELET DISORDERS.pptx
PLATELET DISORDERS.pptxPLATELET DISORDERS.pptx
PLATELET DISORDERS.pptx
 
Quantitative platelet disorders
Quantitative platelet disordersQuantitative platelet disorders
Quantitative platelet disorders
 
CME: Bleeding Disorders - Clinical Features
CME: Bleeding Disorders - Clinical FeaturesCME: Bleeding Disorders - Clinical Features
CME: Bleeding Disorders - Clinical Features
 
Leukemia.pptx
Leukemia.pptxLeukemia.pptx
Leukemia.pptx
 
Bleeding disorders
Bleeding disordersBleeding disorders
Bleeding disorders
 
Hemostastis Pada Anak
Hemostastis Pada AnakHemostastis Pada Anak
Hemostastis Pada Anak
 
Lab investigations in OMFS- ih
Lab investigations in OMFS- ihLab investigations in OMFS- ih
Lab investigations in OMFS- ih
 
Approach to bleeding disorder (coagulation defects) in children
Approach to bleeding disorder (coagulation defects) in childrenApproach to bleeding disorder (coagulation defects) in children
Approach to bleeding disorder (coagulation defects) in children
 
Pediatric thrombocytopenia
Pediatric thrombocytopeniaPediatric thrombocytopenia
Pediatric thrombocytopenia
 
Multiple myeloma 06-11-2022.pptx
Multiple myeloma 06-11-2022.pptxMultiple myeloma 06-11-2022.pptx
Multiple myeloma 06-11-2022.pptx
 
Thrombocytopenia and ITP
Thrombocytopenia and ITPThrombocytopenia and ITP
Thrombocytopenia and ITP
 
Thrombotic disorders
Thrombotic disordersThrombotic disorders
Thrombotic disorders
 
thromboticdisorders-150818135124-lva1-app6892.pdf
thromboticdisorders-150818135124-lva1-app6892.pdfthromboticdisorders-150818135124-lva1-app6892.pdf
thromboticdisorders-150818135124-lva1-app6892.pdf
 
Leukaemia i
Leukaemia iLeukaemia i
Leukaemia i
 
Myeloproliferative disorders.ppt
Myeloproliferative disorders.pptMyeloproliferative disorders.ppt
Myeloproliferative disorders.ppt
 
multiple myeloma
multiple myelomamultiple myeloma
multiple myeloma
 
hemolytic uremic syndrome in children causes and treatment
hemolytic uremic syndrome in children causes and treatmenthemolytic uremic syndrome in children causes and treatment
hemolytic uremic syndrome in children causes and treatment
 
medicine.Acute leukemias.(dr.sabir)
medicine.Acute leukemias.(dr.sabir)medicine.Acute leukemias.(dr.sabir)
medicine.Acute leukemias.(dr.sabir)
 

Recently uploaded

Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
mahaiklolahd
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
9953056974 Low Rate Call Girls In Saket, Delhi NCR
 

Recently uploaded (20)

Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
 
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
 
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
 
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service AvailableCall Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
Call Girls Jaipur Just Call 9521753030 Top Class Call Girl Service Available
 
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
 
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
 
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableTrichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
 
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
Coimbatore Call Girls in Coimbatore 7427069034 genuine Escort Service Girl 10...
 

Causes of Thrombocytopenia in pediatrics other than ITP

  • 1. Causes of Thrombocytopenia in pediatrics other than ITPPrepared by:- Asmaa Rabie Abdel Monem A 5th grade med student Alexandria University Faculty of Medicine
  • 2. Causes of thrombocytopenia increased destruction  Immune mechanism  Iodopathic (ITP)  Secodary to infection, drugs, SLE  Non-immune mechanism  platelet consumption  DIC ,HUS  microangiopathic hemolytic anemia  platelet destruction  Hypersplenism , drugs  Prothetic heart valve  sequesteration  Large spleen Decreased production  Bone marrow depression  Hereditary  Fanconi anemia  TAR syndrome  Acquired  Drugs , chemotherapy  Inefction, hepatitis ,HIV ,EBV  Bone marrow infiltration  Leukemia ,neuroblastoma  Storage disease
  • 3. Secondary immune mechanism Drug-Induced Thrombocytopenia •A number of drugs are associated with immune thrombocytopenia as the result of either an immune process or a megakaryocyte injury.
  • 4. Heparin-induced hrombocytopenia (and rarely thrombosis) is seldom seen in pediatrics but occurs when, after exposure to heparin, the patient develops an antibody directed against the heparin/ platelet factor IV complex.
  • 5. Non immune Platelet Destruction increase platelet consumption DIC hemolytic-uremic syndrome thrombotic thrombocytopenic purpura The syndromes of DIC, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura share the hematologic picture of The microangiopathic hemolytic anemia is characterized by the presence of RBC fragments, including helmet cells, schistocytes, spherocytes, and burr cells.
  • 6. Hemolytic-Uremic Syndrome (HUS) Abnormal red cell morphology Normal numbers of megakaryocytes.
  • 7.
  • 8. Combined Platelet and Fibrinogen Consumption Syndromes Kasabach-Merritt Syndrome Hemangioma platelet trapping and activation of coagulation with fibrinogen consumption and generation of fibrin(ogen)
  • 9. Non immune Platelet Destruction Sequestration •Individuals with massive splenomegaly develop thrombocytopenia, since the spleen acts as a sponge for platelets and sequesters large numbers. •Most such patients will also have mild leukopenia and anemia on the CBC. Individuals who have thrombocytopenia caused by splenic sequestration should undergo a work- up to diagnose the etiology of splenomegaly, including infectious, infiltrative, neoplastic, obstr uctive, and hemolytic causes.
  • 10. Thrombocytopenia - Underproduction Marrow failure: myelodysplasia, aplastic anemia, vitamin deficiencies. Marrow infiltration: tumor, granulomatous diseases, fibrosis, leukemias, lymphomas Marrow toxins: drugs, radiation, infections (CMV, HIV), alcohol.
  • 11. Congenital Thrombocytopenic Syndromes Congenital Amegakaryocytic thrombocytopenia Bone marrow transplant is curative. Bone marrow failure absence of megakaryocytes in bone marrow examination.
  • 12. Thrombocytopenia–absent radius (TAR) The thrombocytopenia of TAR syndrome frequently remits over the first few years of life.
  • 13. Fanconi anemia Aplastic anemia not present at birth, develops about 6 yr of age; fatal without bone marrow transplant; chromosomal breakage challenge test available for early diagnosis.
  • 14. Wiskott-Aldrich syndrome (WAS) Microthrombocytopenia Eczema Recurrent infections X-linked Normal number of megakaryocytes Successful bone marrow transplantation cures WAS. Microthrombocytes
  • 15. Refrences 1. Nelson textbook of pediatrics 19th edition, Chapter 476. 2. Dan L. Longo, HARRISON’S Hematology and Oncology; 3. Childhood idiopathic thrombocytopenic purpura (itp): over 40 year of experiences; Medical Journal of Islamic World Academy of Sciences 19:4, 151-160, 2011. -http://www.uptodate.com/contents/clinical.4 -of-evaluation-and-manifestations children-in-thrombocytopenia

Editor's Notes

  1. HSM, hepatosplenomegaly; ITP, idiopathicimmune thrombocytopenic purpura; NATP, neonatal alloimmune thrombocytopenicpurpura; SLE, systemic lupus erythematosus; TAR, thrombocytopenia-absent radius;TTP, thrombotic thrombocytopenic purpura; UAC, umbilical artery catheter; VWD, vonWillebrand disease; WBC, white blood cell.
  2. Some common drugs used in pediatrics that cause thrombocytopenia include valproic acid, phenytoin, sulfonamides, and trimethoprim-sulfamethoxazole.
  3. http://www.uptodate.com/contents/drug-induced-thrombocytopenia
  4. thrombotic microangiopathy in which there is red cell destruction and a consumptive thrombocytopenia caused by platelet and fibrin deposition in the microvasculature
  5. This acute disease usually follows an episode of acute gastroenteritis, often triggered by Escherichia coli 0157:H7. Shortly thereafter, signs and symptoms of hemolytic anemia, thrombocytopenia, and acute renal failure ensue. Sometimes neurologic symptoms are associated with these findings. E.coli 0157:H7 produces a specific toxin (verotoxin) that binds to and damages renal endothelial cells preferentially.
  6. The association of a giant hemangioma with localized intravascular coagulation causing thrombocytopenia and hypofibrinogenemia is called the Kasabach-Merritt syndrome. In most patients the site of the hemangioma is obvious, but retroperitoneal and intra-abdominal hemangiomas may require body imaging for detection. Inside the hemangioma there is platelet trapping and activation of coagulation with fibrinogen consumption and generation of fibrin(ogen) degradation products. Arteriovenous malformation within the lesions can cause heart failure.The peripheral blood smear shows microangiopathic changes. Multiple modalities have been used to treat Kasabach-Merritt syndrome, including surgical excision , laser photocoagulation, corticosteroids in high doses, local x-ray therapy, and antiangiogenic agents such as interferon a2 . Over time most patients who present in infancy have regression of the hemangioma.
  7. Congenital amegakaryocytic thrombocytopenia is caused by a rare defect in hematopoiesis that usually manifests within the first few days to weeks of life, when the child presents with petechiae and purpura caused by profound thrombocytopenia. Other than skin and mucous membrane findings, the physical examination is normal.
  8. syndrome consists of thrombocytopenia that presents in early infancy with radial anomalies of variable severity from mild changes to marked limb shortening. In many such individuals there are also other skeletal abnormalities of the lower extremities.Intolerance to formula may complicate management by triggering gastrointestinal bleeding.
  9. microcephaly, microphthalmia, epicanthal folds, dangling thumbs, site of ureteralreimplantation, congenital dislocated hips, and rocker bottom feet. (Alter BP, Young NS. The bone marrow failure syndromes.
  10. is characterized by thrombocytopenia with tiny platelets, eczema, and recurrent infections due to immune deficiency. WAS is inherited as an X-linked disorder. The WAS protein appears to play an integral role in regulating the cytoskeletal architecture of both platelets and T lymphocytes in response to receptor-mediated cell signaling. The WAS protein is common to all cells of hematopoietic lineage. Molecular analysis of families with X-linked thrombocytopenia has shown that many members have a point mutation within the WAS gene, whereas individuals with the full manifestation of WAS have large gene deletions. Examination of the bone marrow in WAS shows the normal number of megakaryocytes, although the megakaryocytes may have bizarre morphology. Transfused platelets have a normal life span. Splenectomy often corrects the thrombocytopenia, suggesting that the platelets formed in WAS have accelerated destruction. About 5% of WAS patients develop lymphoreticular malignancies. Successful bone marrow transplantation cures WAS.