PLATELET  DISORDERS PLATELET DISORDERS ARE CLASSIFIED AS QUANTITATIVE OR QUALITATIVE
QUANTATIVE PLATELET DISORDERS <ul><li>THROMBOCYTOPENIA </li></ul><ul><li>IT IS DEFINED AS A PLATELET COUNT BELOW 150X10*9/...
THROMBOCYTOPENIA <ul><li>A COUNT BELOW 100,000/ Ûl is generally considered to constitute  thrombocytopenia </li></ul><ul><...
CLASSIFICATION OF THROMBOCYTOPENIA <ul><li>DECREASED PRODUCTION OF PLATELETS </li></ul><ul><li>DECREASED PLATELET SURVIVAL...
CLASSIFICATION OF THROMBOCYTOPENIA (DECREASED PLATELET SURVIVAL) <ul><li>IMMUNE </li></ul><ul><li>AUTOIMMUNE: IDIOPATHIC T...
CLASSIFICATION OF THROMBOCYTOPENIA (DECREASED PLATELET SURVIVAL) <ul><li>NONIMMUNE </li></ul><ul><li>DIC </li></ul><ul><li...
IDIOPATHIC THROMBOCYTOPENIA  PURPURA (ITP) <ul><li>PRIMARY OR IDIOPATHIC ITP </li></ul><ul><li>ACUTE ITP </li></ul><ul><li...
CHRONIC ITP DEFECTIVE HEMOSTASIS DEFICIENT PLATELET PRODUCTION THROMBOCYTOPENIA PLATELET SENSITIZATION PLT SEQUESTRATION /...
PATHOGENESIS <ul><li>CHRONIC ITP IS CAUSED BY THE FORMATION OF AUTOANTIBODIES AGAINST PLATELET MEMBRANE GLYCOPROTEINS,IIb-...
MORPHOLOGY <ul><li>SPLEEN </li></ul><ul><li>NORMAL IN SIZE </li></ul><ul><li>CONGESTION OF SINUSOIDS </li></ul><ul><li>FOR...
COMPARITIVE FEATURES OF ACUTE AND CHRONIC ITP <ul><li>AGE  CHILDREN 2-6  </li></ul><ul><li>YEARS </li></ul><ul><li>PLT  <2...
CLINICAL FEATURES <ul><li>CHARACTERIZED BY BLEEDING ITO SKIN AND MUCOSAL SURFACES </li></ul><ul><li>PETECHIAE,ECCHYMOSES <...
DIAGNOSIS <ul><li>THE DIAGNOSIS IS MADE BY THE EXCLUSION OFALL OTHER CAUSES OF THROMBOCYTOPENIA </li></ul><ul><li>LABORATO...
Upcoming SlideShare
Loading in …5
×

P L A

1,504 views

Published on

0 Comments
4 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,504
On SlideShare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
105
Comments
0
Likes
4
Embeds 0
No embeds

No notes for slide

P L A

  1. 1. PLATELET DISORDERS PLATELET DISORDERS ARE CLASSIFIED AS QUANTITATIVE OR QUALITATIVE
  2. 2. QUANTATIVE PLATELET DISORDERS <ul><li>THROMBOCYTOPENIA </li></ul><ul><li>IT IS DEFINED AS A PLATELET COUNT BELOW 150X10*9/L </li></ul><ul><li>THROMBOCYTOSIS </li></ul><ul><li>PLATELET COUNT IS ELEVATED ABOVE THE NORMAL </li></ul><ul><li>ACCEPTABLE REFERENCE RANGE </li></ul>
  3. 3. THROMBOCYTOPENIA <ul><li>A COUNT BELOW 100,000/ Ûl is generally considered to constitute thrombocytopenia </li></ul><ul><li>SPONTANEOUS BLEEDING does not become evident until the count falls below 20,000/ul </li></ul><ul><li>PLATELET COUNTS in the range of 20,000 to 50,000/ul can aggravate post-traumatic bleeding </li></ul>
  4. 4. CLASSIFICATION OF THROMBOCYTOPENIA <ul><li>DECREASED PRODUCTION OF PLATELETS </li></ul><ul><li>DECREASED PLATELET SURVIVAL </li></ul><ul><li>SEQUESTRATION </li></ul><ul><li>DILUTIONAL </li></ul>
  5. 5. CLASSIFICATION OF THROMBOCYTOPENIA (DECREASED PLATELET SURVIVAL) <ul><li>IMMUNE </li></ul><ul><li>AUTOIMMUNE: IDIOPATHIC THROMBOCYTOPENIA </li></ul><ul><li>PURPURA </li></ul><ul><li>SLE </li></ul><ul><li>ISOIMMUNE: POST TRANSFUSION AND NEONATAL </li></ul><ul><li>DRUG –ASSOCIATED: QINIDINE,HEPARIN,SULFA </li></ul><ul><li>COMPOUNDS </li></ul><ul><li>INFECTIONS: INFECTIOUS MONONUCLEOSIS,HIV </li></ul><ul><li>INFECTIONS,CYTOMEGALOVIRUS </li></ul>
  6. 6. CLASSIFICATION OF THROMBOCYTOPENIA (DECREASED PLATELET SURVIVAL) <ul><li>NONIMMUNE </li></ul><ul><li>DIC </li></ul><ul><li>THROMBOTIC THROMBOCYTOPENIC PURPURA </li></ul><ul><li>GIANT HEMANGIOMAS </li></ul><ul><li>MICROANGIOPATHIC HEMOLYTIC ANEMIAS </li></ul>
  7. 7. IDIOPATHIC THROMBOCYTOPENIA PURPURA (ITP) <ul><li>PRIMARY OR IDIOPATHIC ITP </li></ul><ul><li>ACUTE ITP </li></ul><ul><li>CHRONIC ITP </li></ul><ul><li>SECONDARY ITP </li></ul>
  8. 8. CHRONIC ITP DEFECTIVE HEMOSTASIS DEFICIENT PLATELET PRODUCTION THROMBOCYTOPENIA PLATELET SENSITIZATION PLT SEQUESTRATION / DESTRUCTION COMPENSATORY ACCELERATION OF PLT PRODUCTION ANTIBODY ANTIGEN-ANTIBODY COMPLEXES MEGAKARYOCYTE INJURY IMPAIRMENT OF PLATELET FUNCTION
  9. 9. PATHOGENESIS <ul><li>CHRONIC ITP IS CAUSED BY THE FORMATION OF AUTOANTIBODIES AGAINST PLATELET MEMBRANE GLYCOPROTEINS,IIb-IIIa OR Ib-IX </li></ul><ul><li>THE ANTIPLATELET ANTIBODIES ARE </li></ul><ul><li>OF IgG CLASS </li></ul><ul><li>OPSONIZED PLATELETS ARE RENDERED SUSCEPTIBLE TO PHAGOCYTOSIS BY THE CELLS OF MONONUCLEAR SYSTEM </li></ul><ul><li>SPLEEN IS THE MAJOR SITE OFREMOVAL OF SENSITIZED PLATELETS </li></ul><ul><li>MEGAKARYOCYTES MAY BE DAMAGED BY AUTOATIBODIES LEADING TO IMPAIRMENT OF PLATELET PRODUCTION </li></ul>
  10. 10. MORPHOLOGY <ul><li>SPLEEN </li></ul><ul><li>NORMAL IN SIZE </li></ul><ul><li>CONGESTION OF SINUSOIDS </li></ul><ul><li>FORMATION OF PROMINENT GERMINAL CENTERS </li></ul><ul><li>SCATTERED MEGAKARYOCYTES WITHIN SINUSES </li></ul><ul><li>BONEMARROW </li></ul><ul><li>INCREASED MEGAKARYOCYTES </li></ul><ul><li>(IMMATURE WITH LARGE NONLOBULATED SINGLE </li></ul><ul><li>NUCLEI) </li></ul><ul><li>SECONDARY CHANGES RELATE TO HEMORRAGES </li></ul>
  11. 11. COMPARITIVE FEATURES OF ACUTE AND CHRONIC ITP <ul><li>AGE CHILDREN 2-6 </li></ul><ul><li>YEARS </li></ul><ul><li>PLT <20X10*9 / L </li></ul><ul><li>ONSET ABRUPT </li></ul><ul><li>( BLEEDING) </li></ul><ul><li>ANTECEDENT 1-3 WEEKS </li></ul><ul><li>INFECTION </li></ul><ul><li>SEX NONE </li></ul><ul><li>SPONTANEOUS 80% </li></ul><ul><li>REMISSION </li></ul><ul><li>THERAPY NONE,CORTICOSTEROIDS </li></ul><ul><li>AGE ADULT 20-40 </li></ul><ul><li>YEARS </li></ul><ul><li>PLT 30-80X10*9 / L </li></ul><ul><li>ONSET INSIDIOUS </li></ul><ul><li>( BLEEDING) </li></ul><ul><li>ANTECEDENT UNUSUAL </li></ul><ul><li>INFECTION </li></ul><ul><li>SEX F:M 3:1 </li></ul><ul><li>SPONTANEOUS UNCOMMON </li></ul><ul><li>REMISSION </li></ul><ul><li>THERAPY CORTICOSTEROIDS,SPLENECTOMY </li></ul>
  12. 12. CLINICAL FEATURES <ul><li>CHARACTERIZED BY BLEEDING ITO SKIN AND MUCOSAL SURFACES </li></ul><ul><li>PETECHIAE,ECCHYMOSES </li></ul><ul><li>H/O EASY BRUISING,NOSE BLEEDS,BLEEDING FROM GUMS,AND HEMORRAGES INTO SOFT TISSUES FROM RELATIVELY MINOR TRAUMA </li></ul><ul><li>THE DISEASE MAY MENIFEST FIRST WITH MELENA,HEMATURIA,OR EXCESSIVE MENSTRUAL FLOW </li></ul><ul><li>SUBARACHNOID HEMORRAGE AND INTRACEREBRAL HEMORRAGE ARE SERIOUS RARE CONSEQUENCES </li></ul><ul><li>SPLENOMEGALY AND LYMPHADENOPATHY ARE UNCOMMON IN PRIMARY ITP,AND THEIR PRESENCE SHOULD LEAD ONE TO CONSIDER OTHER POSSIBLE DIAGNOSES </li></ul>
  13. 13. DIAGNOSIS <ul><li>THE DIAGNOSIS IS MADE BY THE EXCLUSION OFALL OTHER CAUSES OF THROMBOCYTOPENIA </li></ul><ul><li>LABORATORY TESTS SHOULD INCLUDE </li></ul><ul><li>PERIPHERALBLOOD COUNT </li></ul><ul><li>EXAMINATION OF BLOOD SMEAR </li></ul><ul><li>TESTS TO RULE OUT OTHER CAUSES </li></ul><ul><li>BONE MARROW EXAMINATION </li></ul><ul><li>LOW PLATELET COUNT </li></ul><ul><li>THEIMPORTANCE OF BONEMARROW EXAMINATION IS TO RULE OUT THROMBOCYTOPENIAS RESULTING FROM BONE MARROW FAILURE.A DECREASE IN THE NUMBER OF MEGAKARYOCYTES ARGUES AGAINST THE DIAGNOSIS OF ITP </li></ul><ul><li>ABNORMAL LARGE PLATELETS </li></ul><ul><li>BLEEDING TIME PROLONGED </li></ul><ul><li>PT NORMAL </li></ul><ul><li>APTT NORMAL </li></ul><ul><li>TESTS FOR PLATELET AUTOANTIBODIES ARE NOT WIDELY AVAILABLE </li></ul>

×