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Thrombocytopenia_ITP_TTP_HUS_HIT_Presentation.pptx
- 1. Thrombocytopenic Disorders ITP, TTP,HUS, and Heparin-Induced Thrombocytopenia Pathophysiology, Diagnosis & Treatment
- 2. Overview of Thrombocytopenia •Definition and classification • Primary vs secondary • Platelet count thresholds
- 3. Immune Thrombocytopenic Purpura (ITP)- Introduction • Definition and epidemiology • Autoimmune nature • Acute vs chronic
- 4. ITP - Pathophysiology •Autoantibody formation against platelets • Destruction by splenic macrophages • Impaired platelet production
- 5. ITP - ClinicalFeatures • Mucocutaneous bleeding • Petechiae, purpura • Menorrhagia • Asymptomatic cases
- 6. ITP - DiagnosticCriteria • Isolated thrombocytopenia • Normal bone marrow • Diagnosis of exclusion
- 7. ITP - Investigations •CBC and peripheral smear • Antiplatelet antibodies • Bone marrow biopsy (selected cases)
- 8. ITP - TreatmentOverview • Initial and chronic treatment • Indications for therapy • Response criteria
- 9. ITP - First-LineTreatments • Corticosteroids (prednisone, dexamethasone) • IVIG • Anti-D immunoglobulin
- 10. ITP - Second-LineTreatments • Rituximab • Thrombopoietin receptor agonists • Splenectomy
- 11. ITP - RefractoryITP • Definition • Management strategies • Experimental treatments
- 12. Thrombotic Thrombocytopenic Purpura (TTP)- Introduction • Definition • Pentad of symptoms • Medical emergency
- 13. TTP - Pathophysiology •ADAMTS13 deficiency • VWF multimers • Microvascular thrombosis
- 14. TTP - Causes •Congenital (Upshaw-Schulman syndrome) • Acquired (autoimmune)
- 15. TTP - ClinicalFeatures • Thrombocytopenia • Microangiopathic hemolytic anemia • Neurologic symptoms • Fever • Renal involvement
- 16. TTP - Diagnosis •CBC, peripheral smear (schistocytes) • LDH, haptoglobin • ADAMTS13 assay
- 17. TTP - Treatment •Plasma exchange • Corticosteroids • Rituximab • Caplacizumab
- 18. TTP - Prognosis •Improved with prompt treatment • Relapse in acquired cases • Monitoring ADAMTS13 activity
- 19. Hemolytic Uremic Syndrome(HUS) - Introduction • Definition • Typical (post-diarrheal) vs atypical • Pediatric focus
- 20. HUS - Pathophysiology •Endothelial injury • Shiga toxin (typical HUS) • Complement dysregulation (aHUS)
- 21. HUS - Causes •E. coli O157:H7 infection • Complement gene mutations • drug-related and idiopathic
- 22. HUS - ClinicalPresentation • Hemolytic anemia • Thrombocytopenia • Acute kidney injury • Hypertension
- 23. HUS - Diagnosis •CBC and smear • Renal function tests • Stool culture for shiga toxin • Complement studies
- 24. HUS - Treatment •Supportive care (fluids, dialysis) • Plasma exchange (aHUS) • Eculizumab
- 25. HUS - Prognosis •Varies by type • Typical HUS has good recovery • Chronic kidney disease in some cases
- 26. Heparin-Induced Thrombocytopenia (HIT) - Introduction •Definition • Immune-mediated vs non-immune • Risk factors
- 27. HIT - Pathophysiology •Formation of antibodies against heparin-PF4 complex • Platelet activation and thrombosis
- 28. HIT - ClinicalFeatures • Drop in platelet count • Timing after heparin exposure • Thrombosis (venous > arterial)
- 29. HIT - Diagnosis •4Ts score • PF4-heparin antibody ELISA • Serotonin release assay
- 30. HIT - Management •Discontinue heparin • Start non-heparin anticoagulant (argatroban, bivalirudin) • Avoid platelet transfusions
- 31. HIT - AnticoagulationOptions • Direct thrombin inhibitors • Factor Xa inhibitors • Warfarin after platelet recovery
- 32. HIT - Monitoringand Follow-Up • Monitor platelet counts • Evaluate for thrombosis • Long-term anticoagulation
- 33. Comparison: ITP vsTTP vs HUS vs HIT • Key differences in pathogenesis, features, and management
- 34. Platelet Transfusions inThese Conditions • Indications • When contraindicated • Risks
- 35. Role of PlasmaExchange • Indications in TTP and HUS • effectiveness • Procedure
- 36. Newer Therapies • Caplacizumabin TTP • Eculizumab in aHUS • Thrombopoietin agonists in ITP
- 37. Monitoring and Prognosis •Response to therapy • Relapse rates • Long-term outcomes
- 38. Case Study: ITP •Example case with discussion on diagnosis and management
- 39. Case Study: TTP •Example case with discussion on diagnosis and treatment
- 40. Case Study: HUS •Example case and approach
- 41. Case Study: HIT •Diagnostic challenge and treatment approach
- 42. Summary and Conclusion •Review of key concepts • Comparison chart • Importance of early diagnosis