혈소판 감소증(Thrombocytopenia) 및 특발성 혈소판 감소성 자반증(Immune Thrombocytopenic Purpura, ITP )

소개글

혈소판 감소증(Thrombocytopenia) 및 특발성 혈소판 감소성 자반증(Immune Thrombocytopenic Purpura, ITP )에 대한 원인 및 감별진단, 치료법에 대해 자세히 정리한 레포트입니다. 발표자료, 레포트제출, 공부자료로 폭넓게 활용이 가능하도록 내용을 간결하면서도 중요한 내용들을 알아보기 쉽게 잘 정리한 레포트입니다.

목차

Thrombocytopenia
• Peripheral blood smear
Approach to the Patient:
• History and Physical Examination
• Results of CBC
• Review of PB smear
Immune Thrombocytopenic Purpura (ITP)
Definition
• 분류
• 임상양상
• Laboratory Testing
• Treatment

본문내용

Thrombocytopenia
Three processes
decreased bone marrow production
sequestration, usually in an enlarged spleen
increased platelet destruction
Peripheral blood smear : to rule out "pseudothrombocytopenia"
Definition : in vitro artifact resulting from platelet agglutination via antibodies (usually IgG, but also IgM, IgA) when the calcium content is decreased by blood collection in EDTA
blood smear evaluated
platelet count determined in blood collected into sodium citrate or heparin
Approach to the Patient:
History and Physical Examination
overall health
drug medications
Results of CBC
BM disorders → RBC, WBC production에도 영향

<중 략>

임상양상
mucocutaneous bleeding
oral mucosa, GI or heavy menstrual bleeding
life-threatening bleeding은 rare (CNS)
wet purpura or retinal hemorrhage가 있을 경우 출혈로 사망가능
Laboratory Testing
Ab검사는 불필요 (Low sensitivity and specificity)
PB smear : large platelets (다른 소견은 정상)
Iron Deficiency Anemia : may be present
Secondary ITP 원인에 대한 evalutation : HIV, HCV, SLE, hypogammaglobulinemia, IgA
Anemia 보일 경우, direct antiglobulin testing (Coombs test) 시행
to rule out combined autoimmune hemolytic anemia (Evans`s syndrome).

참고 자료

Harrison`s Internal Medicine (해리슨 내과학)