Immune thrombocytopenic purpura
In patients with idiopathic thrombocytopenic purpura presenting with life-threatening bleeding, the first line of treatment is platelet transfusion in addition to a combination of .
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 36-year-old woman comes to the clinic for a routine check up. She feels well but reports that she has noticed that she is bruising more easily. Medical history is noncontributory. She takes a multivitamin daily. Skin examination shows scattered petechiae on all extremities. Laboratory analysis shows leukocyte count: 9,000/mm3, hemoglobin: 12.0 g/dL, platelet count: 75,000/mm3, prothrombin time: 14 seconds, INR: 1.0. A peripheral blood smear is obtained and is shown below. Which of the following treatments should be prescribed for this patient at this time?
Content Reviewers:Rishi Desai, MD, MPH, Viviana Popa, MD, Darren Miller, Evan Debevec-McKenney, Anju Paul
And this result in purpura, or small bleeding spots beneath the skin.
Normally, when there’s any kind of damage to the blood vessel, hemostasis occurs, which is the process that stops the bleeding and plugs the damaged vessel to limit the blood loss.
And there are two steps: primary and secondary hemostasis.
During primary hemostasis, platelets aggregate to form a plug at the site of an injured blood vessel.
While these platelets are aggregating, secondary hemostasis kicks in.
Then, fibrin forms a protein mesh, kinda like a giant net that covers the platelet plug and stabilizes it.
This leads to lowering of platelet counts in the blood, which makes it harder for bleeding to stop.
Now, ITP can be acute or chronic.
Acute ITP usually affects children, a couple of weeks after a viral infection, and resolves spontaneously within two months.
Chronic ITP usually affect females of reproductive age, and persist more than six months.
Most of the time, ITP is asymptomatic.
In some cases, it can cause purpura, which are red or purple spots on the skin, measuring 0.3 to 1 cm in diameter.