ITP

Imune thrombocytopenic
purpura

Definisi
Idiopathic thrombocytopenic purpura
adalah kelainan perdarahan dimana
sistem imun merusak trombosit,
yang penting untuk pembekuan
darah. Orang dengan penyakit ini
memiliki trombosit yang sangat
sedikit.
Sstem imun yang terlibat ialah IgG

Etiologi
Peningkatan kadar IgG sehingga
terjadi penghancuran trombosit
berlebihan yang belum jelas
penyebabnya
Pada beberapa orang, ITP terkait
pada infeksi virus atau bakteri,
seperti HIV

Manifestasi Klinis
Immune thrombocytopenia (ITP) may not cause any signs or symptoms.
However, ITP can cause bleeding inside the body (internal bleeding) or
underneath or from the skin (external bleeding). Signs of bleeding may include:
Bruising or purplish areas on the skin or mucous membranes (such as in the
mouth). These bruises are called purpura. They're caused by bleeding under the
skin, and they may occur for no known reason.
Pinpoint red spots on the skin called petechiae. These spots often are found in
groups and may look like a rash. Bleeding under the skin causes petechiae.
A collection of clotted or partially clotted blood under the skin that looks or feels
like a lump. This is called a hematoma.
Nosebleeds or bleeding from the gums (for example, during dental work).
Blood in the urine or stool (bowel movement).
Any kind of bleeding that's hard to stop could be a sign of ITP. This includes
menstrual bleeding that's heavier than normal. Bleeding in the brain is rare, and
its symptoms may vary.
A low platelet count doesn't directly cause pain, problems concentrating, or other
symptoms. However, a low platelet count might be associated with fatigue
(tiredness).

Patofisiologi
Trombosit terikat pada Fc reseptor
makrofag teraktivasi
mengeluarkan imunoglobulin
mempercepat penghancuran di lien

Penatalaksanaan
Medicine
Removal of the Spleen (Splenectomy)
Other Treatments
Platelet Transfusions
Treating Infections
Stopping Medicines

Pemeriksaan Penunjang
A complete blood count (CBC) shows a low
number of platelets.
Blood clotting tests (PTT and PT) are normal.
Bleeding time is prolonged.
Platelet associated antibodies may be
detected.
A bone marrow aspiration or biopsy appears
normal or may show a greater than normal
number of cells called megakaryocytes.
These cells are an early form of platelets.

Prognosis
treatment, the chance of remission
(a symptom-free period) is good.
Rarely, ITP may become a long-term
condition in adults and reappear,
even after a symptom-free period.

Komplikasi
Complications are more likely to arise from the treatments
corticosteroids and surgery used for chronic or severe ITP. In
fact, many therapies pose more serious potential risks than does
the disease. Long-term use of corticosteroids can cause serious
side effects, including:
Osteoporosis
Cataracts
Loss of muscle mass
Increased risk of infection
High blood sugar, even diabetes

Removal of your spleen (splenectomy), which may be performed

if corticosteroids aren't working, also makes you permanently
more vulnerable to infection, although the risk of an
overwhelming infection in a healthy person who has had a
splenectomy is low.