Persentasi kasus

PPresentasi Kasus

KOMITE INTERNSHIP DOKTER INDONESIA

PUSAT PERENCANAAN DAN PENDAYAGUNAAN SDM KESEHATAN
BADAN PPSDM KESEHATAN
KEMENTERIAN KESEHATAN RI
2016

Idiopathic (Immune)
Thrombocytopenic Purpura

Everybody bleeds sometimes,

I just bleed more..........

Idiopathic / Immune Thrombocytopenic Purpura (ITP)

ITP was used previously to describe

cases of
thrombocytopenia arising
without apparent cause or underlying
disease state.
Later, the word idiopathic has been
replaced by immune because of the
realization that acute and chronic ITP
are immunologically mediated.

Idiopathic / Immune Thrombocytopenic Purpura (ITP)

Two Types of ITP

Acute Immune Thrombocytopenic
Purpura
Chronic Immune Thrombocytopenic
Purpura

Acute Idiopathic/ Immune Thrombocytopenic Purpura

Etiology
Occurs after viral illness and may
follow live viral vaccination
Produces antibody and immune
complexes against viral antigens and
that platelet destruction may result
from binding of these antibodies or
immune complexes to the platelet
surface

Chronic Idiopathic/ Immune Thrombocytopenic Purpura

Etiology
Occurs after viral infection, use of
certain drugs or as part of an
immune disorder
Plasma transfusion
Offending antibodies attach to
platelets, and as a result, the
antibody- labelled platelets are
removed from the circulation by RE
cells, primarily in the spleen.

Acute Idiopathic/ Immune Thrombocytopenic Purpura

Signs and Symptoms

Children ages 2-5 years
Mucosal bleeding
old
GI bleeding
Scattered
petechiae
Hematuria
Bleeding
signs
and
Mucosal
bleeding
hemorrhage
symptoms
GIIntracranial
Bleeding
Retinal hemorrhage
Intracranial
hemorrhage
hematuria

Thrombocytopenia
Purpura

Chronic Idiopathic / Immune Thrombocytopenic

Purpura

Signs
and Symptoms
Chronic
Idiopathic
/ Immune Thrombocytopenic Purpura
Females outnumbers
males Mucosal bleeding
bleeding
AgeGI
target:
20- 50 years
Hematuria
oldAcute
Immune Thrombocytopenic
Mucocutaneous
bleeding
Intracranial
hemorrhage
Bleeding
signs
and
RecurrentPurpura
epistaxis
Retinal hemorrhage
symptoms
hematuria
Chronic Immune Thrombocytopenic
Purpura
Purpura

Chronic Idiopathic / Immune Thrombocytopenic

Purpura

Signs
and Symptoms
Chronic
Idiopathic
/ Immune Thrombocytopenic Purpura
Excessive bleeding with minor
Mucosal bleeding
injuries
GI bleeding
Spontaneous
bleeding from
Hematuria
the mouth
and nose
Acute
Immune
Thrombocytopenic
Intracranial
hemorrhage
Unexplainable
or
spontaneous
Purpura
Retinal hemorrhage
bruising
Excessive
internal
bleeding
Chronic
Immune
Thrombocytopenic
Disturbed sleep
cycle/
Purpura
Insomnia
Irregular appetite
Depression

Idiopathic / Immune Thrombocytopenic Purpura (ITP)

Diagnostic Tests
Coagulation test
Bleeding time: prolonged
Retraction time
CBC: low number of platelets
Platelet associated Antibody may be
detected
Bone Marrow Examination: shows
megakaryocytic
NO SPECIFIC TEST THAT IS
hyperplasia
DIAGNOSTIC
OF ACUTE OR
CHRONIC ITP

Idiopathic / Immune Thrombocytopenic Purpura (ITP)

Characteristic
Age at onset
Sex predilection
Platelet count
Duration
Spontaneous
remission
Seasonal pattern

Acute ITP

Chronic ITP

2- 6 yr

20- 50 yr

None

Female over male,

3: 1

< 20,000/mcL

30,000- 80,000/mcL

2-6 weeks

Months to years

90% of patients

Uncommon

Higher incidence in
winter and spring

None

Idiopathic / Immune Thrombocytopenic Purpura (ITP)

Treatment
In most cases ITP is not fatal and can be
treated.
There is a wide variety of treatment
options, but with only partial success due
to the unknown nature of the disease.
The most commonly excepted, and most
successful treatments for ITP involve the
removal of the spleen because it is a site
for autoantibody production.

Idiopathic / Immune Thrombocytopenic Purpura (ITP)

Treatment
People are also very commonly given
Prednisone which is an artificial steroid
which can enhance platelet production
For emergency case treatment (normally
when platelets get below 20,000) They
will administer IV G or intravenous
gammaglobulin for several days, and they
wait for counts to rebound

THE END
Thank you!!!