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Trombositopenia

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✘ Trombositopenia : jumlah < 150.000/mm3
✘ Penyebab :
a. Penurunan produksi
b. Peningkatan destruksi
c. gangguan distribusi (sequestrasi)
✘Bila tidak ada gangguan fungsi trombosit, ∑ 50.000 – 150.000
/ ml
→ gejala klinik (-)

✘ Jumlah trombosit 20.000 – 50.000 / ml

- pendarahan spontan ringan
- pendarahan pasca operasi

✘ Jumlah trombosit 20.000 /ml

- pendarahan spontan, serius

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Thrombositopenia

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 Tipe trombositopenia
Infection-Induced Thrombocytopenia

Drug-Induced Thrombocytopenia

Heparin-Induced Thrombocytopenia

Immune Thrombocytopenic Purpura (ITP)

Inherited Thrombocytopenia

Thrombotic Thrombocytopenic Purpura

Hemolytic Uremic Syndrome

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TROMBOSITOPENIA

A. Peningkatan Destruksi Trombosit

1. (Auto)immune Thrombocytopenic Purpura
2. Gangguan imunologis lain
- pengaruh obat-obatan
- SLE
- penyakit limfoproliferatif
- infeksi HIV 1
- pasca transfusi

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3. Non-imunologis
- DIC
- Septikemia bakterial
- TTP + HUS
- pengaruh etanol
- pendarahan berat
- toksemia
- penyakit heriditer

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TROMBOSITOPENIA …
B. Gangguan Produksi
- hipoplasia / aplasia sutul
- invasi sel ganas ke sutul
- sindroma dismielopoitik

C. Gangguan Distribusi
- hipersplenisme → pooling trombosit

D. Akibat pengenceran (dilutional loss)

akibat transfusi masif

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TROMBOSITOPENIA HERIDITER
1. Wiskott-Aldrich syndrome
- trombositopenia berat
- ukuran trombosit kecil-kecil
- respon baik terhadap splenektomi
- sifat x-Linked resesif
2. Bernard-Soulier syndrome
- autosomal resesif
- “giant” trombosyte (+)
- defisiensi GP Ib → gangguan fungsi
3. May-Hegglin anomaly
- autosomal dominant
- giant thrombocyte (+)
- dohle bodies (+)
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TROMBOSITOPENIA PADA
TOKSEMIA
. 15 – 20 % TOXAEMIA GRAVIDARUM
. sering disertai dengan
- anemia hemolitik mikroangiopatik
- peningkatan enzim-enzim hati
disebut : HELLP Syndrome
-Hemolysis
-Elevated Liver enzyme,
-Low Platelet count.

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 Differential diagnosis of thrombocytopenia. Evaluation of
thrombocytopenia is best organized according to the apparent defect in
platelet production, distribution, or destruction.

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Algorithm for
thrombcytopenia
evaluation

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 Daftar pustaka

✘ Hematology 2006.Thrombocytopenic :A moving Target. Sadler

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