Thrombocytopenic Purpura in Adults
Sulovská I., Jančíková M., Pospíšilová D.
Hemato-onkologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. K. Indrák, DrSc. Dětská klinika FN a LF UP, Olomouc, přednosta doc. MUDr. V. Mihál, CSc. |
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Summary:
Idiopatic thrombocytopenic purpura is one of the basic clinical entities characterized above all
by thrombocytopenia. It is an autoimmune disease caused by antibodies against glycoproteins
of the thrombocyte membrane, most frequently GP IIIa/IIb and GP Ib/IX. In addition to basic
laboratory examinations (haemogram, biochemistry) as well as special examinations such as
sternal puncture, the diagnosis is supplemented by immunocytoflowmetry and MAIPA with
detection of antibodies against thrombocytes and examinations of thrombocyte survival. By use
of further laboratory examination (haemogram in oxalate) it is important to differentiate ITP
from „pseudothrombopenia“. Secondary autoimmune thrombopenia can be ruled out by laboratory tests used to diagnose systemic diseases, thyroid disorders, paravirus thrombopenia etc.
For the diagnosis of other secondary thrombopenias incl. those caused by hypersplenism or
affection of the bone marrow by another, most frequently malignant disease, a number of
laboratory and imaging methods are used.
In addition to summarizing diagnostic possibilities of ITP the authors analyze therapeutic
possibilities - starting with corticoid treatment, and in serious haemorrhage large doses of
immunoglobulins to second line treatment such as splenectomy, and refractory forms of the
disease and the authors draw attention to undesirable effects of some non-conventional
therapeutic protocols.
Key words:
idiopathic thrombocytopenic purpura - immunoglobulins - corticoids - splenectomy
- MAIPA.
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