Thrombocytopenic purpura (TP) is characterized by cutaneous hemorrhages occurring in association with a reduced platelet count; hemorrhages are clinically usually small (petechiae) but at times larger (ecchymoses) and occur at sites of minor trauma/pressure (platelet count <40,000/ µL) or spontaneously (platelet count < 10,000/ µL).
Causes of Thrombocytopenic Purpura
Platelet plugs by themselves effectively stop bleeding from capillaries and small blood vessels but are incapable of stopping hemorrhage from larger vessels. Platelet defects therefore produce problems with small-vessel hemostasis, small hemorrhages in the skin or in the CNS.
Symptoms of Thrombocytopenic Purpura
- Bruising (purpura): purplish areas on the skin or mucus membranes (such as in the mouth) due to bleeding. The bruises may occur for no apparent reason.
- Petechiae: pinpoint red spots on the skin (typically the legs) that often occur in groups and may look like a rash. The spots are due to bleeding under the skin.
- Bleeding that is hard to stop.
- Heavy menstrual bleeding in women.
- Blood in the stool (bowel movement)
Diagnosis
Clinical suspicion confirmed by platelet count.
Treatment
Identify underlying cause and correct, if possible. If platelet count is very low (< 10,000/µL), bed rest to reduce risk of hemorrhage.
Oral Glucocorticoids, High-Dose Immunoglobulins
Platelet Transfusions If platelet Count < 10,000/ µL, platelet transfusion may be indicated.
Chronic ITP Splenectomy may be indicated.
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