Ppt Itp Ajeng
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Transcript of Ppt Itp Ajeng
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REFERATDIAGNOSIS DAN TATALAKSANA
IDIOPATHIC THROMBOCYTOPENIC
PURPURA (ITP)
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What is ITP
Immune / idiophatic thrombocytopenic
purpura (ITP) is a bleeding disorder in which
the blood doesn’t clot as it should, this is due
to the deficient of blood cell fragments called
platelet or thrombocytes
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• Platelets are small blood cells that alias functionsas blood clotting factors
• Platelets have an important function in
preventing and stopping bleeding.
• Normal number of platelets in the body is from150,000 to 400,000 / cubic mm. Loss or damageto one of the blood cells that causethrombocytopenia will cause noise in the systemdue to platelet hemostasis with vascular systemand blood coagulation factors simultaneously
involved in maintaining normal hemostasis
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What are the types of ITP ?
1. Acute ITP
generally lasts less than 6 month. It mainlyoccurs in children, both boy and girls,
and idiophatic TP is the most common type ofTP it often occurs after an infection from virus
2. Chroic TP lasts around 6 month or more than 6month . It mainly in adults. Women are 2-3times more likely to be affected by chronic TP
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Acute ITP Chronic ITP
age A peak incidence between 2-5
years of age
20 -50 years of age
Female over male , 3:1
onset Relatively acute Relatively chronic
Degree of hemorrhage Relatively acute Relatively mind
Course of desease ≤ 6 months Months to years
Platelet count Mostly, < 20,000/ mcL Commonly 30,000-
80,000/mcL
Number of megakaryocytes of
bonemarrow
Normal or increased Increased markedly
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Manifestations•
Bleeding(most important clinical manifestation of ITP
petechiae
ecchymoses
epistaxis (spontaneous bleeding from nose)gingival bleeding
menorrhagia
• Disabling fatigue
• Proteinuria/ hematuria• Abdomonal pain
• nausea, vomiting
• fever
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Diagnostic testsLaboratory
o Platelets (often <20000-30000 / MCL) and normal blood cells.
o Bleeding Time (BT, Bleeding Time) prolong
o The period of prothrombin (PT, Prothrombin Time): normal
o Partial Prothrombin Time (PTT, Partial PT): normal
o Examination of peripheral blood deletion:
- Leukocytes, hemoglobin in normal circumstances unless thereis bleeding.
- Platelets greater (younger), there is no collection of platelets
o marrow examination:- Result: normal or increased megakaryocytes in acute ITP
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• The bone marrow in patient with ITP contains normal or increasenumber of megacaryocytes
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Commond medications used to treat
idiopathic thrombocytopenic purpura• Corticosteroid
the first line of therapy is acorticosteroid, usuallyPREDNISON which can help raise your platelel count bydecreasing the activity of your immune system.
once your platelet counts is back to a safe level, you cangradually discontinue taking the drug under the direction ofyour doctor. In general, this takes about two to six weeks
Dose : oral tablets 0,1 -2mg/kg/day in devided
doses 1 to 4 times/day
IV IM 0,1 – 2mg/kg/day in devided doses
1 to 4 times/day
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• Intravenous immue globulin (IVIG)
dose intravenous immunoglobulin 1mg/kg/dayfor <5000/ml
2-3 days in a row is used when there is iternalbleeding (platelets
If you have critical bleeding or need to quickly
increase your blood count before surgery, youmay receive medications such as immuneglobulin given inravenously.these medications arequick and effective
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• High dose steroids
therapy ITP patiets can be used in additionalprednison to DEXAMETHASONE oral higedose40mg/day repeated every 28days for 6 cycles
high dose METYLPREDNISOLONE can given tochildre and adults with ITP resistant to doseprednison therapy
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• Anti – D iv
the doseof anti – D 50-75mg/kb/day
mechanisme of action of anti-D is thedestruction of red bloods cells of rhesus D-
positive that specifically grated in the spleen