Ppt Itp Ajeng

8/10/2019 Ppt Itp Ajeng

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REFERATDIAGNOSIS DAN TATALAKSANA

IDIOPATHIC THROMBOCYTOPENIC

PURPURA (ITP)



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



• 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



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



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



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



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



• The bone marrow in patient with ITP contains normal or increasenumber of megacaryocytes



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



• 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



• 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



• 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

Ppt Itp Ajeng

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