Thrombocytopenia: Difference between revisions
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'''Thrombocytopenia''' is a decrease in the platelet count. The half-life of a platelet in a normal person is about 4 days.<ref name="pmid3730614">{{cite journal |author=Fritz E, Ludwig H, Scheithauer W, Sinzinger H |title=Shortened platelet half-life in multiple myeloma |journal=Blood |volume=68 |issue=2 |pages=514–20 |year=1986 |pmid=3730614 |doi=}}</ref> | '''Thrombocytopenia''' is a decrease in the platelet count. The half-life of a platelet in a normal person is about 4 days.<ref name="pmid3730614">{{cite journal |author=Fritz E, Ludwig H, Scheithauer W, Sinzinger H |title=Shortened platelet half-life in multiple myeloma |journal=Blood |volume=68 |issue=2 |pages=514–20 |year=1986 |pmid=3730614 |doi=}}</ref> | ||
== | ==Classification== | ||
The following classification is proposed by Robbins and Cotran.<ref name="isbn0-7216-0187-1">{{cite book |author=Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. |title=Robbins and Cotran pathologic basis of disease |publisher=Elsevier Saunders |location=St. Louis, Mo |year=2005 |pages= |isbn=0-7216-0187-1 |oclc= |doi=}}</ref> | |||
===Decreased production of platelets=== | |||
===Decreased survival of platelets=== | |||
====Immunolologic destruction==== | |||
'''Autoimmune''' includes [[immune thrombocytopenia purpura]] or Werlhof's Disease. The chronic form in adults is usually caused by antibodies to [[Platelet glycoprotein GPIIb-IIIa complex]] or Ib-IX.<ref name="isbn0-7216-0187-1"/> | |||
;Isoimmune | |||
;Drug associated | |||
;Infections | |||
====Nonimmunolologic destruction==== | |||
;Disseminated intravascular coagulation (DIC) | |||
;Giant hemangiomas | |||
'''Microangiopathic hemolytic anemias (MAHAs)''' include [[thrombotic thrombocytopenia purpura]] (TTP) and [[hemolytic uremia syndrome]] (HUS). TTP is usually an inherited or acquired deficiency of von Willebrand factor (vWF) metalloprotease, also called ADAMTS 13. | |||
==Cause/etiology== | |||
===Medications=== | ===Medications=== | ||
[[Systematic review]]s have identified common causes of drug-induced thrombocytopenia.<ref name="pmid20530792">{{cite journal| author=Reese JA, Li X, Hauben M, Aster RH, Bougie DW, Curtis BR et al.| title=Identifying drugs that cause acute thrombocytopenia: an analysis using 3 distinct methods. | journal=Blood | year= 2010 | volume= 116 | issue= 12 | pages= 2127-33 | pmid=20530792 | doi=10.1182/blood-2010-03-276691 | pmc=PMC2951857 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20530792 }} </ref><ref name="pmid9867731">{{cite journal |author=George JN, Raskob GE, Shah SR, ''et al'' |title=Drug-induced thrombocytopenia: a systematic review of published case reports |journal=Ann. Intern. Med. |volume=129 |issue=11 |pages=886–90 |year=1998 |pmid=9867731 |doi=|url=http://www.annals.org/cgi/content/full/129/11_Part_1/886}}</ref> | |||
Drug-induced thrombocytopenia maybe immune | Drug-induced thrombocytopenia maybe immune mediated by antibodies against immune complexes of drugs bound to [[Platelet glycoprotein GPIIb-IIIa complex]] or Ib/V/IX complexes.<ref name="pmid17687133">{{cite journal |author=Aster RH, Bougie DW |title=Drug-induced immune thrombocytopenia |journal=N. Engl. J. Med. |volume=357 |issue=6 |pages=580–7 |year=2007 |pmid=17687133 |doi=10.1056/NEJMra066469|url=http://content.nejm.org/cgi/content/full/357/6/580}}</ref> [[Heparin-induced thrombocytopenia]] (HIT) is usually caused by antibodies against immune complexes of platelet factor 4 (PF4) and [[heparin]].<ref name="pmid16928996">{{cite journal |author=Arepally GM, Ortel TL |title=Clinical practice. Heparin-induced thrombocytopenia |journal=N. Engl. J. Med. |volume=355 |issue=8 |pages=809–17 |year=2006 |pmid=16928996 |doi=10.1056/NEJMcp052967|url=http://content.nejm.org/cgi/content/full/355/8/809}}</ref> Other drugs include [[vancomycin]] | ||
<ref name="pmid17329697">{{cite journal |author=Von Drygalski A, Curtis BR, Bougie DW, ''et al'' |title=Vancomycin-induced immune thrombocytopenia |journal=N. Engl. J. Med. |volume=356 |issue=9 |pages=904–10 |year=2007 |pmid=17329697 |doi=10.1056/NEJMoa065066}}</ref> and oxaliplatin<ref name="pmid12859182">{{cite journal |author=Dold FG, Mitchell EP |title=Sudden-onset thrombocytopenia with oxaliplatin |journal=Ann. Intern. Med. |volume=139 |issue=2 |pages=E156 |year=2003 |pmid=12859182 |doi=|url=http://www.annals.org/cgi/content/full/139/2/W-59}}</ref> | <ref name="pmid17329697">{{cite journal |author=Von Drygalski A, Curtis BR, Bougie DW, ''et al'' |title=Vancomycin-induced immune thrombocytopenia |journal=N. Engl. J. Med. |volume=356 |issue=9 |pages=904–10 |year=2007 |pmid=17329697 |doi=10.1056/NEJMoa065066}}</ref> and oxaliplatin<ref name="pmid12859182">{{cite journal |author=Dold FG, Mitchell EP |title=Sudden-onset thrombocytopenia with oxaliplatin |journal=Ann. Intern. Med. |volume=139 |issue=2 |pages=E156 |year=2003 |pmid=12859182 |doi=|url=http://www.annals.org/cgi/content/full/139/2/W-59}}</ref> | ||
===Infection=== | |||
Septicemia has been associated with antibody mediated thrombocytopenia.<ref name="pmid423910">{{cite journal |author=Kelton JG, Neame PB, Gauldie J, Hirsh J |title=Elevated platelet-associated IgG in the thrombocytopenia of septicemia |journal=N. Engl. J. Med. |volume=300 |issue=14 |pages=760–4 |year=1979 |pmid=423910 |doi=}}</ref> | |||
==References== | ==References== | ||
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==External links== | ==External links== | ||
* [http://w3.ouhsc.edu/platelets/ University of Oklahoma Health Sciences Center's Platelets on the Web] | * [http://w3.ouhsc.edu/platelets/ University of Oklahoma Health Sciences Center's Platelets on the Web]. This includes a database of reports of drug-induced thrombocytopenia. | ||
[[Category:Suggestion Bot Tag]] | |||
Latest revision as of 16:00, 28 October 2024
Thrombocytopenia is a decrease in the platelet count. The half-life of a platelet in a normal person is about 4 days.[1]
Classification
The following classification is proposed by Robbins and Cotran.[2]
Decreased production of platelets
Decreased survival of platelets
Immunolologic destruction
Autoimmune includes immune thrombocytopenia purpura or Werlhof's Disease. The chronic form in adults is usually caused by antibodies to Platelet glycoprotein GPIIb-IIIa complex or Ib-IX.[2]
- Isoimmune
- Drug associated
- Infections
Nonimmunolologic destruction
- Disseminated intravascular coagulation (DIC)
- Giant hemangiomas
Microangiopathic hemolytic anemias (MAHAs) include thrombotic thrombocytopenia purpura (TTP) and hemolytic uremia syndrome (HUS). TTP is usually an inherited or acquired deficiency of von Willebrand factor (vWF) metalloprotease, also called ADAMTS 13.
Cause/etiology
Medications
Systematic reviews have identified common causes of drug-induced thrombocytopenia.[3][4]
Drug-induced thrombocytopenia maybe immune mediated by antibodies against immune complexes of drugs bound to Platelet glycoprotein GPIIb-IIIa complex or Ib/V/IX complexes.[5] Heparin-induced thrombocytopenia (HIT) is usually caused by antibodies against immune complexes of platelet factor 4 (PF4) and heparin.[6] Other drugs include vancomycin [7] and oxaliplatin[8]
Infection
Septicemia has been associated with antibody mediated thrombocytopenia.[9]
References
- ↑ Fritz E, Ludwig H, Scheithauer W, Sinzinger H (1986). "Shortened platelet half-life in multiple myeloma". Blood 68 (2): 514–20. PMID 3730614. [e]
- ↑ 2.0 2.1 Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease. St. Louis, Mo: Elsevier Saunders. ISBN 0-7216-0187-1.
- ↑ Reese JA, Li X, Hauben M, Aster RH, Bougie DW, Curtis BR et al. (2010). "Identifying drugs that cause acute thrombocytopenia: an analysis using 3 distinct methods.". Blood 116 (12): 2127-33. DOI:10.1182/blood-2010-03-276691. PMID 20530792. PMC PMC2951857. Research Blogging.
- ↑ George JN, Raskob GE, Shah SR, et al (1998). "Drug-induced thrombocytopenia: a systematic review of published case reports". Ann. Intern. Med. 129 (11): 886–90. PMID 9867731. [e]
- ↑ Aster RH, Bougie DW (2007). "Drug-induced immune thrombocytopenia". N. Engl. J. Med. 357 (6): 580–7. DOI:10.1056/NEJMra066469. PMID 17687133. Research Blogging.
- ↑ Arepally GM, Ortel TL (2006). "Clinical practice. Heparin-induced thrombocytopenia". N. Engl. J. Med. 355 (8): 809–17. DOI:10.1056/NEJMcp052967. PMID 16928996. Research Blogging.
- ↑ Von Drygalski A, Curtis BR, Bougie DW, et al (2007). "Vancomycin-induced immune thrombocytopenia". N. Engl. J. Med. 356 (9): 904–10. DOI:10.1056/NEJMoa065066. PMID 17329697. Research Blogging.
- ↑ Dold FG, Mitchell EP (2003). "Sudden-onset thrombocytopenia with oxaliplatin". Ann. Intern. Med. 139 (2): E156. PMID 12859182. [e]
- ↑ Kelton JG, Neame PB, Gauldie J, Hirsh J (1979). "Elevated platelet-associated IgG in the thrombocytopenia of septicemia". N. Engl. J. Med. 300 (14): 760–4. PMID 423910. [e]
External links
- University of Oklahoma Health Sciences Center's Platelets on the Web. This includes a database of reports of drug-induced thrombocytopenia.