Lecture 4: Thrombocytopenia in Pediatric Patients Flashcards Preview

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Flashcards in Lecture 4: Thrombocytopenia in Pediatric Patients Deck (13)
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At which platelet counts is spontaneous bleeding, clinically significant bleeding, and life threatening hemorrhage possible?

- Spontaneous = <50 x 103/uL

- Clinically significant = <20 x 103/uL***

- Life threatening = <10 x 103/uL


What are the 4 most common conditions associated with fetal/neonatal thrombocytopenia?

- Alloimmune thrombocytopenia

- Congenital infection (i.e., CMV, toxoplasma, rubella, HIV)

- Aneuploidy (i.e., triomy 18, 13, or 21 or triploidy)

- Autoimmune conditions (i.e., ITP, SLE)


Kasabach-Merrit syndrome can be associated with early-onset neonatal (<72 hrs) thrombocytopenia and what other finding?

Large hemangiomas


Late onset neonatal (>72 hr) thrombocytopenia is almost always due to what?

Late-onset sepsis


Which disorder in children causing thrombocytopenia is a primary platelet consumption syndrome?

Idiopathic thrombocytopenia purpura


Which 2 disorders causing thrombocytopenia in children are due to combined platelet and fbrinogen consumption syndromes?


- Kasabach-Merritt syndrome


Ecchymosis/bruising may be seen with platelet disorders in childre, you should worry if what 3 things are seen?

- Multiple

- Atypical distribution

- Bruising inconsistent with activity or force of injury


A young male presenting with eczema, recurrent infections, and small platelets should make you think what?

Wiscott-Aldrich Syndrome


How does acute idiopathic thrombocytopenic purpura (ITP) most commonly manifest in a child and what is the platelet level/morphology?

- Sudden onset of petechiae and bruising in otherwise well child; most often following a viral infection

- Platelet count usually <20x103/uL ---> platelets presents are usually large


Which 3 treatments are most commonly used for acute ITP (usually only when severe or life-threatening hemorrhage)?


- Prednisone (or other corticosteroid)

- Anti-D immunoglobulin (only in Rh (-) children)


After 12 months of ongoing ITP (chronic) in a child what other disorders should you evaluate for?

- Autoimmune diseases like SLE, chronic infections like HIV

- Non-immune causes like platelet type vWF, x-linked thrombocytopenia

- H. pylori infection***


Hemolytic-uremic syndrome (HUS) is due to what?

Vascular injury (especially kidneys and colonic mucosa) from toxins from E.coli O157:H7 causing consumption of platelets


What is the only cell line involved in ITP?