Special Issue "Diagnosis and Management of Thrombocytopenia"
Deadline for manuscript submissions: closed (31 July 2021).
2. Cardiometabolic Programme-NIHR UCLH/UCL BRC, London, UK
Interests: immune thrombocytopenic purpura (ITP); thrombotic thrombocytopenic purpura (TTP); hemolytic uremic syndrome (HUS); disseminated intravascular coagulation (DIC); acute thrombocytopenia
Thrombocytopenia is a common haematological finding that may be isolated or associated with abnormalities of other haematological laboratory parameters. Excluding leukaemia, the differential diagnosis of acute thrombocytopenia includes immune thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura (TTP), or thrombotic microangiopathy (TMA) and disseminated intravascular coagulation (DIC). The importance of diagnosing and differentiating these conditions ensures the correct treatment is given, which could have a major impact on patient outcomes. All of these acute conditions may have comparable clinical phenotypes, typically epithelial type bleeding, but may have a thrombotic risk. Treatments may be supportive or specific, for example, for ITP or TMAs for which immunosuppression or plasma exchange would respectively be initiated. These three conditions can affect any age group and are precipitated by an underlying trigger to varying degrees.
ITP is a relatively common condition and is diagnoses of exclusion, requiring steroids, blood products, or supportive pharmacological agents such as tranexamic acid. The use of newer therapies such as thrombopoietin agonists has improved acute and long-term outcomes for patients.
DIC is a syndrome for which there is an underlying trigger, typically sepsis, malignancy, pregnancy, or trauma. The treatment of DIC is symptomatic; treatment of the underlying trigger is critical in order to prevent disease progression.
TMAs are diagnosed by microangiopathic haemolytic anaemia, thrombocytopenia, and organ dysfunction secondary to microvascular thrombi. Confirmation of a diagnosis of TTP is by severe ADAMTS 13 activity deficiency, whereas HUS is a diagnosis of exclusion related to complement dysregulation or toxin from bacterial gut pathogens such as Escherichia coli. These conditions are medical emergencies, and acute and long-term therapies will be discussed.
Prof. Dr. Marie Scully
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- immune thrombocytopenic purpura (ITP)
- thrombotic thrombocytopenic purpura (TTP)
- hemolytic uremic syndrome (HUS)
- disseminated intravascular coagulation (DIC)
- acute thrombocytopenia