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PURPLE TROMBOCITOPÉNICA IDIOPÁTICA | |
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 DEFINITIONS YOU CAUSE CLINIC DIAGNOSTIC TREATMENT TO CONSULT |
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Purple. It is a symptom (the appearance of violet spots in the skin) that it characterizes to many different hemorrhagic disorders. Purple trombocitopénica idiopática (PTI). It is an illness that is characterized by an absence of thrombocytes, for which hemorrhages happen in skin and other organs. It is caused because the immune organs produce antibodies against the thrombocytes, what does that the spleen recognizes to the proper thrombocytes like strange cells and destroys them. In the children it appears after an infection by virus. The sharp PTI is more common in the children between the two and nine years of age. It is caused because the immune organs produce antibodies (antibody G ó IgG, especially) against the thrombocytes, what does that the spleen recognizes to the proper thrombocytes like strange cells and destroys them. The patients with PTI can remain asymptomatic, or present persistent cutaneous hemorrhage (especially in areas exposed to the traumatism) or hemorrhages for the mucous membranes (epistaxis or bled nasal, menorragia or bled vaginal, equimosis). The internal hemorrhages and the hemartrosis (hemorrhages you will articulate) are rare. The diagnosis is established across the case history, the physical exploration and the inventory of thrombocytes. The hemorrhage not related to traumatism usually does not raise problems while the thrombocytes inventory supports over 20.000/mm 3. The traumatic hemorrhage can appear with numbers of thrombocytes between 40.000 and 60.000/mm 3. Other habitual coagulation studies are usually normal, except the extension of the time of hemorrhage. The treatment is unnecessary in the patients with trombocitopenia set sail, and it is reserved for the cases with hemorrhage due to trombocitopenia or the patients with numbers of thrombocytes below 20.000/mm3. The target of the therapy consists of stopping the hemorrhages and raising the number of thrombocytes over 20.000/mm3. The treatment consists in: Corticoids. The prednisona can be used for 6 weeks and provides a percentage of success of up to 80 %. Esplenectomía (surgical Eradication of the spleen). The esplenectomía saves herself for the cases resistant to the conservative therapy, it is strange in the infancy. It provides a percentage of successes of 60 % to 80 %. Medicines immunosuppressants. These medicines are used if the low number of thrombocytes persists in spite of the treatment with corticoids or esplenectomía. The vincristina and the vinblastina are the agents of this type used with major frequency. Gammaglobulinas I.V.: The intravenous gammaglobulina to dose from 400 to 1.000 mg / kg / day has been used successfully in cases of refractory PTI. Other therapeutic options. Danazol, colchicina has provided a success limited in patients with PTI, as the plasmaféresis. The treatment of the PTI monoclonales meets antibodies in experimental phase. The PTI cannot get ready. |
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