Authors: Rolf Bambauer, Ralf Schiel.
Thrombocytopenia is one of the most common hematologic disorders, characterized by an abnormally low number of platelets from multiple causes. The normal count of thrombocytes is between 150,000 and 450,000/microliter. The clinical expression of thrombocytopenia is a variation from asymptomatic to life-threatening bleeding. The immune thrombocytopenias include the idiopathic thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura (TTP), and the post-transfusion purpura (PTP). ITP is a form of thrombocytopenia, caused by autoantibodies, which are mostly accompanied by bleeding. TTP is a rare disease of unclear genesis and a poor prognosis with polyetiological complex, which the kidneys and brain as target organs. PTP is also a rare bleeding disorders caused by alloantibody specific to platelet antigens. Therapeutic apheresis (TA) is accepted as supportive therapy in all immune thrombocytopenia. Further second-line therapies are the human monoclonal antibodies (HMA) and thrombopoietin receptors agonists (TPO-RAs). Besides, the pathological aspects, the first-line and second-line therapies are shown.
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