Idiopathic Thrombocytopenic Purpura (ITP)

7/30/2019 Idiopathic Thrombocytopenic Purpura (ITP)

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IDIOPATHIC

THROMBOCYTOPENIC

PURPURA (ITP)CASE ANALYSIS PRESENTATION

Sarah G. Lopez

Clinical Pharmacy Laboratory


2/20

Patient Information

LR, an 18 year old F was diagnosed with ITP.

The only indication present up until now are

bruises, red to violet spots in the skin,menorrhagia and rarely bleeding gums. As a

child the said signs appeared but the condition

was only diagnosed in her high school years.

There are no significant PMH, SH and FH

present. She had NKA.

Case Presentation by S.Lopez


3/20


Patient is currently taking prednisone 15mg

tablet PO BID (Available dose 30mg, broken

half), Vitamin C 500mg PO TID after meals,Fersulfate 500mg PO as needed during

menstruation period. Herbal Supplements,

Complete Phyto Energizer 500mg PO BID,

Power C plus 500mg PO BID 2xper meal and

Power greens 500mg PO BID 2x per meal.


4/20

General PE; well developed, VS; BP, temp. andRR normal, weight 50kg, height 142cm.

Extremities; petechia and purpura present whenPLT is low. Gets easily bruised. Blood testing,

PLT count, Bone marrow testing and X-ray was

done. Lowest PLT count recorded was 7x109.



5/20


Bone marrow testing showed normal results and

she has no other blood related condition. It was

done to rule out other conditions that manifest

thrombocytopenia. X-ray is done to monitor the

effects of prednisone in bones.


6/20

Platelets


Produced in blood cell formation in bone marrow

They circulate in the blood of mammals and are

involved in homeostatis, leading to the formationof blood clots. Low levels can lead to excessivebleeding, high levels leads to blood clots(thrombosis)

Normal level 150000-400000 mm3 is Life spanis 5 to 10 days

Platelets are destroyed by phagocytosis in thespleen


7/20

Discussion of Disease State

Idiopathic Thrombocytopenic Purpura (ITP) is an

acquired hemorrhagic disorder characterized by:

Thrombocytopenia - excessive destruction ofplatelets

Purpura - a discoloration caused by petechiae

beneath the skin

Normal bone marrow with normal or increased

number of immature platelets(megakaryocytes)

and eosinophils



8/20

Although the cause is unknown, it is believed tobe an autoimmune response to disease-related

antigens. It is the most frequentlyoccurring thrombocytopenia of childhood. The

greatest frequency of occurrence is between 0

and 10 years of age. The disease occurs in one

of two forms: an acute, self limiting course or

a chronic condition (greater than 6 months

duration).



9/20

Clinical Manifestation


Easy Bruising(purpura); Petechiae

Ecchymoses, most often over bony

prominences

Bleeding from mucous membrane

Epistaxis

Bleeding gums Internal hemorrhage: hematuria, hematemesis,

melena hemarthrosis, menorrhagia


10/20Purpura andPetechiae


11/20

Diagnostic Evaluation


In ITP, the PLT count is reduced to below 20,000

mm3; therefore, tests that depend on PLT

function such as bleeding time, and clotretraction are abnormal. Although there is no

definite test on which to establish a diagnosis

of ITP, several are usually performed to rule out

other disorders in which thrombocytopenia is a

manifestation, such as systemic lupus

erythematosus, lymphoma or leukemia.


12/20

Discussion of Drug Therapy


Prednisone


13/20



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Project Description

Objective

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Results

Add your results here



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Procedure/Methodology

Add your procedure here

Key assumptions

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Key Findings/Result 2

Project

Item 1

Item 2

Item 3

Item 4



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Key Findings/Result 3

Run Number Description Result A Result B

1 Condition A True True

2 Condition B True False

3 Condition C False False



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Conclusion

Add your conclusion here



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Questions and Discussion


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Idiopathic Thrombocytopenic Purpura (ITP)

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