Idiopathic thrombocytopenic purpura: predictors of chronic disease

Article Abstract:

Purpura is bleeding which is visible through the skin; the common bruise is one example. In idiopathic thrombocytopenic purpura, purpura is associated with a reduction in the number of platelets. In 70 to 90 percent of cases, the condition resolves by itself, and is labelled acute; there is little sickness or mortality associated with this condition. In some cases, the condition persists; documented platelet counts under 150 billion per liter for over six months warrant the term chronic. Although small, there is a persistent risk for intracranial hemorrhage among children with chronic idiopathic thrombocytopenic purpura. These children often require regular follow-up visits and, perhaps, a restriction of physical activities. The records of 289 children, diagnosed with idiopathic thrombocytopenic purpura over a 20-year period, were examined to determine if specific factors might predict the likelihood of chronic thrombocytopenia. It was found that neither age, sex, season of onset, or history of viral infection at the time of diagnosis had any influence on the likelihood of chronic illness. However, it was found that the symptoms in most children resolved far sooner than six months, and that a history of symptoms for over two weeks was, in fact, a strong predictor of continued thrombocytopenia at six months. At 28 days, 47 percent of the children had a normal platelet count. However, at 28 days, a platelet count under 150 carried a roughly three-fold risk of chronic idiopathic thrombocytopenic purpura; a platelet count under 50 had a five-fold risk. In this study 53 (18 percent) of the 289 cases remained chronic; two-thirds of these children were thrombocytopenic two years after they were diagnosed, despite treatment. Three children died from intracranial hemorrhage; the proportion of children dying today is declining due to the availability of gamma globulin therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Thrombocytopenic purpura

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Ultrasonography to diagnose and exclude intussusception in Henoch-Schonlein purpura

Article Abstract:

Purpura is a condition characterized by bleeding into the skin, mucous membranes, internal organs, and other tissues. The Henoch-Schonlein form of purpura is characterized by pain in the abdomen, bleeding from the digestive tract, inflammation of the blood vessels, fluid accumulation in the intestines, bleeding for the walls of the organs, tissue death, and rupture. Intussusception is invagination, or ensheathing, of one portion of the intestine into another. It is a rare complication of the Henoch-Schonlein purpura and can be corrected by surgery. The diagnosis and treatment of intussusception may be difficult due to other symptoms affecting the intestine. The use of ultrasonography in diagnosing intussusception was assessed in 152 children with Henoch-Schonlein purpura. Symptoms included abdominal pain in 60 cases and bleeding from the stomach and intestines in 19 cases. Intussusception was suspected in nine cases and confirmed in two cases using ultrasonography. These findings show that ultrasound is useful in diagnosing intussusception associated with Henoch-Schonlein purpura, and may also be useful in detecting the recurrence of intussusception following corrective surgery, formation of blood masses in the intestinal wall, and inflammation of the blood vessels supplying the intestine associated with swelling. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Ultrasound imaging, Diagnosis, Complications and side effects, Pediatric diseases, Intussusception in children, Intussusception, Schonlein-Henoch purpura, Allergic purpura

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Platelet antigens in varicella associated thrombocytopenia

Article Abstract:

Purpura, bruising or bleeding into the skin, is a common complication of varicella, or chickenpox, a viral disease characterized by development of rash. The appearance of the rash progresses through several stages consisting of macules, discolored spots or patches on the skin; papules, red elevated areas on the skin; vesicles, or blisters; and crusts, or hardened skin lesions. The mechanism leading to varicella-associated thrombocytopenia, an abnormal decrease in the number of blood platelets, which are the cells involved in blood clotting, is not known. Thrombocytopenia may result from the destruction of platelets by immune reactions or by the virus. Antibodies are immune proteins that specifically act against elements of the cells called antigens. Patients with varicella were shown to have antibodies specifically against platelets. The antigens on the platelets that attach to platelet antibody were assessed. Platelet antigens included the glycoproteins, or glucose and protein complexes, GPIb, GPIIb, GPIIIa, and other proteins with a molecular mass of 25 to 260 kilodaltons. These findings suggest that varicella-associated thrombocytopenia may result from an autoimmune reaction, in which the immune system attacks the body's own tissues and factors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Thrombocytopenia, Chickenpox

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