Immune Thrombocytopenia (ITP) Case No. 6 (Pathology)

Here is our next Pathology case study is Immune Thrombocytopenia (ITP) and its clinical correlation and how to investigate it. You should try to guess it and if you guess it writes after reading the case study scenario then must write in the comment ” I did it ”  so now let’s move to our case scenario.

Immune Thrombocytopenia (ITP) Scenario

A 30-year-old woman reports to the doctor with complaints about the appearance of petechial bleeding on the skin of her legs and arms in the past 2 days. It also gives a history of four episodes of epistaxis in the past 6 months. She had heavy periods for the past 6-7 cycles as well.
The petechiae are purple on examination and pale on pressing. Jaundice is not seen.

Requirements:

1. Discuss the clinical correlation with the pathogenesis of the features.

2. What is the probable diagnosis?

3. How will you investigate and confirm the diagnosis?

Clinical Correlation

Here is the correlation of Immune Thrombocytopenia (ITP) Case No. 6.

This 30-year-old woman has been bleeding in the form of purplish blotches, nosebleeds and heavy menstrual blood loss for more than 6 months recently. Such bleeding is more common with bleeding due to thrombocytopenia than with bleeding disorders. A slight enlargement of the spleen indicates a chronic disease.

Probable Diagnosis

Chronic immune thrombocytopenic purpura (ITP)

Investigations:

  1. CBC (haemoglobin, counts, indices), ESR, PCV, blood smear for type of anaemia.
  2. Urine examination (albumin, glucose, microscopy).
  3. Biochemical estimation: Renal function tests (urea, creatinine, BUN), liver function tests (bilirubin, ALT, AST, alkaline phosphatase, total proteins and AG ratio), blood glucose.
  4. X-ray chest.
  5. Ultrasound examination of the abdomen

Additional tests

  1. Bone marrow examination.
  2. Antiplatelet antibody test.
  3. Platelet survival studies.

Reference: Harsh Mohan Pathology

 

Read Case No. 1 Here

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