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Dr.Leni Lismayanti, SpPK Dept of Clinical Pathology RSHS/FKUP Bandung
Platelet Disorders Dr.Leni Lismayanti, SpPK Dept of Clinical Pathology RSHS/FKUP Bandung
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Reference book: - Denise M Harmening. Clinical Hematology and Fundamental of Hemostasis. 5th edition. Philadelphia: FA Davis Co, 2009.
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Introduction Primary hemostasis platelet + vessel
Disorders of primary hemostasis inability to perform platelet plug. Defect: quantitative & qualitative Inherited, congenital, acquired Clinical manifestation
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Hemostasis Primer (Sumbat trombosit)
Hemostasis Sekunder (Sumbat hemostasis)
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Clinical Manifestation of Primary Hemostasis Disorders:
Ecchymosis: Mucosal Bleeding: Epistaxis Gingival bleeding Gastrointestinal bleeding Menorrhagia Hematuria Petechiae Purpura
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Laboratory Tests to Assess Disorders of Primary Hemostasis
Platelet count Peripheral blood smear Ivy bleeding time or PFA-100 von Willebrand study Platelet antibody testing Flowcytometry Platelet aggregation study BM aspiration & biopsy
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Any Questions?
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Platelet Disorders: Number: Decreased (Thrombocytopenia)
Increased (Thrombocytosis/ Thrombocythemia) Function: Adhesion Release reaction Aggregation
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Thrombocytopenia Etiology: Deficient platelet production
Abnormal platelet distribution Increased platelet destruction
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Deficient Platelet Production
Myelophthisic (marrow infiltratif processes) Aplasia Ineffective erythropoiesis Congenital Disoders
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Abnormal Platelet Distribution
Hypersplenism (splenomegaly) Hemangioma (Kasabach-Merrit syndrome)
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Increased Platelet Destruction
Immune (primary) (ITP) Immune (secondary) (SLE, Infection) Microangiopathic thrombocytopenia (TTP, HUS, DIC) Pregnancy-associated thrombocytopenia (HELLP syndrome)
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Qualitative Platelet Disorders
Congenital: Platelet Membrane Defects Platelet Release (secretion) Defects Platelet Coagulant Defects Von Willebrand Disease 2. Acquired
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Acquired Qualitative Platelet Disorders
Renal disease (Uremia) Liver disease Paraproteinemia Myeloproliferative diorders Acquired von Willebrand disease Cardiopulmonary bypass Acquired storage pool deficiencies Drug therapy
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Vascular Disorders (purpura)
Results from another disease process and is just one of the manifestations of the disease process. Primary purpura (Senile Purpura) Secondary Purpura (Allergic)
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Thank You for Your Attention
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