1. Dr.Leni Lismayanti, SpPK Dept of Clinical Pathology RSHS/FKUP Bandung
Platelet Disorders
Dr.Leni Lismayanti, SpPK
Dept of Clinical Pathology
RSHS/FKUP Bandung

2. Reference book:
- Denise M Harmening. Clinical Hematology and Fundamental of Hemostasis. 5th edition. Philadelphia: FA Davis Co, 2009.

3. Introduction Primary hemostasis  platelet + vessel
Disorders of primary hemostasis  inability to perform platelet plug.
Defect: quantitative & qualitative
Inherited, congenital, acquired
Clinical manifestation 

4. Hemostasis Primer (Sumbat trombosit)
Hemostasis Sekunder (Sumbat hemostasis)

5. Clinical Manifestation of Primary Hemostasis Disorders:
Ecchymosis:
Mucosal Bleeding:
Epistaxis
Gingival bleeding
Gastrointestinal bleeding
Menorrhagia
Hematuria
Petechiae
Purpura

10. 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

11. Any Questions?

12. Platelet Disorders: Number: Decreased (Thrombocytopenia)
Increased (Thrombocytosis/
Thrombocythemia)
Function:
Adhesion
Release reaction
Aggregation

13. Thrombocytopenia Etiology: Deficient platelet production
Abnormal platelet distribution
Increased platelet destruction

14. Deficient Platelet Production
Myelophthisic (marrow infiltratif processes)
Aplasia
Ineffective erythropoiesis
Congenital Disoders

15. Abnormal Platelet Distribution
Hypersplenism (splenomegaly)
Hemangioma (Kasabach-Merrit syndrome)

16. Increased Platelet Destruction
Immune (primary) (ITP)
Immune (secondary) (SLE, Infection)
Microangiopathic thrombocytopenia (TTP, HUS, DIC)
Pregnancy-associated thrombocytopenia (HELLP syndrome)

17. Qualitative Platelet Disorders
Congenital:
Platelet Membrane Defects
Platelet Release (secretion) Defects
Platelet Coagulant Defects
Von Willebrand Disease
2. Acquired

18. Acquired Qualitative Platelet Disorders
Renal disease (Uremia)
Liver disease
Paraproteinemia
Myeloproliferative diorders
Acquired von Willebrand disease
Cardiopulmonary bypass
Acquired storage pool deficiencies
Drug therapy

19. 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)

20. Thank You for Your Attention