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

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Presentation transcript:

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

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

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

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

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

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

Any Questions?

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

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

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

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

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

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

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

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)

Thank You for Your Attention