Clinical Approach To A Case Of Purpura

Clinical Approach To A Case Of Purpura

Question. Write a short note on Purpura.

Answer. Any rash in which blood cells leak into the skin or mucus membrane, usually at multiple sites.
Purpuric rashes are often associated with disorders of coagulation or thrombosis.
Pinpoint purpuric lesions are called petechiae, large hemorrhages into the skin are called as ecchymoses.

Types Of Purpura

• Allergic purpura: Any of a group of purpuras caused by a variety of agents, including bacteria, drugs and food.
• Anaphylactic purpura or Henöch-Schönlein purpura: A form of small vessel vasculitis that affcts children more commonly than adults, it is marked by abdominal pain, polyarticular joint disease and purpuric lesions of the lower extremities.
• Idiopathic thrombocytopenic purpura or hemorrhagic purpura:
  It is hemorrhagic autoimmune disease in which there is destruction of circulating platelets, caused by autoantibodies that bind with antigen on the platelet membrane.

Clinical Approach to a Case of Purpura

Symptoms

• Bleeding from nose, the gums or the gastrointestinal tract.
• Physical fidings include petechiae, especially on the lower extremities and ecchymoses.

laboratory Findings

Platelet count is usually less than 100, 000 per cumm.

Purpura Diagnosis and Clinical Management

Treatment

• If patient are asymptomatic and platelet count is about 40,000 per cumm, treatment is unnecessary.
• For symptomatic patients, treatment regimen include high dose corticosteroid, IV immunoglobulin, splenectomy.