Friday, October 28, 2016

An adolescent girl presents with a rash that is made up of very small, bright red, non blanching macules.



An adolescent girl presents with a rash that is made up of very small, bright red, non blanching macules. The child had nonspecific viral symptoms last week. She appears to be in excellent health except for the rash. She is not on any medications. What is the most common cause of this condition?

A. Penicillin
B. Hemolysis
C. Human immunodeficiency virus (HIV)
D. Lupus
E. Idiopathic thrombocytopenic purpura.

Answer: E. Idiopathic thrombocytopenic purpura.

Discussion: 
Thrombocytopenia can be caused by decreased platelet production, increased platelet destruction, dilutional phenomena, platelet sequestration, or pseudothrombocytopenia. 

Common causes of platelet descruction include :
  • DIC, 
  • the anti-phospholipid antibody syndrome, 
  • drugs such as heparin, 
  • infections such as HIV and infectious mononucleosis, and 
  • ITP. 
ITP is characterized by isolated, idiopathic thrombocytopenia. Purpura, bruising, and bleeding are encountered. Other symptoms are usually absent—hepatosplenomegaly, lymphadenopathy, fever, or bone or joint pain. Medications can cause thrombocytopenia and purpura, but we have no history of any medication use. Medications that can cause ITP include penicillin, valproic acid, quinidine, sulfonamides, cimetidine, and heparin. HIV and lupus are less common causes of ITP; viral illnesses will often be associated with ITP in children. Eighty to ninety percent of younger individuals recover in a few weeks, but ITP can be more recalcitrant in adults

1 comment:

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