Pathogenesis (disease development) Chronic idiopathic thrombocytopenic purpura is characterized by: Isolated thrombocytopathy* (dysfunction of platelets/platelets) with no apparent cause (degradation in the spleen). Platelet survival time reduced to hours. Detection of IgG antibodies (formation in the spleen). Increased megakaryocytopoiesis in the bone marrow. * Clinical manifestations often do not occur until platelet counts are below … Werlhof’s Disease: Causes
General measures If there is no bleeding and the blood count shows platelets > 30,000/μl, it is possible to wait. Review of permanent medication due topossible effect on the existing disease. Conventional non-surgical therapy methods If H. pylori infestation of the stomach is present, eradication (germ elimination via antibiotic therapy) should be performed. Vaccinations The … Werlhof’s Disease: Therapy
Medical history (history of illness) represents an important component in the diagnosis of Werlhof disease. Family history Are there any people in your family who suffer from blood clotting disorders? Social history Current medical history/systemic medical history (somatic and psychological complaints). Have you noticed fleabite-like skin lesions? If yes, since when and on which body … Werlhof’s Disease: Medical History
Blood, hematopoietic organs-immune system (D50-D90). Thrombocytopenia of other cause such as immune thrombocytopenia (idiopathic thrombocytopenic purpura (ITP); synonyms: Immune thrombocytopenia; purpura haemorrhagica; thrombocytopenic purpura; autoimmune thrombocytopenia; immune thrombocytopenic purpura; mainly affects children), HUS (synonym: Gasser syndrome – rare disease mainly affecting infants and young children. One speaks of complete enteropathic HUS in the presence of … Werlhof’s Disease: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by Werlhof disease: Cardiovascular system (I00-I99). Intracranial hemorrhage (bleeding within the skull; parenchymal, subarachnoid, sub- and epidural, and supra- and infratentorial hemorrhage)/intracerebral hemorrhage (ICB; cerebral hemorrhage), unspecified Infectious and parasitic diseases (A00-B99). Infections, unspecified; often due to therapy. Mouth, esophagus (food … Werlhof’s Disease: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [petechiae (minute skin/mucous membrane hemorrhages (flea-like), often first on hocks, lower legs)] Palpation (palpation) of the abdomen (abdomen) (tenderness?, … Werlhof’s Disease: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Differential blood count Inflammatory parameter – CRP (C-reactive protein) Detection of platelet IgG, antibodies against glycoproteins. Laboratory parameters 2nd order – depending on the results of the history, physical examination and the obligatory laboratory parameters – for differential diagnostic clarification. Bone marrow aspiration
Therapeutic target Increase in platelet count Therapy recommendations The American Society of Hematology recommends initiation of glucocorticoid therapy for: Platelets <50,000/μl with a marked bleeding tendency. Platelets < 30,000/μl with slight bleeding tendency Platelets < 20,000/μl in general Furthermore, note: In the absence of success of glucocorticoid therapy, do not continue it for more than … Werlhof’s Disease: Drug Therapy
Obligatory medical device diagnostics. Abdominal ultrasonography (ultrasound examination of the abdominal organs) – for basic diagnosis. Optional medical device diagnostics – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. X-ray of the thorax (X-ray thorax/chest), in two planes. Computed tomography (CT) of the abdomen (abdominal … Werlhof’s Disease: Diagnostic Tests
Splenectomy (splenectomy) is indicated in the following situations (according to the American Society of Hematology): Chronic thrombocytopenia with <10,000/μl – after six weeks of initial treatment (adults). Chronic thrombocytopenia with < 30,000/μl – after three months of initial treatment (adults). Children should wait up to one year before indication for splenectomy Recurrence may also occur … Werlhof’s Disease: Surgical Therapy
The following symptoms and complaints may indicate Werlhof disease: Leading symptoms Petechiae – minute skin/mucosal hemorrhages (flea-like); often first on the ankles, lower legs Associated symptoms Epistaxis (nosebleed) Gum bleeding Menorrhagia – prolonged and increased menstruation (menstrual bleeding). Gastrointestinal bleeding Intracranial hemorrhage (ICB; cerebral hemorrhage). These symptoms usually do not occur until the platelet concentration … Werlhof’s Disease: Symptoms, Complaints, Signs
