master's thesis
THROMBOCYTOPENIA IN CHILDREN

Ivana Deveđija (2014)
Sveučilište u Zagrebu
Medicinski fakultet
KATEDRA ZA PEDIJATRIJU
Metadata
TitleTROMBOCITOPENIJA U DJECE
AuthorIvana Deveđija
Mentor(s)Josip Konja (thesis advisor)
Abstract
Trombociti su mali dijelovi stanice koji igraju važnu ulogu u zgrušavanju krvi, formiranjem trombocitnih čepova. Trombocitopenija se definira brojem trombocita manjim od 150x10/L. Uzroci trombocitopenije su povećana razgradnja i uništenje trombocita, smanjena proizvodnja trombocita i uništavanje trombocita u slezeni. Na trombocitopeniju treba posumnjati kada dijete ima često modrice, krvne podljeve u koži i sluznicama. Osnovni cilj liječenja pacijenata s trombocitopenijom je postizanje odgovarajućeg broja trombocita kako bi se spriječilo ozbiljno krvarenje. Najčešći uzrok trombocitopenije u djece je idiopatska trombocitopenična purpura (ITP). Pojam idiopatska ukazuje na nepoznavanje pravog uzroka pada broja trombocita. Zna se da imunološki sustav razara trombocite, što rezultira modricama i obilnim krvarenjem. U većine djece je ITP akutno stanje koje se blago, te se rješava bez liječničke intervencije. Ako je potrebno liječenje, najčešće se liječi kortikosteroidima kako bi se spriječio napad imunološkog sustava. U težim slučajevima su potrebni splenektomija i imunosupresivi kako bi se trombocitopenija stavila pod kontrolu. U 75% novorođenčadi s trombocitopenijom, ona je prisutna pri porođaju ili se razvije unutar 75 sati. Većina novorođenčadi s trombocitopenijom je rođeno prerano zbog insuficijencije posteljice tijekom trudnoće i/ ili fetalne hipoksije. 25-30% slučajeva novorođenačke trombocitopenije je povezano s povećanom potrošnjom trombocita ili sekvestracijom trombocita u slezeni. Transplacentarni prijelaz majčinih aloantitijela i autoantitijela je uzrokom 15-20% slučajeva trombocitopenija pri porodu. Za 10-15% neonatalnih trombocitopenija je odgovorna disiminirana intravaskularna koagulacija koja je povezana s neonatalnom asfiksijom i sepsom.
Keywordsthrombocytopenia idiopathic thrombocytopenic purpura children
Parallel title (English)THROMBOCYTOPENIA IN CHILDREN
Committee MembersLjubica Rajić
Marija Jelušić
Josip Konja
GranterSveučilište u Zagrebu
Medicinski fakultet
Lower level organizational unitsKATEDRA ZA PEDIJATRIJU
PlaceZagreb
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Pediatrics
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2014-07-15
Parallel abstract (English)
Platelets (thrombocytes) are small pieces of cell that play an important role in blood clotting by clumping and forming plugs when necessary. Thrombocytopenia, defined as a platelet count of less than 150x109/L. Causes of thrombocytopenia include increased breakdown and destruction of platelets, reduced production of platelets or platelets trapped in the spleen. Thrombocytopenia should be suspected when a child presents with a history of easy bruising or bleeding, particulary mucosal or cutaneous bleeding. The principal management goal in all patients who have thrombocytopenia is to maintain a safe platelet count to prevent significant bleeding. The most common reason of thrombocytopenia in children is idiopathic thrombocytopenic purpura (ITP). Idiopathic is a term indicating that there is no known cause for the drop in platelets. What is inderstood is that the immune system is destroying platelets, resulting in easy bruising and abnormal amounts of bleeding. In most children, ITP is acute and may be mild enough to resolve on its own without medical intervention. The most common treatment involves corticosteroids that interrupt the immune system's attack on blood platelets. In severe cases, splenectomy and stronger immunosuppressive medications may be necessary to get the condition under control. Thrombocytopenia is either present at birth or develops in the first 72 hours of life in 75% of the neonates. The majority of newborns with thrombocytopenia are born prematurely after pregnancies complicated by placental insufficiency and/or fetal hypoxia. 25-30% cases of neonatal thrombocytopenia are ralated with increase platelet consumption or sequestration to the spleen. Transplancental passage of maternal platelet alloantibodies and autoantibodies account for 15-20% of thrombocytopenia present at birth. Disseminated intravascular coagulapathy associated with perinatal asphyxia and sepsis is responsible for 10-15% cases of neonatal thrombocytopenia.
Parallel keywords (Croatian)trombocitopenija idiopatska trombocitopenična purpura djeca
Resource typetext
Access conditionOpen access
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:105:123420
CommitterLea Škorić