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🌱 來自: Huppert’s Notes

Qualitative Platelet Disorders🚧 施工中

Qualitative Platelet Disorders

•   Definition: Normal platelet count but abnormal platelet function (i.e., normal platelet number but bleeding time is elevated)

•   Etiologies:

-   Von Willebrand Disease (vWD): Mixed platelet/coagulation disorder

   Pathophysiology: Defect or absence in vWF, which helps platelets aggregate when functioning appropriately. vWF is also a carrier for factor VIII.

   Clinical features: Prolonged PTT, mucocutaneous bleeding, heavy menstrual or post-partum bleeding

-   Bernard-Soulier:

   Pathophysiology: Autosomal recessive disorder. ↓GpIb defect in platelet to vWF adhesion.

   Clinical features: Blood smear – platelets abnormally large, platelet count mildly low. Clinically, patients have bleeding out of proportion to their platelet number (which is often normal)

-   Glanzmann’s thrombasthenia:

   Pathophysiology: Autosomal recessive disorder. ↓GpIIb/IIIa defect in platelet-to-platelet aggregation.

   Clinical features: Normal platelet count, no platelet clumping, mucocutaneous bleeding

-   Acquired: Medications (ASA, NSAIDs, antibiotics), uremia (toxins affect vWF/XIII), liver disease, bone marrow disorders, dysproteinemias (multiple myeloma), antiplatelet antibodies, cardiopulmonary bypass (partial degranulation of platelets)

•   Treatment: Platelet transfusions, DDAVP