[免疫性血小板减少症的病理生理学和诊断学]。

Aristoteles Giagounidis
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摘要

免疫性血小板减少症(ITP)是由针对血小板表面抗原的自身抗体引起的。免疫性血小板减少症被视为原发性血小板减少症(病因不明确)或继发性血小板减少症(药物诱发;潜在疾病)。自身抗体会导致血小板在脾脏和/或肝脏中丢失,但同时也会减少血小板的生成。与其他血小板减少的疾病相反,ITP 会降低血小板生成素的水平。ITP仍是一种排除性诊断。目前还不存在单一的确定性实验室检查。只有约50%的病例能检测到糖蛋白特异性抗体。排除 EDTA 引起的假性血小板减少症尤为重要。应通过病史(尤其是用药史)、体格检查和可能的骨髓穿刺排除血小板减少的继发性原因。
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[Pathophysiology and Diagnostics of Immune Thrombocytopenia].

Immune thrombocytopenia (ITP) is due to autoantibodies against platelet surface antigens. ITP is considered as either primary, with no clear etiology, or as secondary ITP (drug-induced; underlying diseases). Autoantibodies lead both to loss of platelets in the spleen and/or liver but simultaneously reduce their production. Contrary to other disorders with thrombocytopenia, ITP has reduced levels of thrombopoetin. ITP remains a diagnosis of exclusion. A single defining laboratory test does not exist. Glycoprotein-specific antibodies can be detected in only about 50% of cases. Ruling out EDTA-induced pseudo thrombocytopenia is of particular relevance. Secondary causes of thrombocytopenia should be excluded through medical history (especially medication history), physical examination and possibly bone-marrow puncture.

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