Author Question: A 28-year-old woman sees her family physician complaining of easy bruising and menorrhagia. She has ... (Read 74 times)

dmcintosh · **on:** Jun 25, 2018

A 28-year-old woman sees her family physician complaining of easy bruising and menorrhagia. She has a platelet count of 60 x 109/L.

All other hematology and routine coagulation tests are normal. She has a platelet-associated immunoglobulin G (IgG) autoantibody in her serum. Which of the following is most likely?

a. Chronic immune thrombocytopenic purpura
b. Thrombotic thrombocytopenic purpura
c. Acute immune thrombocytopenic purpura
d. Hemolytic uremic syndrome

Question 2

What kind of antibody causes neonatal alloimmune thrombocytopenia?

a. Maternal antibody against a fetal platelet antigen inherited from the father
b. Fetal antibody directed against maternal platelet antigen
c. Fetal antibody against a fetal platelet antigen inherited from the father
d. Maternal autoantibody against a mother's platelet antigen

stillxalice · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A
Chronic immune thrombocytopenic purpura is most often seen in women between the ages of 20 and 50 years of age. Patients most often complain of easy bruising, recurrent epistaxis, and menorrhagia. Platelet destruction in chronic immune thrombocytopenic purpura is the result of an IgG autoantibody, with various membrane glycoproteins being the most frequent targets.

Answer to Question 2

ANS: A
Neonatal alloimmune thrombocytopenia develops when a mother, during pregnancy, develops an alloantibody against a platelet antigen inherited by the fetus from the father. These antibodies cross the placenta, bind to the antigen-bearing fetal platelets, and cause their premature destruction.