las causas más comunes de purpura en niños

1. PURPURA TROMBOCITOPENICA
IDIOPÁTICA(TROMBOCITOPENIA INMUNE)-
PURPURA DE SCHÖNLEIN-HENOCH
Cátedra de pediatría Universidad de Nariño
Alvaro Javier CórdobaVillota

2. PTI- Generalidades
• Resolución
• 3-6 mesesBenigno
Común

3. Patogenia

4. Epidemiologia
2-5 años
1-6.4
80%<8
Sexo

5. Manifestaciones Clínicas

6. Examen físico

7. Evolución de la enfermedad
 ●Newly diagnosed ITP – ITP within three
months from diagnosis
 ●Persistent ITP – Ongoing ITP between 3 and
12 months from the initial diagnosis
 ●Chronic ITP – ITP lasting for more than 12
months
http://www.uptodate.com.sci-hub.org/contents/immune-thrombocytopenia-itp-in-children-clinical-
manifestations-and-diagnosis?source=search_result&search=itp&selectedTitle=3~150

8. Diagnostico
• Platelet count <100,000/microL (often <20,000/microL).
• Otherwise normal complete blood count (CBC) with differential white count, and
reticulocyte count
• No abnormalities on the peripheral blood smear after review by an experienced
practitioner. In particular, there should be no evidence of hemolysis or of blast cells
• No clinically apparent associated conditions that may cause
thrombocytopenia, after a thorough history and physical examination.
Findings that suggest a diagnosis other than ITP include enlargement
of lymph nodes, liver, or spleen; systemic symptoms

10. Manejo

11. Manejo

12. Indicaciones tto farmacológico
 ●NO pharmacologic intervention ("watchful waiting") for
most children with no bleeding or mild bleeding (defined as
skin manifestations only, such as bruising and petechiae),
regardless of platelet count.
 ●Pharmacologic intervention for any child with severe or
life-threatening bleeding (eg, severe or prolonged
epistaxis, gastrointestinal bleeding, or intracranial
hemorrhage [ICH]); this occurs in about 3 percent of
children with ITP. These patients also should be admitted to
the hospital for treatment and monitoring. Patients with
head trauma or suspected ICH also should be urgently
evaluated with computerized tomography (CT) of the head

13. Opciones farmacológicas
 Inmunoglobulinas intravenosas (IGIV). Las IGIV
en dosis de 0,8-1 g/kg/día durante 1 o 2 días
 Tratamiento anti-D intravenoso i.v. de 50-75
mg/kg de anti-D a pacientes Rh positivos
 1-4 mg/kg/24 horas de prednisona induce una
elevación del recuento plaquetario

14. Purpura de SCHÖNLEIN-HENOCH
Vasculitis
IgA
90%
Auto
limitada

15. Patogenia

16. Manifestaciones Clínicas

17. Diagnostico Diferencial
El edema hemorrágico agudo (EHA

18. Manejo
Medidas
generales
Prednisona Segumiento