Page 539 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

CHAPTER 26 ■ Disorders of Primary Hemostasis and Thrombosis Vasculature and Platelets 523

quantity o ate ets increases above the re erence range, ■ Acce erate consu tion o ate ets is another cause o

thro bocytosis resu ts. thro bocyto enia. One o the ost i ortant an re-

■ T ro bocyto enia can resu t ro the use o extracor o- quent y encountere or s o increase consu tion o
rea circu ation in car iac by ass surgery or in a coho ic ate ets is I P.

iver isease. ■ A ate et istribution isor er can resu t ro a oo ing

■ HI an associate thro botic events are re ative y co - o ate ets in the s een, which is requent i s eno ega y
on si e e ects o he arin thera y that can contribute to is resent.

orbi ity an orta ity. ■ Tro bocytosis is genera y e ne as a substantia

■ Most thro bocyto enic con itions can be c assi e into increase in circu ating ate ets over the re erence u er
the ajor categories o isor ers o ro uction, isor ers i it o 450 × 10 /L.
9
o estruction, an isor ers o ate et istribution an

i ution. Qualitative Characteristics of Platelets:

■ hro bocyto enia cause by hy o ro i eration can Thrombocytopathy
resu t ro acquire a age to he ato oietic ce s o

the bone arrow cause by actors such as irra iation, ■ I ate ets are nor a in nu ber but ai to unction

rugs an cancer che othera eutic agents, che ica s, ro er y, one o our se arate categories o ate et ys-

an a coho . unction can exist. T ese inc u e the ore co on

■ Here itary thro bocyto enias inc u e Fanconi syn- acquire an ess requent here itary causes. Hy eractive
ro e, constitutiona a astic ane ia an its variants, ate ets associate with hy ercoagu abi ity an thro -

a egakaryocytic thro bocyto enia ( AR syn ro e), bosis ake u an a itiona category o abnor a ate-

X- inke a egakaryocytic thro bocyto enia, et unction.

Wiskott-A rich syn ro e, May-Hegg in ano a y, ■ Acquire ate et unction e ects can be cause by a

an here itary acrothro bocyto enia (e.g., A ort b oo as a inhibitory substance. In a ition, acquire

syn ro e). ate et ys unction is co on y seen in the ye o ro i -

■ Increase estruction or uti ization o ate ets can be erative syn ro es an ure ia.
cause by antigens, antibo ies, rugs, or oreign sub- ■ Here itary isor ers inc u e a hesion isor er;

stances. Bacteria se sis causes increase estruction o Bernar -Sou ier syn ro e; ri ary aggregation isor-

ate ets owing to the attach ent o ate ets to bacteria ers, such as G anz ann’s thro basthenia an essentia

antigen-antibo y i une co exes. Antibo ies o either athro bia; an secon ary aggregation isor ers, such

autoi une or isoi une origin ay ro uce increase as here itary storage oo e ect an here itary as irin-

estruction o ate ets. ike e ects.

CASE STUDY

Case Study 26.1 Her coagu ation ro e resu ts were as o ows:

A 22-year-o white wo an ha recent y gra uate ro B ee ing ti e 7 inutes (nor a , 1 to 3 inutes)

co ege an re ocate to acce t her rst ro essiona job. P 11 secon s (contro , 12.2 secon s)

She was being seen or the rst ti e by a oca gyneco o- AP 29 secon s (contro , 34 secon s)

gist because o ro onge enstrua b ee ing. Her e i- C ot retraction ecrease

ca history inc u e severa e iso es o severe noseb ee s ■ Critical Thinking Group Discussion Questions

uring chi hoo that require cauterization to arrest. 1. What a itiona tests wou be suggeste base on the

She re orte that her enses aste ro 8 to 12 ays. initia aboratory resu ts?

When questione about a i y i nesses or isor ers, she

re orte that her other an two sisters a so ha ong 2. What wou the Wright-staine b oo ook ike?

enstrua erio s an that one o her two brothers nee e

severa b oo trans usions a er an a en ecto y. 3. What is the ost ike y iagnosis an rognosis?

Physica exa ination revea e an essentia y nor a atient.

However, she a eare a e, an severa arge bruises were

note on her extre ities. T e atient was re erre to the

out atient aboratory or a he og obin, he atocrit, an NOTE: This is a good time to write out the answers to the

coagu ation ro e.
Critical Thinking Group Discussion Questions.

■ Laboratory Data
He og obin 10.0 g/L

He atocrit 27%