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Gepubliceerd in: Tijdschrift voor Kindergeneeskunde 5/2007

01-10-2007 | Artikelen

Idiopathische trombocytopenische purpura (itp), capita selecta

Auteurs: Dr. R. Y. J. Tamminga, M. C. A. Bruin

Gepubliceerd in: Tijdschrift voor Kindergeneeskunde | Uitgave 5/2007

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Samenvatting

Per jaar wordt in Nederland bij 130-140 kinderen idiopathische trombocytopenische purpura (itp) vastgesteld. Het betreft een in korte tijd ontstane bloedingsneiging ten gevolge van een geïsoleerde trombopenie bij een overigens gezond kind. Bepaling van het trombopoietinegehalte kan helpen bij de diagnose. Over de immunologische mechanismen en het ‘natuurlijk’ beloop van itp is de laatste jaren meer bekend geworden. Bij ongeveer 30% van de kinderen is na zes maanden het trombocytenaantal nog niet normaal, na twaalf maanden geldt dit voor 20%. Factoren van invloed op herstel binnen zes maanden zijn: leeftijd, voorafgaande infectie, laag plaatjesaantal, Fc?R2b-polymorfisme en waarschijnlijk behandeling met intraveneuze immuunglobuline. Het aantal ernstige bloedingen is uiterst gering. Alleen bij graad 3-bloedingsneiging is immuunmodulerende behandeling geïndiceerd; het plaatjesaantal dient geen rol te spelen bij de beslissing om te behandelen. Voordat bij chronische itp overgegaan wordt tot splenectomie kan experimentele rituximabbehandeling worden overwogen.
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Metagegevens
Titel
Idiopathische trombocytopenische purpura (itp), capita selecta
Auteurs
Dr. R. Y. J. Tamminga
M. C. A. Bruin
Publicatiedatum
01-10-2007
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Kindergeneeskunde / Uitgave 5/2007
Print ISSN: 0376-7442
Elektronisch ISSN: 1875-6840
DOI
https://doi.org/10.1007/BF03061692

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