Erworbene immunvermittelte Thrombozytopenie in der Intensivmedizin: Ein Update über relevante Aspekte der Diagnostik und Therapie

Was ist neu?

Thrombozytopenie bei Intensivpatienten und medikamenteninduzierte Immunthrombozytopenie Aktuell sind mehr als 300 Medikamente mit der medikamenteninduzierten Immunthrombozytopenie assoziiert. Bei schwerer Thrombozytopenie kann neben dem Absetzen des auslösenden Medikaments eine hochdosierte IVIG-Therapie über 2 Tage durchgeführt werden.

Heparin-induzierte Thrombozytopenie Typ II HIT-Patienten mit längerer Thrombozytopenie, die auf eine Standardbehandlung nicht ansprechen, könnten von einer IVIG-Therapie profitieren.

Idiopathische Immunthrombozytopenie Bei der Immunthrombozytopenie bekommt die Verwendung von TPO-Rezeptor-Agonisten bei Notfallpatienten in Kombination mit First-Line-Wirkstoffen einen höheren Stellenwert.

Abstract

Acquired thrombocytopenias represent a group of bleeding diseases, which can be mediated by immune or non-immune factors. Acquired immune thrombocytopenia (AITP) leads to an accelerated decrease in platelet count by platelet reactive antibodies arising from several mechanisms. In AITP, autoantibodies, alloantibodies or drug-dependent antibodies are usually targeting platelet surface glycoproteins. The consequence of this is a significant decrease in the number of circulating platelets, leading to clinic pathological disorders including immune thrombocytopenia, heparin-induced thrombocytopenia or drug-induced thrombocytopenia, respectively. The aforementioned disorders are characterized by a severe reduction in platelet count (< 20 × 10⁹/l), which is, with the exception of HIT, associated with high bleeding risk. In this review we provide current insight into recent achievements regarding diagnosis and management of AITP.

Schlüsselwörter

Immunerkrankungen - Diagnose - Therapie

Key words

immune disease - diagnosis - treatment

Publication History

Article published online:
03 June 2020

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