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Samenvatting Klinische biologie: bloedstolling
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Samenvatting klinische biologie (deel bloedstolling, gegeven door Katrien Devreese)
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bronywiedeman
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Klinische biologie: bloedstollingBloedstolling
bloeding (hemostase + verspreiding thrombose
- VC
Stoornissen in de primaire homeostase
Primaire homeostase
Beschadigd endotheel
o Secr tromboplastine + vWF (adhesie: GPIb + aggregatie: GPIIbIIIa trombocyten)
Vorming hemostatische plug thv beschadigd endotheel
o Instabiel
Thrombocyten: adhesie thv subendotheel (coll)
o Receptoren (glycoprot), granules, fosfolipidenmembr (fosfatidyl Ser)
Vasculaire afwijkingen
- Telangiectasiën, purpura, ecchymosen, huidbloedingen, mucosale bloedingen
Afwijkingen trombocyten
- Trombo(cyto)penie
o Petechiën, slijmvliesbloedingen, bloedingen opp wonden
o Oorzaak:
Afbraak ↗: idiopatische trombocytopenische purpura (auto-Ab)
Reuzeotrombocyten, MPV
Abnormale distributie: splenomegalie, leukemie, lymfomen
Celtelling, bm oz
Aanmaak ↘: toxisch, aandoeningen bm
Bm oz (megakaryocyten)
- Trombo(cyto)pathie
o GPIIbIIIa: thrombasthenie van Glanzmann
o GPIb: ziekte van Bernard Soulier
o Granules: storage pool disease
- Medicatie: trombocytenfunctie remmers
Afwijkingen vWF
- Te weinig aanmaak
- Kwalitatieve afwijkng
- Ziekte van von Willebrand
Laboratoriumtesten
- Trombocytenaantal
o 50-100: matige bloeding na trauma
o 20-50: purpura mogelijk, bloeding na trauma
o <10-20: vaak purpura, spontane mucosale bloedingen, IC bloeding
- PFA: platelet function analyser
o Vol citraatbloed door geperforeerd membr (max 4u na afname (functieverlies Tbc))
o Activ trombocyten mbv coll + ADP/ADR
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