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Immune-mediated thrombocytopenia

ffelis

Synonym(s): IMTP, idiopathic thrombocytopenic purpura, IMT


Introduction

  • Immune-mediated thrombocytopenia (IMTP) is rare and poorly documented in the cat (in contrast to the dog).
  • Cause: most cases are likely to be secondary (particularly to FeLV infection and associated neoplasia) rather than primary autoimmune thrombocytopenia.
  • Signs: vague, eg anorexia, lethargy.
  • Diagnosis: often presumptive, platelet count <50,000.
  • Treatment: treat underlying condition and immunosuppression if required.
  • Prognosis: guarded.
    Print off the owner factsheet on Immune-mediated thrombocytopenia Immune-mediated thrombocytopenia to give to your client.

Pathogenesis

Predisposing factors

General

  • Underlying disease.

Specific

Pathophysiology

  • Antibody binds to platelets  →  early removal from circulation  →  clinical signs.
  • Antibody (IgG or IgM) and/or complement bound to platelet membrane. Antibody-labeled cells are removed by phagocytic cells in spleen (Type II hypersensitivity) in excess of replacement by bone marrow thrombopoiesis.
  • Antibody may also inhibit platelet function (dog; not documented in cat).
  • Antibody may be specific for platelet membrane antigens, or for adsorbed drug or infectious agent, or membrane antigens modified or exposed by binding of such agents.
  • Antibody may be specific for bone marrow precursors (megakaryocytes) leading to immune-mediated amegakaryocytic thrombocytopenia.
  • May be concurrent immune-mediated hemolytic anemia Anemia: immune-mediated hemolytic.

Timecourse

  • Months.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Ellis J, Bell R, Barnes D C, Miller R (2018) Prevalence and disease associations in feline thrombocytopenia: a retrospective study of 194 cases. J Small Anim Pract 59(9), 531-538 PubMed.
  • Wondratschek C, Weingart C, Kohn B (2010) Primary immune-mediated thrombocytopenia in cats. J Am Anim Hosp Assoc 46(1),12-19 PubMed.
  • Bianco D, Armstrong P J, Washabau R J (2008) Presumed primary immune-mediated thrombocytopenia in four cats. J Feline Med Surg 10(5), 495-500 PubMed
  • Kohn B, Linden T, Leibold W (2006) Platelet-bound antibodies detected by a flow cytometric assay in cats with thrombocytopenia. J Feline Med Surg 8(4), 254-260 PubMed.
  • Garon C L, Scott M A, Selting K A et al (1999) Idiopathic thrombocytopenic purpura in a cat. JAAHA 35 (6), 464-470 PubMed.
  • Jordan H L, Grindem C B & Breitschwerdt E B (1993) Thrombocytopenia in cats- a retrospective study of 41 cases. JVIM (5), 261-265 PubMed.

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