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Immune thrombocytopenia

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https://www.readbyqxmd.com/read/28734656/patterns-of-emergency-department-care-for-newly-diagnosed-immune-thrombocytopenia-in-united-states-children-s-hospitals
#1
LaQuita Jones, Terah Koch, Joseph Stanek, Sarah H O'Brien
We used the Pediatric Health Information Systems database to ascertain treatment patterns of immune thrombocytopenia across the US. Despite the recently published guidelines by the American Society of Hematology, most patients are still being hospitalized for immune thrombocytopenia, even in the absence of documented bleeding symptoms.
July 19, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28726165/long-term-outcomes-of-laparoscopic-versus-open-splenectomy-for-immune-thrombocytopenia
#2
Kazuhiro Tada, Masayuki Ohta, Kunihiro Saga, Hiroomi Takayama, Teijiro Hirashita, Yuichi Endo, Hiroki Uchida, Yukio Iwashita, Masafumi Inomata
PURPOSE: Splenectomy is the standard therapy for medically refractory immune thrombocytopenia (ITP). Laparoscopic splenectomy (LS) has gained wide acceptance; however, the long-term outcomes of LS versus open splenectomy (OS) for patients with ITP remain unclear. METHODS: We analyzed, retrospectively, 32 patients who underwent splenectomy, as LS in 22 and OS in 10, for refractory ITP at our institute. Data were evaluated based on the American Society of Hematology 2011 evidence-based practice guidelines for ITP...
July 19, 2017: Surgery Today
https://www.readbyqxmd.com/read/28724194/paving-the-way-for-improved-management-of-severe-itp-in-pregnancy
#3
Andra H James
Those of us who take care of women with blood disorders have few data on which to base our management of thrombocytopenia in pregnancy, particularly immune thrombocytopenia purpura (ITP). We extrapolate from the management of ITP in nonpregnant individuals and try to raise platelet counts in an attempt to meet the bleeding challenges of childbirth. Thirty years ago we believed that ITP conferred fetal risks similar to those conferred by alloimmune thrombocytopenia. This article is protected by copyright. All rights reserved...
July 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28723711/epidemiology-of-autoimmune-and-inflammatory-diseases-in-a-french-nationwide-hiv-cohort
#4
D Lebrun, M Hentzien, L Cuzin, D Rey, V Joly, L Cotte, C Allavena, P Dellamonica, A Servettaz, F Bani-Sadr
HIV infection and inflammatory and autoimmune diseases (IAD) are both related to immune dysfunction. Epidemiological data on IAD in patients living with HIV (PLHIV) are scarce. The aim of this study was thus to estimate the prevalence of 26 IAD among PLHIV followed in a large French multicenter cohort in the cART era (from January 2000 to July 2013), and to describe their occurrence according to cART onset, the immuno-virological status of patients and HCV and/or HBV co-infection.During the study period, 33 403 PLHIV were included in the Dat'AIDS cohort; 1381 patients with an IAD were identified...
July 18, 2017: AIDS
https://www.readbyqxmd.com/read/28721327/two-catastrophes-in-one-patient-drug-reaction-with-eosinophilia-and-systemic-symptoms-and-toxic-shock-syndrome
#5
Moayed Ibrahim, Diana L Nunley
A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. She was treated with steroids and discharged after her condition improved. However, a month later, she returned to the ER, complaining of nausea, vomiting, diarrhea, dizziness, chills, and shortness of breath over the past two days...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28720688/primary-immune-thrombocytopenia-in-adults-clinical-practice-versus-management-guidelines
#6
EDITORIAL
Thomas Ng, Alex Gatt, Mark Smith
No abstract text is available yet for this article.
July 18, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28719512/a-pediatric-case-of-persistent-thrombocytopenia-in-a-patient-who-developed-all
#7
Haroon Shaukat, Jessica O'Mara, Michelle Neier
Inherited thrombocytopenia is a topic that was expanded greatly over the last decade and many new genes are being identified. However, inheritance patterns are not always easy to identify because sporadic cases from de novo mutations may in fact be more common. Few studies have assessed the relationship between thrombocytopenia and malignancies, specifically acute lymphoblastic leukemia (ALL). Here we present a pediatric case of persistent thrombocytopenia associated with T-cell ALL. Our patient was initially diagnosed with immune thrombocytopenic purpura with no evidence of malignancy on bone marrow biopsy but presented shortly after with ALL...
July 17, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28716661/the-prevalence-and-morphometry-of-an-accessory-spleen-a-meta-analysis-and-systematic-review-of-22-487-patients
#8
REVIEW
Jens Vikse, Beatrice Sanna, Brandon Michael Henry, Dominik Taterra, Silvia Sanna, Przemysław A Pękala, Jerzy A Walocha, Krzysztof A Tomaszewski
BACKGROUND: An accessory spleen (AS) is a lobule of splenic tissue found in ectopic locations. Identification of AS is particularly important in patients with immune thrombocytopenia (ITP) requiring splenectomy as unrecognized AS can later cause refractory symptoms. The AS can also be a source of significant intraabdominal hemorrhage. The aim of this meta-analysis was to systematically analyze the data on the prevalence, number, location, and morphometry of AS. MATERIALS AND METHODS: An extensive search of the major electronic databases was conducted to identify all studies that reported relevant data on the AS...
July 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28714241/cytokine-profiles-in-tibetan-macaques-following-%C3%AE-1-3-galactosyltransferase-knockout-pig-liver-xenotransplantation
#9
Zhuochao Zhang, Xiao Li, Hong Zhang, Xuan Zhang, Hui Chen, Dengke Pan, Hongchen Ji, Liang Zhou, Juan Ling, Jingshi Zhou, Shuqiang Yue, Desheng Wang, Zhaoxu Yang, Kaishan Tao, Kefeng Dou
BACKGROUND: Pig-to-nonhuman primate orthotopic liver xenotransplantation is often accompanied by thrombocytopenia and coagulation disorders. Furthermore, the release of cytokines can trigger cascade reactions of coagulation and immune attacks within transplant recipients. To better elucidate the process of inflammation in liver xenograft recipients, we utilized a modified heterotopic auxiliary liver xenotransplantation model for xeno-immunological research. We studied the cytokine profiles and the relationship between cytokine levels and xenograft function after liver xenotransplantation...
July 17, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28702343/eb-virus-reactivation-triggers-thrombotic-thrombocytopenic-purpura-in-a-healthy-adult
#10
Satoko Oka, Masaharu Nohgawa
Thrombotic thrombocytopenic purpura (TTP) is rare but life-threatening disease, characterized typically by microangiopathic hemolytic anemia (MAHA), profound peripheral thrombocytopenia and severe deficiency in the von Willebrand factor-cleaving prortease ADAMTS13. It has been reported that acquired immune TTP is closely associated with human immunodeficiency virus infection and influenza infection or vaccination. However, it has not been reported to be associated with Epstein Barr Virus infection or reactivation...
2017: Leukemia Research Reports
https://www.readbyqxmd.com/read/28702029/inflammation-related-gene-polymorphisms-associated-with-primary-immune-thrombocytopenia
#11
Ju Li, Sai Ma, Linlin Shao, Chunhong Ma, Chengjiang Gao, Xiao-Hui Zhang, Ming Hou, Jun Peng
Primary immune thrombocytopenia (ITP) is an acquired autoimmune disease characterized by a reduced platelet count and an increased risk of bleeding. Although immense research has improved our understanding of ITP, the pathogenesis remains unclear. Here, we investigated the involvement of 25 single-nucleotide polymorphisms (SNPs) of the inflammation-related genes, including CD24, CD226, FCRL3, IL2, IRF5, ITGAM, NLRP3, CARD8, PTPN22, SH2B2, STAT4, TNFAIP3, and TRAF1, in the pathogenesis and treatment response of ITP...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28698848/treatment-and-response-of-autoimmune-cytopenia-occurring-after-allogeneic-hematopoietic-cell-transplantation-in-children
#12
Seok Hwang-Bo, Seong-Koo Kim, Jae Wook Lee, Pil-Sang Jang, Nack-Gyun Chung, Dae-Chul Jeong, Bin Cho, Hack-Ki Kim
BACKGROUND: Autoimmune cytopenia (AIC) is a rare complication of allogeneic hematopoietic cell transplantation (HCT). In this study, we reviewed the diagnosis, treatment and response to therapy for pediatric patients with post-HCT AIC at our institution. METHODS: Of the 292 allogeneic HCTs performed from January, 2011 to December, 2015 at the Department of Pediatrics, The Catholic University of Korea, seven were complicated by post-HCT AIC, resulting in an incidence of 2...
June 2017: Blood Research
https://www.readbyqxmd.com/read/28698844/dapsone-therapy-for-refractory-immune-thrombocytopenia-patients-a-case-series
#13
Ji Yun Lee, Jeong-Ok Lee, Joo Young Jung, Soo-Mee Bang
BACKGROUND: Dapsone has been recommended as a second-line immunosuppressive agent for patients with immune thrombocytopenia (ITP). METHODS: We retrospectively analyzed the efficacy and safety of dapsone therapy in patients with ITP. RESULTS: Nine ITP patients were treated with dapsone at a dose of 50-100 mg/day between May 2013 and March 2016. All patients were refractory to multiple previous treatments, with a median of 7 agents (range, 4-8), and 3 patients had undergone a previous splenectomy...
June 2017: Blood Research
https://www.readbyqxmd.com/read/28692146/validation-of-an-algorithm-identifying-incident-primary-immune-thrombocytopenia-in-the-french-national-health-insurance-database
#14
Salim Mezaache, Helene Derumeaux, Pierre Ferraro, Pascal Capdepon, Jean-Christophe Steinbach, Xavier Abballe, Deborah Palas, Nabil Saichi, Karine Desboeuf, Maryse Lapeyre-Mestre, Laurent Sailler, Guillaume Moulis
OBJECTIVES: To evaluate the accuracy of an algorithm identifying newly diagnosed immune thrombocytopenia (ITP) patients in the French national health insurance database (SNIIRAM). METHODS: The source of data was the SNIIRAM of Midi-Pyrenees region (South-West of France, 3 million inhabitants). Data of patients with at least one ITP code (D69.3 code of the International Classification of Disease, version 10) were extracted between January 1, 2012 and December 31, 2014...
July 10, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28690918/erratum-efficacy-and-safety-of-clairyg%C3%A2-a-ready-to-use-intravenous-immunoglobulin-in-adult-patients-with-primary-immune-thrombocytopenia
#15
Borhane Slama, Olivier Fain, Hervé Maisonneuve, Eric Jourdan, Jean-François Viallard, Rabye Ouaja, Ousmane Alfa-Cissé, Bertrand Godeau
[This corrects the article on p. 1 in vol. 7, PMID: 28203488.].
2017: American Journal of Blood Research
https://www.readbyqxmd.com/read/28690092/-long-lasting-thrombocytopenia-induced-by-glycoprotein-iib-iiia-inhibitor
#16
J-R Christen, C Soubrier, E Martinez, V Roumieu, O Darmon, S Scandaliaris, L Picou, T Cuisset, A Grados, E Bernit, M Ebbo, J-R Harlé, N Schleinitz
INTRODUCTION: Glycoprotein IIb/IIIa inhibitors (anti-GPIIbIIIa) prevent platelet binding to fibrinogen. Transient sometimes-severe thrombocytopenia is a well-known side effect. OBSERVATION: A 71-year-old patient presented severe thrombocytopenia after the administration of tirofiban (anti-GPIIbIIIa). Corticosteroid treatment was initiated at day 10 because of persistence of severe thrombocytopenia with poor platelet transfusion efficacy. Corticosteroid treatment led to platelet recovery evoking an immune mediated mechanism for thrombocytopenia...
July 6, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28688202/influence-of-human-leukocyte-antigen-hla-alleles-and-killer-cell-immunoglobulin-like-receptors-kir-types-on-heparin-induced-thrombocytopenia-hit
#17
Jason H Karnes, Christian M Shaffer, Robert Cronin, Lisa Bastarache, Silvana Gaudieri, Ian James, Rebecca Pavlos, Heidi Steiner, Jonathan D Mosley, Simon Mallal, Joshua C Denny, Elizabeth J Phillips, Dan M Roden
OBJECTIVES: Heparin-induced thrombocytopenia (HIT) is an unpredictable, life-threatening, immune-mediated reaction to heparin. Variation in human leukocyte antigen (HLA) genes is now used to prevent immune-mediated adverse drug reactions. Combinations of HLA alleles and killer cell immunoglobulin-like receptors (KIR) are associated with multiple autoimmune diseases and infections. The objective of this study is to evaluate the association of HLA alleles and KIR types, alone or in the presence of different HLA ligands, with HIT...
July 8, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28686909/unraveling-the-role-of-maternal-anti-hla-class-i-antibodies-in-fetal-and-neonatal-thrombocytopenia-antibody-specificity-analysis-using-epitope-data
#18
Jesper Dahl, Erle Refsum, Maria Therese Ahlen, Torstein Egeland, Tore Jensen, Marte K Viken, Tor Brynjar Stuge, Ganesh Acharya, Anne Husebekk, Bjørn Skogen, Heidi Tiller
Anti-HLA class I antibodies have been suggested as a possible cause of fetal and neonatal alloimmune thrombocytopenia (FNAIT). The aim of this study was to characterize maternal anti-HLA class I alloantibodies in suspected cases of FNAIT. The study population consisted of all nationwide referrals of neonates with suspected FNAIT to the National Unit for Platelet Immunology in Tromsø, Norway, during 1998-2009 (cases), and 250 unselected pregnancies originally included in a prospective study (controls). Inclusion criterion was a positive screening for maternal anti-HLA class I antibodies...
June 27, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/28682499/high-dose-dexamethasone-or-all-trans-retinoic-acid-restores-the-balance-of-macrophage-toward-m2-in-immune-thrombocytopenia
#19
Q Feng, M Xu, Y Y Yu, Y Hou, X Mi, Y X Sun, S Ma, X Y Zuo, L L Shao, M Hou, X H Zhang, J Peng
Immune thrombocytopenia (ITP) is an autoimmune disorder. Deficiency of immune-tolerance in antigen-presenting cells (APCs) and cross-communication between APCs and T cells are involved in the pathogenesis of ITP. Macrophages can polarize into pro-inflammatory M1 or anti-inflammatory M2 phenotypes in response to different environmental stimuli, and possess diverse immunological functions OBJECTIVES: To investigate the imbalance of M1/M2 in ITP and whether high-dose dexamethasone (HD-DXM) or all-trans retinoic acid (ATRA) could restore this imbalance METHODS: Numbers of M1 and M2 in the spleens of ITP patients and patients with traumatic spleen rupture were analyzed by immunofluorescence...
July 6, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28680969/differential-antagonism-of-human-innate-immune-responses-by-tick-borne-phlebovirus-nonstructural-proteins
#20
Veronica V Rezelj, Ping Li, Vidyanath Chaudhary, Richard M Elliott, Dong-Yan Jin, Benjamin Brennan
In recent years, several newly discovered tick-borne viruses causing a wide spectrum of diseases in humans have been ascribed to the Phlebovirus genus of the Bunyaviridae family. The nonstructural protein (NSs) of bunyaviruses is the main virulence factor and interferon (IFN) antagonist. We studied the molecular mechanisms of IFN antagonism employed by the NSs proteins of human apathogenic Uukuniemi virus (UUKV) and those of Heartland virus (HRTV) and severe fever with thrombocytopenia syndrome virus (SFTSV), both of which cause severe disease...
May 2017: MSphere
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