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Immune thrombocytopenia

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https://www.readbyqxmd.com/read/28337190/epidemiological-characteristics-and-environmental-risk-factors-of-severe-fever-with-thrombocytopenia-syndrome-in-hubei-province-china-from-2011-to-2016
#1
Tang Wang, Xin-Lou Li, Man Liu, Xiao-Jia Song, Hao Zhang, Yu-Bin Wang, Bao-Pin Tian, Xue-Sen Xing, Shi-Yue Li
Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral disease affecting hundreds of people in China each year. To better understand the epidemiological characteristics and environmental risk factors associated with the incidence of SFTS in Hubei Province, China, we conducted a retrospective epidemiological study and risk assessment of SFTS from 2011 to 2016. Although, the incidence and epidemic areas of SFTS are increasing, the fatality rate has decreased. Elderly farmers are the population most commonly infected with SFTS virus between May and July in the northeast Hubei Province, which seems to be consistent with local agricultural activities and the seasonal abundance of ticks...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28331458/immune-thrombocytopenia-and-obesity-predictive-relationship
#2
Ehab Hanafy, Mohammed Al Pakra
BACKGROUND: Chronic refractory immune thrombocytopenia (ITP) is defined as the failure of any modality to maintain the platelet count above 20 × 10(3)/μL for an appreciable time without unacceptable toxicity. To date, certain predictive factors have been associated with refractory ITP. However, none of the published studies has declared the possible association between obesity and refractory ITP. CASE REPORTS: We present the cases of 3 children with ITP who failed to achieve remission on different therapeutic approaches including rituximab, vincristine, and romiplostim...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28321089/improvement-in-platelet-count-after-3rd-line-and-4th-line-eradication-therapy-for-helicobacter-pylori-in-patients-with-immune-thrombocytopenia
#3
Wataru Jomen, Takashi Sato, Chihaya Maesawa
Case 1: A 78-year-old woman was diagnosed with H. pylori positive gastritis at a previous hospital in April 2012 and received 3rd-line H. pylori eradication therapy, which ended in failure. She was referred to our department due to oral hemorrhage, petechiae involving all four extremities, and thrombocytopenia in January 2016. She was hospitalized with a diagnosis of ITP and received inpatient treatment. While receiving outpatient prednisolone (PSL) treatment, we administered 4th-line eradication therapy in March...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28303661/immunological-and-physiological-observations-in-baboons-with-life-supporting-genetically-engineered-pig-kidney-grafts
#4
Hayato Iwase, Hidetaka Hara, Mohamed Ezzelarab, Tao Li, Zhongqiang Zhang, Bingsi Gao, Hong Liu, Cassandra Long, Yi Wang, Amy Cassano, Edwin Klein, Carol Phelps, David Ayares, Abhinav Humar, Martin Wijkstrom, David K C Cooper
BACKGROUND: Genetically engineered pigs could provide a source of kidneys for clinical transplantation. The two longest kidney graft survivals reported to date have been 136 and 310 days, but graft survival >30 days has been unusual until recently. METHODS: Donor pigs (n=4) were on an α1,3-galactosyltransferase gene-knockout (GTKO)/human complement regulatory protein (CD46) background (GTKO/CD46). In addition, the pigs were transgenic for at least one human coagulation regulatory protein...
March 17, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28300523/assessment-of-th17-treg-cells-and-th-cytokines-in-an-improved-immune-thrombocytopenia-mouse-model
#5
Guoyang Zhang, Ping Zhang, Hongyun Liu, Xiaoyan Liu, Shuangfeng Xie, Xiuju Wang, Yudan Wu, Jianxing Chang, Liping Ma
OBJECTIVES: The improved passive immune thrombocytopenia (ITP) mouse model has been extensively utilized for the study of ITP. However, how closely this model matches the human inflammation state and immune background is unclear. Our study aimed to explore the profile of Th cytokines and Th17/Treg cells in the model. METHODS: We induced the ITP mouse model by dose-escalation injection of MWReg30. The serum levels of cytokines (IFN-γ, IL-2, IL-4, IL-10, IL-17A, and TGF-β1) were measured by enzyme-linked immunosorbent assay and the frequency of Th17 and Treg cells was measured by flow cytometry...
March 16, 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/28298667/suspected-heparin-induced-thrombocytopenia-in-patients-receiving-extracorporeal-membrane-oxygenation
#6
Bhupinder Natt, Cameron Hypes, Robyn Basken, Joshua Malo, Toshinobu Kazui, Jarrod Mosier
Heparin-induced thrombocytopenia (HIT) is an immune reaction usually secondary to unfractionated heparin. Anticoagulation management is critical in patients while on extracorporeal membrane oxygenation (ECMO) to prevent thromboembolism and for the optimal functioning of the circuit. We identified five patients with respiratory failure at our hospital managed with ECMO in the last 2 years that were treated for HIT. A brief clinical course and their management are discussed. We also briefly review the literature for best evidence for management of such patients...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28295360/human-platelet-antigen-antibody-induction-in-uncomplicated-pregnancy-is-associated-with-hla-sensitization
#7
Viktoria S A Reiher, Gideon Hönger, Laura Infanti, Jakob R Passweg, Irene Hösli, Beat M Frey, Christoph Gassner, Stefan Meyer, Andreas S Buser, Andreas Holbro, Stefan Schaub
BACKGROUND: Alloimmunization against human platelet antigens (HPAs) during pregnancy is rare but can lead to severe bleeding disorders, such as fetal and neonatal alloimmune thrombocytopenia. STUDY DESIGN AND METHODS: In a cohort of 241 uncomplicated pregnancies, we investigated the immunogenicity of HPA mismatches and correlated HLA sensitization with HPA antibody formation. HPA antibodies were measured with a Luminex-based multiplex assay. RESULTS: HPA mismatches were observed in 109 of 241 pregnancies (45%), but child-specific HPA antibodies were only found in two of 109 cases (2%), indicating a low immunogenicity...
March 10, 2017: Transfusion
https://www.readbyqxmd.com/read/28295201/thrombopoetin-receptor-agonist-therapy-in-thrombocytopenia-itp-and-beyond
#8
Alice Taylor, John Paul Westwood, Faidra Laskou, Siobhan McGuckin, Marie Scully
Eltrombopag is well established in treatment of severe immune thrombocytopenia (ITP) and is increasingly commonplace in second-line management. A role is also suggested for both bridging therapy for surgery, as well as treating thrombocytopenia due to non-immune aetiologies. We present the largest single-centre experience with eltrombopag, with our cohort of 62 patients. Patients with severe ITP (n = 34) had 91·2% response, which was sustained over a median of 18·5 months. In 41·4% of ITP cases (n = 14), complete response (CR- platelet count >100 × 10(9) /l) was achieved and in 2 cases, therapy was stopped and CR maintained...
March 14, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28295192/state-of-the-art-how-i-manage-immune-thrombocytopenia
#9
REVIEW
Nichola Cooper
The management of patients with immune thrombocytopenia (ITP) is rapidly evolving. Over the last 15 years, a number of novel treatments have improved practice, with many steroid-sparing agents and a reduction in the progression to splenectomy. Although this has improved clinical care, many therapeutic challenges remain. There is no diagnostic test, no biomarkers to direct treatment and few comparative studies to help management decisions. Development of up to date guidelines is difficult with little high-grade evidence...
March 10, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28294347/nadroparin-carries-a-potentially-high-risk-of-inducing-cutaneous-delayed-type-hypersensitivity-responses
#10
Marc Schindewolf, Andreas Recke, Detlef Zillikens, Edelgard Lindhoff-Last, Ralf J Ludwig
BACKGROUND: Heparins are widely used for the prophylaxis/treatment of thromboembolic events. As adverse effects, heparin-induced skin lesions occur frequently (in 7.5-39% of patients). Skin lesions may be the only clinical manifestation of life-threatening immune-mediated heparin-induced thrombocytopenia, but are commonly caused by a delayed-type hypersensitivity response [heparin-induced delayed-type hypersensitivity (HIHS)]. Risk factors have not been prospectively identified. OBJECTIVES: To identify possible risk factors for heparin-induced skin lesions from three independent clinical trials in a combined analysis...
March 14, 2017: Contact Dermatitis
https://www.readbyqxmd.com/read/28287030/immediate-transient-thrombocytopenia-at-the-time-of-alemtuzumab-infusion-in-multiple-sclerosis
#11
Usha Ranganathan, Ulrike Kaunzner, Stacyann Foster, Timothy Vartanian, Jai S Perumal
BACKGROUND: Alemtuzumab is a monoclonal antibody approved for relapsing-remitting multiple sclerosis (RRMS). Although Immune thrombocytopenia (ITP) has been reported as a secondary autoimmune phenomenon following alemtuzumab infusion, immediate thrombocytopenia during the infusion has not been reported. OBJECTIVE: We report transient, reversible, self-limiting acute-onset thrombocytopenia during the first course with alemtuzumab. RESULTS AND CONCLUSION: In total, 3 of 22 paitents developed mild self-limited bruising associated with a drop in platelet count from their baseline during the intial 5-day course of alemtuzumab...
March 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28286634/the-efficacy-of-colchicine-and-dapsone-combination-therapy-in-relapsed-immune-thrombocytopenia
#12
Thanawat Rattanathammethee, Wasan Theerajangkhaphichai, Ekarat Rattarittamrong, Sasinee Hantrakool, Chatree Chai-Adisaksopha, Lalita Norasetthada, Adisak Tantiworawit
The aim of the present paper is to evaluate the efficacy and safety of colchicine and dapsone combination therapy in cases of steroid-dependent, relapsed and refractory immune thrombocytopenia (ITP). This is a retrospective study of ITP patients who attended the Hematology Clinic at Chiang Mai University Hospital (Thailand) from 1 January 2008 to 30 September 2014. Medical records and clinical data were reviewed for efficacy and adverse effects. Sixty-four ITP patients received the combination therapy. The median age was 46 years and 70...
February 23, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28286630/a-fatal-case-of-immune-hyperhemolysis-with-bone-marrow-necrosis-in-a-patient-with-sickle-cell-disease
#13
Matthew S Karafin, Arun Singavi, Susan T Johnson, Joshua J Field
In patients with sickle cell disease, hyperhemolysis is a rare but life-threatening complication of transfusion. In this case report, we describe a 61 year-old woman with hemoglobin sickle cell (SC) disease and history of alloimmunization who developed hyperhemolysis associated with a transfusion. She was found to have a warm and a clinically-significant cold autoantibody. Severe anemia (Hb 2.7 g/dL) with reticulocytopenia and thrombocytopenia prompted a bone marrow biopsy, which demonstrated extensive bone marrow necrosis...
February 23, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28286199/abnormalities-of-the-bone-marrow-immune-microenvironment-in-patients-with-prolonged-isolated-thrombocytopenia-after-allogeneic-hematopoietic-stem-cell-transplantation
#14
Yang Song, Min-Min Shi, Yuan-Yuan Zhang, Xiao-Dong Mo, Yu Wang, Xiao-Hui Zhang, Lan-Ping Xu, Xiao-Jun Huang, Yuan Kong
Prolonged isolated thrombocytopenia (PT) is a serious complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, whether abnormalities of the bone marrow immune microenvironment are involved in the pathogenesis of PT remains unknown. In total, 20 patients with PT, 40 matched patients with good graft function (GGF) after allo-HSCT, and 20 healthy donors (HD) were enrolled in this nested case-control study. Th1, Th2, Tc1, Tc2, Th17 and Treg cells were analysed by flow cytometry, and IFN-γ, IL-4, IL-17, IL-6, IL-21 and thrombopoietin levels in bone marrow (BM) plasma were evaluated using cytometric beads assay and enzyme-linked immunosorbent assay...
March 9, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28285286/necrotizing-polyarteritis-nodosa-like-vasculitis-in-a-child-with-systemic-lupus-erythematosus
#15
Ritambhra Nada, Joseph L Matthews, Sagar Bhattad, Anju Gupta, Surjit Singh
A 10-year-old child presented with prolonged fever, lymphadenopathy, weight loss, oral ulcers, alopecia and parotitis. She later developed arterial thrombosis, poly-serositis, nephritis, myocarditis, sacro-ilitis, autoimmune hemolytic anemia and refractory thrombocytopenia. Though anti-dsDNA was negative, she was diagnosed to have systemic lupus erythematosus (SLE). Terminally, she had pulmonary symptoms and succumbed to her illness. The autopsy showed lupus nephritis-Class II, polyserositis, myocarditis, inflammatory myositis, immune mediated vasculitis involving renal, coronary, pancreatic, adrenal, dermal and intramuscular arteries, and pulmonary hemorrhages and edema...
February 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28284263/immune-thrombocytopenia-secondary-to-tuberculosis-a-case-and-review-of-literature
#16
S F Weber, S Bélard, S Rai, R Reddy, S Belurkar, K Saravu
Immune thrombocytopenia (ITP) is an auto-immune condition that results in isolated thrombocytopenia associated with possibly lethal haemorrhage. In its secondary form, ITP can be triggered by many infectious and non-infectious conditions. Secondary ITP associated with tuberculosis (TB) has rarely been described in the literature. We report on a 22-year-old patient presenting with hypermenorrhoea and petechiae due to ITP secondary to tuberculous lymphadenitis. Normalisation of thrombocytopenia was only achieved after initiation of anti-tuberculosis treatment following failure of thrombocyte substitution and immune-modulatory treatment...
April 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28275823/beyond-immune-thrombocytopenia-the-evolving-role-of-thrombopoietin-receptor-agonists
#17
REVIEW
Francesco Rodeghiero, Giuseppe Carli
Since its discovery, the thrombopoietin (TPO) pathway has been an important pharmaceutical target for the treatment of thrombocytopenia. The first generation of TPO mimetics included peptide agents sharing homology with endogenous TPO, but these introduced a risk of antibody formation to endogenous TPO and were not successful. However, second-generation TPO mimetics or TPO receptor agonists (RAs) are currently being used to treat thrombocytopenia associated with a number of conditions, such as immune thrombocytopenia (ITP), severe aplastic anaemia (SAA), and hepatitis C virus-associated chronic liver disease...
March 8, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28267088/sirolimus-as-an-effective-agent-in-the-treatment-of-immune-thrombocytopenia-itp-and-evans-syndrome-es-a-single-institution-s-experience
#18
Sylwia Jasinski, Mark E Weinblatt, Chana L Glasser
BACKGROUND: Autoimmune cytopenias are characterized by immune-mediated destruction of hematopoietic cell lines with immune thrombocytopenia (ITP) affecting platelets and Evans syndrome (ES) affecting platelets and red blood cells. For patients with persistent disease, limited options for effective and well-tolerated therapies exist. OBJECTIVES: Our aim is to describe our institution's experience with sirolimus as therapy for pediatric patients with persistent ITP and ES...
March 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28264696/a-rare-case-report-of-acyclovir-induced-immune-thrombocytopenia-with-tongue-hematomas-as-the-first-sign-and-a-literature-review
#19
Xiaowei Hong, Xiaoqian Wang, Zhiyong Wang
BACKGROUND: Acyclovir has been widely used to treat infections caused by herpes simplex virus (HSV) and varicella zoster virus (VZV). The common adverse effects of this drug include nausea, diarrhea, headache, dizziness and mental changes. The immune thrombocytopenia induced by acyclovir is rare. CASE PRESENTATION: A 67-year-old Chinese male who was given acyclovir 5 mg kg(-1) 8 hourly intravenously for treatment of VZV infection developed severe thrombocytopenia with fist sign in oral cavity within 10 days of starting using acyclovir...
March 7, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28264674/epstein-barr-virus-and-cytomegalovirus-infections-and-their-clinical-relevance-in-egyptian-leukemic-pediatric-patients
#20
Samah Aly Loutfy, Maha A Abo-Shadi, Mohamed Fawzy, Mohamed El-Wakil, Shimaa A Metwally, Manar M Moneer, Nasra F Abdel Fattah, Sara Kassem, Ahmed Elgebaly
BACKGROUND: Epstein-Barr virus (EBV) and human cytomegalovirus (CMV) infections are environmental risk factors affecting the outcome of cancer due to an impairment in the cell-mediated immunity. Therefore, this study aimed to detect the frequency of EBV and CMV DNA and their association with clinical characteristics and outcome of pediatric leukemic patients. METHODS: Samples of 50 immunocompromised pediatric leukemic patients and 30 apparently healthy children were subjected to the amplification of EBV DNA by one version of PCR targeting the Bam H1 W region of the genomic region of EBV, and the amplification of CMV DNA by targeting the CMV UL97 genomic region by a second round PCR...
March 6, 2017: Virology Journal
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