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Immune thrombocytopenia

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https://www.readbyqxmd.com/read/28917657/oral-all-trans-retinoic-acid-plus-danazol-versus-danazol-as-second-line-treatment-in-adults-with-primary-immune-thrombocytopenia-a-multicentre-randomised-open-label-phase-2-trial
#1
Fei-Er Feng, Ru Feng, Min Wang, Jia-Min Zhang, Hao Jiang, Qian Jiang, Jin Lu, Hui Liu, Jun Peng, Ming Hou, Jian-Liang Shen, Jing-Wen Wang, Lan-Ping Xu, Kai-Yan Liu, Xiao-Jun Huang, Xiao-Hui Zhang
BACKGROUND: Primary immune thrombocytopenia is a severe bleeding disorder. About 50-85% of patients achieve initial remission from first-line therapies, but optimal second-line treatment remains a challenge. All-trans retinoic acid (ATRA) has an immunomodulatory effect on haemopoiesis, making it a possible treatment option. We aimed to evaluate the efficacy and safety of ATRA plus danazol versus danazol in non-splenectomised patients with corticosteroid-resistant or relapsed primary immune thrombocytopenia...
September 13, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28917656/is-oral-all-trans-retinoic-acid-plus-danazol-a-refinement-of-second-line-therapy-for-primary-immune-thrombocytopenia-in-adults
#2
Simon Panzer, Ingrid Pabinger
No abstract text is available yet for this article.
September 13, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28905389/the-first-reported-case-of-concurrent-trimethoprim-sulfamethoxazole-induced-immune-hemolytic-anemia-and-thrombocytopenia
#3
Yevgeniy A Linnik, Edison W Tsui, Isabella W Martin, Zbigniew M Szczepiorkowski, Gregory A Denomme, Jerome L Gottschall, John M Hill, Nancy M Dunbar
BACKGROUND: Drug-induced immune hemolytic anemia (DIIHA) and drug-induced immune thrombocytopenia (DIIT) are rare but dangerous complications of pharmacotherapy that may be underrecognized in hematopoietic stem cell transplant (HSCT) patients due to overlap of signs and symptoms with those of more common disease processes. CASE REPORT: A 61-year-old woman with NK-cell deficiency and GATA-2-associated myelodysplastic syndrome, status post-recent allogeneic HSCT (Day +58), presented with 3 days of acute-onset severe back pain, muscle cramps, and increasingly dark urine...
September 14, 2017: Transfusion
https://www.readbyqxmd.com/read/28902958/nonregenerative-immune-mediated-anemia-associated-with-a-diffuse-large-b-cell-lymphoma-in-a-captive-jaguar-panthera-onca
#4
Monika A Keresztes, Manfred Henrich, Penelope Baloi, Sascha Gerst, Jens-Christian Rudnick, Judith Langenstein, Andreas Moritz, Natali Bauer
An 18-year-old male castrated jaguar (Panthera onca) was presented with anorexia and continuous bleeding from the oral cavity after a history of fighting with the partner animal. Clinical evaluation revealed ulcerating lesions on the gingiva and hard palate and a hematoma on the tongue. Computed tomography of the head and endoscopic examination of the esophagus and stomach were unremarkable. Hematology and clinical chemistry revealed severe nonregenerative anemia, mild thrombocytopenia, and moderate azotemia...
September 13, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28893804/immune-thrombocytopenic-purpura-associated-with-fingolimod
#5
Hiu Lam Agnes Yuen, Susan Brown, Noel Chan, George Grigoriadis
Fingolimod is an oral sphingosine-1-phosphate receptor modulator which causes lymphocyte sequestration in lymph nodes and is approved for relapsing multiple sclerosis. The Therapeutic Goods Administration of Australia is aware of only one case where fingolimod preceded immune thrombocytopenic purpura (ITP) by 5 weeks. Here we report three such cases.None were on any medications known to cause ITP and routine investigations were unremarkable. All cases were treated with immunosuppression. Case 1 successfully weaned prednisolone after fingolimod cessation whereas case 2 weaned slowly while continuing fingolimod therapy...
September 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28886489/increased-plasma-scxcl16-levels-may-have-a-relationship-with-th1-th2-imbalance-in-primary-immune-thrombocytopenia
#6
Yating Hao, Yang Li, Huiyuan Li, Mingen Lyu, Donglei Zhang, Rongfeng Fu, Yue Guan, Shixuan Wang, Boyang Sun, Xueqing Dou, Lei Zhang, Renchi Yang
Primary immune thrombocytopenia (ITP) is a disease of autoimmunity in which there are Th1/Th2 imbalance and disordered cytokine profiles. CXC chemokine ligand 16 (CXCL16) was proved to implicate in some autoimmune diseases. Our research aimed to determine plasma soluble CXCL16 (sCXCL16) levels and its effects in ITP. We used ELISA to measure plasma sCXCL16, IFN-γ and IL-4 and flow cytometry to determine expression of CXCR6 on lymphocyte subsets. We used real-time PCR to detect the CXCL16 and CXCR6 mRNA expression...
September 5, 2017: Cytokine
https://www.readbyqxmd.com/read/28880361/a-randomized-multicenter-study-safety-and-efficacy-of-mini-pool-intravenous-immunoglobulin-versus-standard-immunoglobulin-in-children-aged-1-18-years-with-immune-thrombocytopenia
#7
Mohsen Elalfy, Marwa Reda, Islam Elghamry, Omar Elalfy, Mohamed Meabed, Nada El-Ekiaby, Mahmoud A El-Hawy, Hadi Goubran, Magdy El-Ekiaby
BACKGROUND: Because there is a global shortage of intravenous immunoglobulin, there is a need for new products to fill the gap. STUDY DESIGN AND METHODS: This was a multicenter, open-label study investigating the safety and efficacy of a newly developed mini-pool intravenous immunoglobulin G for children with immune thrombocytopenia. Seventy-two patients ages 1 to 18 years with newly diagnosed (<1 month) immune thrombocytopenia who had platelet counts from 5 to 20 × 10(9) /L with no serious bleeding were recruited from four centers in Egypt...
September 6, 2017: Transfusion
https://www.readbyqxmd.com/read/28878866/association-of-autoimmune-hepatitis-type-1-in-a-child-with-evans-syndrome
#8
Chaowapong Jarasvaraparn, Hamayun Imran, Abdul Siddiqui, Felicia Wilson, David A Gremse
Autoimmune hepatitis (AIH) is a progressive liver disease that is often associated with extrahepatic autoimmune disorders. Evans syndrome (ES) is a rare autoimmune disorder, which is characterized by immune thrombocytopenia and autoimmune hemolytic anemia. Association of AIH with ES is rare, especially in children. We report a 3-year-old female with a past medical history of ES who presented with jaundice and significant transaminitis due to AIH type 1. She required multiple treatments with steroids as well as azathioprine, intravenous immunoglobulin and a course of rituximab...
August 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28876485/the-care-of-a-child-with-a-newly-diagnosed-immune-thrombocytopenia
#9
EDITORIAL
Rolf Ljung
No abstract text is available yet for this article.
October 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28871277/the-centenary-of-immune-thrombocytopenia-part-2-revising-diagnostic-and-therapeutic-approach
#10
REVIEW
Rita Consolini, Giorgio Costagliola, Davide Spatafora
Primary immune thrombocytopenia (ITP) is the most common cause of thrombocytopenia in children and adolescents and can be considered as a paradigmatic model of autoimmune disease. This second part of our review describes the clinical presentation of ITP, the diagnostic approach and overviews the current therapeutic strategies. Interestingly, it suggests an algorithm useful for differential diagnosis, a crucial process to exclude secondary forms of immune thrombocytopenia (IT) and non-immune thrombocytopenia (non-IT), which require a different therapeutic management...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28868658/bisoprolol-induced-thrombocytopenia-a-case-report
#11
F Mousinho, T Mendes, P Sousa E Santos, A P Azevedo, G Mousinho, C Malcata, E Viegas, B Madureira, F Falcão, A P Gomes, F Lima
WHAT IS KNOWN AND OBJECTIVE: Thrombocytopenia, not associated with bone marrow primary disease, is a common clinical problem. The possibility of drug-induced thrombocytopenia must be considered, especially in hospitalized patients. Drugs can cause thrombocytopenia by several mechanisms including direct bone marrow or other organ toxicity, and immune reactions. CASE DESCRIPTION: We describe a patient presenting with thrombocytopenia likely related to bisoprolol. WHAT IS NEW AND CONCLUSION: We report a case of bisoprolol-induced thrombocytopenia which resolved with drug discontinuation and steroid therapy...
September 3, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28860338/hif1a-is-a-critical-downstream-mediator-for-hemophagocytic-lymphohistiocytosis
#12
Rui Huang, Yoshihiro Hayashi, Xiaomei Yan, Jiachen Bu, Jieyu Wang, Yue Zhang, Yile Zhou, Yuting Tang, Lingyun Wu, Zefeng Xu, Xin Liu, Qianfei Wang, Jianfeng Zhou, Zhijian Xiao, James P Bridges, Rebecca A Marsh, Kejian Zhang, Michael B Jordan, Yuhua Li, Gang Huang
Hemophagocytic lymphohistiocytosis is a life-threatening syndrome characterized by overwhelming immune activation. A steroid and chemotherapy-based regimen remains as the first-line of therapy but it has substantial morbidity. Thus, novel, less toxic therapy for hemophagocytic lymphohistiocytosis is urgently needed. Although differences exist between familial hemophagocytic lymphohistiocytosis and secondary hemophagocytic lymphohistiocytosis, they have many common features. Using bioinformatic analysis with familial hemophagocytic lymphohistiocytosis and systemic juvenile idiopathic arthritis, which is associated with secondary hemophagocytic lymphohistiocytosis, we identified a common hypoxia-inducible factor 1A (HIF1A) signature...
August 31, 2017: Haematologica
https://www.readbyqxmd.com/read/28859400/association-between-peripheral-%C3%AE-%C3%AE-t-cell-subsets-and-disease-progression-of-severe-fever-with-thrombocytopenia-syndrome-virus-infection
#13
Wen Xu, Xiao-Kun Li, Qing-Bin Lu, Zhen-Dong Yang, Juan Du, Bo Xing, Ning Cui, Xiao-Ai Zhang, Shao-Fei Zhang, Xin-Xin Yang, Wei Liu, Wei-Wei Chen
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by SFTS virus. The cellular immune responses during SFTS virus infection have not been fully understood. This study examined the association between circulating γδ T cell subsets and clinical outcome of SFTS patients from China. A total of 101 hospitalized SFTS patients and 28 healthy controls were enrolled. Peripheral blood was collected, and lymphocyte subgroups and γδ T cell frequencies were evaluated by flow cytometry analysis...
September 29, 2017: Pathogens and Disease
https://www.readbyqxmd.com/read/28859046/wiskott-aldrich-syndrome-misdiagnosed-as-immune-thrombocytopenic-purpura-a-case-report
#14
Maria A Karalexi, Marianna Tzanoudaki, Andreas Fryganas, Alexia Gkergki, Dora Spyropoulou, Anna Papadopoulou, Vassiliki Papaevangelou, Ioannis Petrocheilos
Wiskott-Aldrich syndrome (WAS) is a rare X-linked immunodeficiency characterized by various clinical phenotypes. We report the case of a 3-year-old immigrant boy presenting with persistent infant-onset thrombocytopenia treated for refractory immune thrombocytopenic purpura. Sequence analysis confirmed the diagnosis of WAS. The patient responded neither to IV infusions of immunoglobulin (Ig) nor a thrombopoietin receptor agonist and is currently planned for stem cell transplantation. Raised awareness is thus vital of this potentially misdiagnosed and lethal disorder...
August 30, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28846826/autoimmune-heparin-induced-thrombocytopenia
#15
REVIEW
A Greinacher, Kathleen Selleng, T E Warkentin
Autoimmune heparin-induced thrombocytopenia (aHIT) indicates patients with anti-PF4/polyanion antibodies that are able to activate platelets strongly even in the absence of heparin (heparin-independent platelet activation). Nevertheless, as seen with serum obtained from patients with otherwise typical HIT, serum-induced platelet activation is inhibited at high heparin concentrations (10-100 IU/mL heparin). Further, upon serial dilution, aHIT serum will usually exhibit heparin-dependent platelet activation. Clinical syndromes associated with aHIT include: delayed-onset HIT, persisting HIT, spontaneous HIT, fondaparinux-associated HIT, heparin "flush"-induced HIT, and severe HIT (platelet count <20×10(9) /L) with associated disseminated intravascular coagulation (DIC)...
August 28, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28845713/thrombopoietin-receptor-agonists-for-children-with-immune-thrombocytopenia-a-systematic-review
#16
Youping Li, Jiaxing Zhang, Yi Liang, Yuan Ai, Juan Xie, Wenyi Zheng
OBJECTIVE: We conducted a systematic review to assess the efficacy and safety of Thrombopoietin-receptor agonists(TPOras) for pediatric immune thrombocytopenia(ITP). METHODS: We searched PubMed, Embase and Cochrane Library from their earliest records to January 2017. Randomized controlled trials(RCTs) evaluating the efficacy and safety of TPOras in children were included. Primary outcomes were durable response and clinically significant bleeding. Secondary outcomes were overall response, overall bleeding events, the proportion of patients receiving rescue medication and adverse events(AEs)...
August 28, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28840942/hemolysis-related-to-intravenous-immunoglobulins-is-dependent-on-the-presence-of-anti-blood-group-a-and-b-antibodies-and-individual-susceptibility
#17
Orell Mielke, Stefano Fontana, Vesselina Goranova-Marinova, Amgad Shebl, Martin O Spycher, Sandra Wymann, Billie L Durn, John P Lawo, Alphonse Hubsch, Abdulgabar Salama
BACKGROUND: Patients treated with intravenous immunoglobulins (IVIG) rarely experience symptomatic hemolysis. Although anti-A and anti-B isoagglutinins from the product are involved in most cases, the actual mechanisms triggering hemolysis are unclear. STUDY DESIGN AND METHODS: A prospective, open-label, multicenter, single-arm clinical trial in 57 patients with immune thrombocytopenia treated with IVIG (Privigen, CSL Behring) was conducted. RESULTS: Twenty-one patients received one infusion (1 g/kg) and 36 received two infusions (2 × 1 g/kg) of IVIG...
August 25, 2017: Transfusion
https://www.readbyqxmd.com/read/28838216/bet-inhibitors-a-novel-epigenetic-approach
#18
D B Doroshow, J P Eder, P M LoRusso
Epigenetics has been defined as 'the structural adaptation of chromosomal regions so as to register, signal or perpetuate altered activity states.' Currently, several classes of anticancer drugs function at the epigenetic level, including inhibitors of DNA methyltransferase, histone deacetylase (HDAC), lysine-specific demethylase 1, zeste homolog 2, and bromodomain and extra-terminal motif (BET) proteins.BET proteins have multiple functions, including the initiation and elongation of transcription and cell cycle regulation...
August 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28837581/fetal-exposure-to-maternal-human-platelet-antigen-1a-does-not-induce-tolerance-an-analytical-observational-study
#19
Mette Kjær, Heidi Tiller, Gøril Heide, Jens Kjeldsen-Kragh, Bjørn Skogen, Anne Husebekk
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a disease that may cause severe bleeding complications with risk of perinatal death or lifelong disability. The main cause of FNAIT is maternal antibodies against human platelet antigen (HPA)-1a. Both fetomaternal bleeding and transplacental trafficking of fetal cells during pregnancy could be the cause of alloimmunization. Persistence of fetal cells in the mother (fetal microchimerism) and maternal cells in the child (maternal microchimerism) are well-recognized phenomena...
2017: PloS One
https://www.readbyqxmd.com/read/28837208/platelet-count-recovery-and-seroreversion-in-immune-hit-despite-continuation-of-heparin-further-observations-and-literature-review
#20
Andrew W Shih, Jo-Ann I Sheppard, Theodore E Warkentin
One of the standard distinctions between type 1 (non-immune) and type 2 (immune-mediated) heparin-induced thrombocytopenia (HIT) is the transience of thrombocytopenia: type 1 HIT is viewed as early-onset and transient thrombocytopenia, with platelet count recovery despite continuing heparin administration. In contrast, type 2 HIT is viewed as later-onset (i. e., 5 days or later) thrombocytopenia in which it is generally believed that platelet count recovery will not occur unless heparin is discontinued. However, older reports of type 2 HIT sometimes did include the unexpected observation that platelet counts could recover despite continued heparin administration, although without information provided regarding changes in HIT antibody levels in association with platelet count recovery...
August 24, 2017: Thrombosis and Haemostasis
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