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Immune thrombocytopenia

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https://www.readbyqxmd.com/read/29778924/cerbera-odollam-toxicity-a-review
#1
REVIEW
Ritesh G Menezes, Muhammad Shariq Usman, Syed Ather Hussain, Mohammed Madadin, Tariq Jamal Siddiqi, Huda Fatima, Pradhum Ram, Syed Bilal Pasha, S Senthilkumaran, Tooba Qadir Fatima, Sushil Allen Luis
Cerbera odollam is a plant species of the Apocynaceae family. It is often dubbed the 'suicide tree' due to its strong cardiotoxic effects, which make it a suitable means to attempt suicide. The plant grows in wet areas in South India, Madagascar, and Southeast Asia; and its common names include Pong-Pong and Othalanga. The poison rich part of the plant is the kernel which is present at the core of its fruit. The bioactive toxin in the plant is cerberin, which is a cardiac glycoside of the cardenolide class...
May 9, 2018: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29777278/low-platelet-count-as-risk-factor-for-infections-in-patients-with-primary-immune-thrombocytopenia-a-retrospective-evaluation
#2
Mingming Qu, Qiang Liu, Hong-Guo Zhao, Jun Peng, Heyu Ni, Ming Hou, A J Gerard Jansen
Infectious complications are common and sometimes life threatening in patients with immune thrombocytopenia (ITP), mainly due to the immune-suppressive therapy. Recent evidence suggests a potential role of platelets in the inflammation process. In this clinical study, we further investigated the role of thrombocytopenia on infections in patients with primary ITP. We retrospectively evaluated data from the recently published large randomized clinical trial of a cohort of 195 patients with primary ITP, who were randomized for prednisone or high-dose dexamethasone...
May 18, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29769193/pyopericardium-progressing-to-tamponade-in-a-patient-with-immune-thrombocytopenia
#3
Manoj Gopalakrishnan, Robin George Manappallil, Harilal Nambiar, John Francis John
Pericardial effusion can develop during any stage of pericarditis, and small effusions that appear rapidly can cause cardiac tamponade. Pyopericardium is a rare aetiology for tamponade. This is a case of an elderly diabetic lady, on steroid therapy for immune thrombocytopenia, who presented with fever and acute dyspnoea. She developed cardiac tamponade due to pyopericardium with Staphylococcus as the causative organism. Staphylococcus pyopericardium, in the absence of a primary focus of infection, progressing to tamponade is an uncommon scenario...
May 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29767837/romiplostim-for-the-management-of-perioperative-thrombocytopenia
#4
Hanny Al-Samkari, Ariela L Marshall, Katayoon Goodarzi, David J Kuter
Thrombocytopenic patients requiring invasive surgery have few options to improve their platelet count preoperatively. This is a single-centre, retrospective review of thrombocytopenic patients receiving the thrombopoietin receptor agonist romiplostim perioperatively to allow for surgical interventions. Patient characteristics, romiplostim use, and surgical and safety outcomes (bleeding, thrombosis, transfusions) were collected and analysed. Forty-seven patients underwent 51 surgical procedures (ranging from total hip arthroplasty to open cardiac surgery) with romiplostim support...
May 16, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29760702/emerging-concepts-in-immune-thrombocytopenia
#5
REVIEW
Maurice Swinkels, Maaike Rijkers, Jan Voorberg, Gestur Vidarsson, Frank W G Leebeek, A J Gerard Jansen
Immune thrombocytopenia (ITP) is an autoimmune disease defined by low platelet counts which presents with an increased bleeding risk. Several genetic risk factors (e.g., polymorphisms in immunity-related genes) predispose to ITP. Autoantibodies and cytotoxic CD8+ T cells (Tc) mediate the anti-platelet response leading to thrombocytopenia. Both effector arms enhance platelet clearance through phagocytosis by splenic macrophages or dendritic cells and by induction of apoptosis. Meanwhile, platelet production is inhibited by CD8+ Tc targeting megakaryocytes in the bone marrow...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29755993/the-role-of-hydroxychloroquine-as-a-steroid-sparing-agent-in-the-treatment-of-immune-thrombocytopenia-a-review-of-the-literature
#6
REVIEW
Fatemeh Mohammadpour, Mona Kargar, Molouk Hadjibabaie
Immune Thrombocytopenia (ITP) is an autoimmune disease in which platelet destruction causes thrombocytopenia. Due to the known steroid toxicities, alternative agents have been evaluated for the treatment of these patients. We aimed to review the literature and find evidences regarding the potential benefits of hydroxychloroquine (HCQ) as a steroid-sparing agent in the treatment of ITP. We searched English language articles within Web of Science, PubMed, and Scopus. Cohorts, clinical trials, case reports, conference papers, and letters were included...
January 2018: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/29745420/bcl-2-levels-do-not-predict-azathioprine-treatment-response-in-inflammatory-bowel-disease-but-inhibition-induces-lymphocyte-apoptosis-and-ameliorates-colitis-in-mice
#7
Bruce Weder, Mahdi Mozaffari, Luc Biedermann, Céline Mamie, Anja Moncsek, Lichun Wang, Stephen H Clarke, Gerhard Rogler, Bradford L McRae, Candace L Graff, Pedro A Ruiz, Martin Hausmann
INTRODUCTION: In inflammatory bowel disease (IBD), inflammation is sustained by an exaggerated response of lymphocytes. This results from enhanced expression of anti-apoptotic BCL-2 and BCL-XL associated with a diminished turnover. Azathioprine (AZA) directly targets BCL-2 family-mediated apoptosis. We investigated whether the BCL-2 family expression pattern could be used to predict treatment response to AZA and determined whether BCL-2 inhibitor A-1211212 effectively diminishes lymphocytes and ameliorates inflammation in a model of colitis...
May 10, 2018: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/29744018/eptifibatide-induced-profound-thrombocytopenia-after-percutaneous-intervention-for-acute-coronary-syndrome-a-challenging-clinical-scenario
#8
Nirmanmoh Bhatia, Robert D Sawyer, Sohail Ikram
Eptifibatide is a glycoprotein (GP) IIb/IIIa inhibitor used mostly in the treatment of acute coronary syndrome (ACS). The GP IIb/IIIa antagonists occupy the fibrinogen binding site at the GP IIb/IIIa and block thrombocyte aggregation independent of the initial activation pathway. Severe thrombocytopenia has been reported with eptifibatide use. Thrombocytopenia after ACS can have multiple etiologies. Human immunodeficiency virus (HIV) infection has also been implicated in immune-mediated thrombocytopenia. In this manuscript, we report a case of acute severe thrombocytopenia secondary to eptifibatide use in a patient with a history of HIV infection who presented with an ST elevation myocardial infarction...
October 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29738335/treatment-characteristics-efficacy-and-safety-of-thrombopoietin-analogues-in-routine-management-of-primary-immune-thrombocytopenia
#9
María E Mingot-Castellano, Isabel S Caparrós, Fernando Fernández, María Del Mar Perera-Alvarez, Reyes Jimenez-Bárcenas, Alberto Casaus García, Manuel González-Silva, María Yera-Cobo, María M Nieto-Hernandez, María J Rodríguez-Fernandez, Dana Díaz-Canales
: Thrombopoietin receptor agonist (TPO-RAs) have demonstrated good efficacy and tolerance in clinical trials in refractory chronic primary immune thrombocytopenia (ITP) or chronic ITP with contraindication for splenectomy. No head-to-head study is available, and differences in trials design do not allow comparisons. Information on the use of TPO-RAs in nonchronic ITP is scant. We described our experience with TPO-RAs in ITP (chronic, persistent and newly diagnosed ITP) in routine clinical practice. Retrospective series of 100 adult ITP patients was analysed; 41 treated with eltrombopag, 37 with romiplostim and 22 with both...
June 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29736158/efficacy-and-safety-of-a-new-10-intravenous-immunoglobulin-product-in-patients-with-primary-immune-thrombocytopenia-itp
#10
Junshik Hong, Soo-Mee Bang, Yeung-Chul Mun, Ho-Young Yhim, Jaehoon Lee, Hyeong-Seok Lim, Doyeun Oh
Background: In the current study, we aimed to investigate the efficacy and safety of intravenous immunoglobulin (IVIg)-SN 10%, a new 10% IVIg formulation, in adult patients with severe primary immune thrombocytopenia (ITP; platelet count < 20 × 109 /L). Methods: Patients diagnosed as primary ITP, aged 19 years old or more, and had a platelet count of < 20 × 109 /L by screening complete blood cell count performed within 2 weeks of study commencement were eligible...
May 7, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29727898/-immunosuppressive-therapy-in-dogs-and-cats-properties-of-drugs-and-their-use-in-various-immune-mediated-diseases
#11
Johanna Rieder, Reinhard Mischke
Veterinarians are regularly faced with the diagnosis and therapy of immune-mediated diseases. More frequently occurring immune-mediated diseases are immune-mediated hemolytic anemia, immunemediated thrombocytopenia and polyarthritis. Glucocorticoids are commonly used as first-line treatment because of their availability, efficacy and rapid action. Nevertheless, some patients do not respond to glucocorticoid therapy alone. Others require a rapid dose reduction because of severe side effects from glucocorticoid treatment...
April 2018: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/29723924/cellular-immune-responses-to-platelet-factor-4-and-heparin-complexes-in-patients-with-heparin-induced-thrombocytopenia
#12
Ishac Nazy, Rumi Clare, Phillip Staibano, Theodore E Warkentin, Mark Larche, Jane C Moore, James W Smith, Richard P Whitlock, John G Kelton, Donald M Arnold
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is an adverse reaction to heparin characterized by thrombocytopenia and thrombotic complications. HIT is caused by pathogenic antibodies that bind to complexes of platelet factor 4 and heparin (PF4/heparin) leading to platelet activation and inducing a hypercoagulable state. Previous studies have shown immunity to PF4/heparin occurs early in life even before heparin exposure; however, the immunogenesis of HIT is not well characterized...
May 3, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29719658/occurrence-and-potential-causative-factors-of-immune-mediated-hemolytic-%C3%A2-anemia-in-cattle-and-river-buffaloes
#13
Seyedeh Missagh Jalali, Masood Ghorbanpour, Mohammad Razi Jalali, Aria Rasooli, Pegah Safaie, Farideh Norvej, Imaneh Delavari
The main objectives of this study were to determine the occurrence and potential causative factors of Immune-mediated hemolytic anemia (IMHA) in native cattle and water buffaloes from southwest of Iran. Fifty-three anemic animals (37 cattle and 16 buffaloes) were studied. A full clinical history and physical examinations were undertaken for all animals. Four clinically healthy cattle and four healthy buffaloes were also used as control animals. Blood samples were subjected to a complete blood count, Coombs' test, erythrocyte osmotic fragility test and serum biochemical analysis...
2018: Veterinary Research Forum
https://www.readbyqxmd.com/read/29709062/management-of-newly-diagnosed-high-risk-and-intermediate-risk-follicular-lymphoma-with-90-y-ibritumomab-tiuxetan-in-a-phase-ii-study
#14
Neil L Berinstein, Nancy M Pennell, Rashmi Weerasinghe, Rena Buckstein, Eugenia Piliotis, Kevin R Imrie, Lisa Chodirker, Mary-Anne Cussen, Ellen Miles, Marciano D Reis, Zeina Ghorab, Matthew C Cheung
Five-year overall survival for high-risk Follicular Lymphoma International Prognostic Index follicular lymphoma is only approximately 50% compared with 90% for low risk. To evaluate an approach to improve upon this poor outcome, we completed an exploratory phase II trial of intensified treatment for patients with intermediate and high-risk follicular lymphoma. Front-line treatment with chemo-immunotherapy consisting of rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone was followed by radio- immunotherapy with 90-Yttrium ibritumomab tiuxetan consolidation, and 2 years of rituximab maintenance...
April 30, 2018: Hematological Oncology
https://www.readbyqxmd.com/read/29704458/gm-csf-and-il-4-are-not-involved-in-ivig-mediated-amelioration-of-itp-in-mice-a-role-for-il-11-cannot-be-ruled-out
#15
Bonnie J B Lewis, Danila Leontyev, Anton Neschadim, Megan Blacquiere, Donald R Branch
Previously, we reported that interleukin 4 (IL-4), granulocyte-macrophage colony-stimulating factor (GM-CSF), and interleukin 11 (IL-11), but not interleukin 33 (IL-33), are up-regulated in two strains of mice with immune thrombocytopenia (ITP) that are responsive to intravenous immunoglobulin (IVIg) treatment. Previously, IL-4 was ruled out in the mechanism of IVIg; however, other publications have suggested this cytokine as a major player in the mechanism of IVIg action. Thus, we sought to further investigate a role for IL-4 and, in addition, GM-CSF and IL-11 in the mechanism of action of IVIg using a murine model of ITP...
April 28, 2018: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/29701391/diagnostic-challenges-in-chronic-constrictive-pericarditis
#16
Ana Braga, Afonso Oliveira, Kevin Domingues, Maria João Andrade, Miguel Abecacis, José Pedro Neves
INTRODUCTION: Chronic constrictive pericarditis (CCP) is a disease that has multiple possible causes and is associated with variable clinical findings, depending on its severity. It develops insidiously, and in many cases, particularly in developed countries, no antecedent diagnosis can be found. These cases are termed idiopathic. Tuberculosis is the leading cause of constrictive pericarditis in developing nations but represents only a small minority in developed countries. METHODS: Here the authors describe two different case reports where tuberculosis was the probable cause of CCP...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699806/corticosteroid-response-predicts-success-of-laparoscopic-splenectomy-in-treating-immune-thrombocytopenia
#17
Alexandra C Istl, Greig McCreery, Laura J Allen, Kelly Vogt, Luc Dubois, Daryl K Gray
BACKGROUND: Laparoscopic splenectomy is a second-line therapy for immune thrombocytopenia with a sustained success rate of 66%. In a climate of new available medical therapies for immune thrombocytopenia, the comparative safety and efficacy of laparoscopic splenectomy are worthy of attention. The purpose of this study is to identify factors predictive of laparoscopic splenectomy success that will enable preoperative prognostication. METHODS: A retrospective cohort study was conducted of patients undergoing laparoscopic splenectomy for immune thrombocytopenia...
April 23, 2018: Surgery
https://www.readbyqxmd.com/read/29696721/il-10-polymorphisms-and-t-cell-subsets-could-affect-the-clinical-presentation-and-outcome-of-childhood-immune-thrombocytopenia-in-egyptian-population
#18
Mohamed A Soliman, Mohamed A Helwa, Samar K Fath-Allah, Mahmoud A El-Hawy, Hassan S Badr, Naglaa Fathy Barseem
The aim is to study IL-10 polymorphisms and IL-10 level and assess their relation to T-cell subsets in childhood immune thrombocytopenia (ITP). In all, 40 (25 acute, 15 chronic) ITP child patients were investigated at time of presentation, compared to 15 healthy, age- and gender-matched controls and followed up for 1 year to determine chronic cases. Studying the effect of IL-10 promoter polymorphism was done by PCR-RFLP, IL-10 level was determined by ELISA, natural killer cells and T-cell subsets were evaluated by flow cytometry...
May 2018: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/29696684/fostamatinib-for-the-treatment-of-adult-persistent-and-chronic-immune-thrombocytopenia-results-of-two-phase-3-randomized-placebo-controlled-trials
#19
James Bussel, Donald M Arnold, Elliot Grossbard, Jiří Mayer, Jacek Treliński, Wojciech Homenda, Andrzej Hellmann, Jerzy Windyga, Liliya Sivcheva, Alhossain A Khalafallah, Francesco Zaja, Nichola Cooper, Vadim Markovtsov, Hany Zayed, Anne-Marie Duliege
Spleen tyrosine kinase (Syk) signaling is central to phagocytosis-based, antibody-mediated platelet destruction in adults with immune thrombocytopenia (ITP). Fostamatinib, an oral Syk inhibitor, produced sustained on-treatment responses in a phase 2 ITP study. In two parallel, phase 3, multicenter, randomized, double-blind, placebo-controlled trials (FIT1 and FIT2), patients with persistent/chronic ITP were randomized 2:1 to fostamatinib (n=101) or placebo (n=49) at 100mg BID for 24 weeks with a dose increase in non-responders to 150mg BID after 4 weeks...
April 26, 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/29695020/significant-hypo-responsiveness-to-gpvi-and-clec-2-agonists-in-pre-term-and-full-term-neonatal-platelets-and-following-immune-thrombocytopenia
#20
Alexander T Hardy, Verónica Palma-Barqueros, Stephanie K Watson, Jean-Daniel Malcor, Johannes A Eble, Elizabeth E Gardiner, José E Blanco, Rafael Guijarro-Campillo, Juan L Delgado, María L Lozano, Raúl Teruel-Montoya, Vicente Vicente, Steve P Watson, José Rivera, Francisca Ferrer-Marín
Neonatal platelets are hypo-reactive to the tyrosine kinase-linked receptor agonist collagen. Here, we have investigated whether the hypo-responsiveness is related to altered levels of glycoprotein VI (GPVI) and integrin α2β1, or to defects in downstream signalling events by comparison to platelet activation by C-type lectin-like receptor 2 (CLEC-2). GPVI and CLEC-2 activate a Src- and Syk-dependent signalling pathway upstream of phospholipase C (PLC) γ2. Phosphorylation of a conserved YxxL sequence known as a (hemi) immunotyrosine-based-activation-motif (ITAM) in both receptors is critical for Syk activation...
April 25, 2018: Thrombosis and Haemostasis
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