Read by QxMD icon Read


Arun Agarwal, Samiksha Sharma, Mala Airun
In Dengue Hemorrhagic Fever (DHF), hemorrhagic manifestations are common but thrombotic events are uncommonly reported, despite the wide range of increased procoagulant activity during Dengue Fever illness. We report a case of a 55-year-old man of Asian Indian ethnicity who developed large vein thrombotic event -Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) in the acute phase of DHF. His condition was further complicated by associated thrombocytopenia. The etiological connections between dengue viral infection with thrombocytopenia, DVT/PE and abnormal thrombophilia profile as well as the treatment dilemmas posed in treating a patient of DF with hemorrhagic manifestations and associated DVT/PE, and the role of eltrombopag are discussed...
August 2016: Journal of the Association of Physicians of India
Renchi Yang, Junmin Li, Jie Jin, Meijuan Huang, Ziqiang Yu, Xiaojun Xu, Xiaohui Zhang, Ming Hou
Eltrombopag, a thrombopoietin receptor agonist, raises platelet counts and reduces bleeding in patients with immune thrombocytopenia (ITP). In Chinese patients, eltrombopag was evaluated at an initial dose of 25 mg, vs. 50 mg for non-Asians, because the plasma exposure of eltrombopag is higher in East Asians. A multicentre, double-blind, randomised, placebo-controlled, 8-week, phase III study enrolled 155 patients with chronic, previously treated ITP. Dosage could be adjusted (25-75 mg/day) to maintain platelet counts 50-250 × 10(9) /l...
October 13, 2016: British Journal of Haematology
Kensuke Usuki
Treatments of aplastic anemia are comprised of supportive therapy and aplastic anemia-specific therapy aimed at restoring hematopoiesis. Supportive therapies include transfusion, G-CSF, and the administration of iron chelation agents, as well as dealing specifically with individual symptoms. Aplastic anemia-specific treatments given with the aim of achieving hematopoietic recovery include immunosuppressive therapy, allogeneic hematopoietic stem cell transplantation, and anabolic hormone therapy. Although transplantation provides complete recovery of hematopoiesis (cure), there is a risk of death due to transplant-related complications...
2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Su Han Lum, John D Grainger
Aplastic anemia (AA) is a potential life-threatening hematopoietic stem cell (HSC) disorder resulting in cytopenia. The mainstays of treatment for AA are definitive therapy to restore HSCs and supportive measures to ameliorate cytopenia-related complications. The standard definitive therapy is HSC transplantation for young and medically fit patients with suitable donors and immunosuppressive therapy (IST) with antithymocyte globulin and cyclosporine for the remaining patients. A significant proportion of patients are refractory to IST or relapse after IST...
2016: Drug Design, Development and Therapy
Ryszard Grenda, Wioletta Jarmużek, Joanna Latoszyńska, Sylwester Prokurat, Jacek Rubik
SIOD is rare disorder related to SMARCAL1 or SMARCAL2 gene mutation, including (among other comorbidities) T-cell immunodeficiency, nephrotic syndrome, and renal failure. Up to 22% of primary patients may develop various autoimmune disorders. We report the case of 11-year-old male with SIOD, who presented ITP at 2 years after renal transplantation with decrease in platelet count (from normal) to 56 000/μL and then (gradually) to 2000/μL. There was no effect of iv. methylprednisolone/dexamethasone. As the presence of antibodies against GPIIb/IIIa, GPIb, and GPIaIIa platelet glycoproteins was confirmed, patient was given 50 g of IVIG and then was put on plasmapheresis; however, both showed poor direct effect...
September 26, 2016: Pediatric Transplantation
Nuria Bermejo, Raúl Sigüenza, Fátima Ibáñez
No abstract text is available yet for this article.
September 17, 2016: Revista Española de Cardiología
J D Simpson, G V Matthews, T A Brighton, J E Joseph
Symptomatic cytomegalovirus (CMV) in immunocompetent individuals is an uncommon, yet recognised, phenomenon. This report discusses a case of CMV-associated thrombocytopenia refractory to immunomodulation and antivirals. Ultimately, a clinicopathological response was attained with eltrombopag. This is the first report of the efficacy of thrombopoietin receptor agonists in this context. This experience provides insight into possible pathogenic mechanisms of CMV-associated thrombocytopenia and presents a therapeutic option...
September 2016: Internal Medicine Journal
Tiana Kazemi, Sabrina Martin, Scott Worswick
Eltrombopag is a thrombopoietin mimetic used for the treatment of thrombocytopenia in patients with chronic immune thrombocytopenia, hepatitis C patients undergoing antiviral therapy, and thrombocytopenia secondary to aplastic anemia that is refractory to immunosuppressive therapy. We report a case of a 25-year-old man with a history of aplastic anemia who presented with fever and a monomorphic papular rash. Subsequent labs, biopsy, and clinical course favored drug-induced cutaneous toxicity, with eltrombopag as the likely culprit...
2016: Dermatology Online Journal
Jyothis Purushothaman, Kochuthresia J Puthumana, Aswath Kumar, Susheela J Innah, Sareena Gilvaz
Immune thrombocytopenic purpura is a common acquired autoimmune disorder defined by a low platelet count secondary to accelerated platelet destruction or impaired thrombopoesis by anti-platelet antibodies. Thrombopoietin (TPO)-mimetic drugs such as eltrombopag and romiplostim have been used successfully in many nonpregnant individuals with immune thrombocytopenia (ITP) but studies based on its effects in pregnancy are limited. A 27-year-old multigravida who is a known case of ITP with bad obstetric history was referred to the Department of Obstetrics and Gynecology at 26 weeks of gestation with complaints of mucosal bleeding and recurrent abortions...
July 2016: Asian Journal of Transfusion Science
Masao Hagihara, Morihiro Inoue, Kenichiro Kodama, Tomoyuki Uchida, Jian Hua
An 80-year-old man was admitted to our hospital because of severe thrombocytopenia. He was diagnosed with idiopathic thrombocytopenia, and prednisolone together with eltrombopag was started, leading to significant improvement of platelet counts. Four years later, there was a prominent increase of peripheral blood monocytes, which was accompanied by recurrence of thrombocytopenia. Bone marrow aspirates and serum electrophoresis revealed coexistence of chronic myelomonocytic leukemia (CMML) and multiple myeloma (MM)...
2016: Case Reports in Hematology
Ahmed Saber Elgebaly, Gehad El Ashal, Mohamed Elfil, Ahmed Menshawy
BACKGROUND: Eltrombopag is an oral thrombopoietin receptor agonist that stimulates the production of normally functioning platelets. The aim of this meta-analysis is to synthesize evidence about the safety and efficacy of eltrombopag for both adult and children with primary immune thrombocytopenia (ITP). METHODS: A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central was conducted. Records were screened for eligible studies, and data were extracted and synthesized using Review Manager for Windows...
August 29, 2016: Clinical and Applied Thrombosis/hemostasis
Carlo Caffarelli, Francesca Santamaria, Dora Di Mauro, Carla Mastrorilli, Virginia Mirra, Sergio Bernasconi
This review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature...
August 27, 2016: Italian Journal of Pediatrics
Rachel Allen, Peter Bryden, Kelly M Grotzinger, Ceilidh Stapelkamp, Bethan Woods
OBJECTIVES: To evaluate the cost-effectiveness of eltrombopag compared with romiplostim to be used in the treatment of chronic immune thrombocytopenia in patients in England and Wales who are splenectomized or ineligible for splenectomy and are refractory to other treatments. METHODS: A Markov cohort model in which patients were administered a sequence of treatments was used to predict long-term outcomes associated with each treatment. The model was informed by data from the eltrombopag clinical trial program and the available literature...
July 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Hanadi Ramadan, Vu H Duong, Najla Al Ali, Eric Padron, Ling Zhang, Jeffrey E Lancet, Alan F List, Rami S Komrokji
INTRODUCTION: Eltrombopag used for thrombocytopenia in myelodysplastic syndrome (MDS) patients is being explored in clinical trials including those with chronic myelomonocytic leukemia (CMML). PATIENTS AND METHODS: We report our experience treating patients with CMML enrolled in a sequential 2-stage dose escalation study with eltrombopag in patients with MDS after hypomethylating agent failure. Patients with CMML were compared with patients with MDS in respect to response and adverse events...
August 2016: Clinical Lymphoma, Myeloma & Leukemia
Christian A Di Buduo, Manuela Currao, Alessandro Pecci, David L Kaplan, Carlo L Balduini, Alessandra Balduini
Eltrombopag is a small non-peptide thrombopoietin mimetic that has been approved for increasing platelet count not only in immune thrombocytopenia and HCV-related thrombocytopenia, but also in aplastic anemia. Moreover, this drug is under investigation for increasing platelet count in myelodysplastic syndromes. Despite current clinical practice, the mechanisms governing Eltrombopag's impact on human hematopoiesis are largely unknown in part due to the impossibility of using traditional in vivo models. To investigate Eltrombopag's impact on megakaryocyte functions, we employed our established in vitro model for studying hematopoietic stem cell differentiation combined with our latest 3D silk-based bone marrow tissue model...
August 11, 2016: Haematologica
Shosaku Nomura
Immune thrombocytopenia (ITP) is an acquired hemorrhagic condition characterized by the accelerated clearance of platelets caused by antiplatelet autoantibodies. A platelet count in peripheral blood <100 × 10(9)/L is the most important criterion for the diagnosis of ITP. However, the platelet count is not the sole diagnostic criterion, and the diagnosis of ITP is dependent on additional findings. ITP can be classified into three types, namely, acute, subchronic, and persistent, based on disease duration...
2016: Clinical Medicine Insights. Blood Disorders
A Rashidi, M A Blinder
WHAT IS KNOWN AND OBJECTIVE: Immune destruction and decreased platelet production are major components of immune thrombocytopenia (ITP) pathogenesis. The aim of this study was to critically evaluate the role of combination therapy in relapsed/refractory ITP and the concept of medication tapering/discontinuation. COMMENT: Although a number of combination regimens have been reported, little is published on combining immunosuppression with thrombopoietin receptor agonists (TPO-RAs)...
October 2016: Journal of Clinical Pharmacy and Therapeutics
Matthieu Mahévas, Mathieu Gerfaud-Valentin, Guillaume Moulis, Louis Terriou, Sylvain Audia, Sophie Guenin, Guillaume Le Guenno, Gilles Salles, Olivier Lambotte, Nicolas Limal, Jean-François Viallard, Stephane Cheze, Cecile Tomowiak, Bruno Royer, Antoine Neel, Odile Debouverie, Arnaud Hot, Isabelle Durieu, Antoinette Perlat, Manuel Cliquennois, Clémence Deteix, Marc Michel, Bertrand Godeau
Refractory immune thrombocytopenia (ITP) was previously defined as lack of a minimum response to splenectomy and the requirement for long-term treatment to reduce the risk of significant bleeding events. In this multicenter study, we included 37 patients with multirefractory ITP, defined as no response to splenectomy, rituximab, romiplostim, and eltrombopag. As compared with a historical cohort of 183 ITP patients, matched on the calendar year of ITP diagnosis with a 5:1 ratio, patients with multirefractory ITP were more likely to have secondary ITP (odds ratio [OR], 4...
September 22, 2016: Blood
Bertrand Godeau
During the last two decades, new therapeutic strategies have been developed, particularly anti-CD20 agents and thrombopoietin-receptor (TPO-r) mimetics, for immune thrombocytopenia (ITP). However, although the new efficient drugs have deeply modified the therapeutic strategy and the disease prognosis, there are still unmet needs and challenges. Concerning rituximab, reassuring data concerning its safety have recently been reported. The main limitation of the treatment is its modest long-term efficacy, with frequent disease relapse...
April 2016: Seminars in Hematology
Alexandra Schifferli, Thomas Kühne
In 2008, new drugs that mimic the effects of thrombopoietin became available for the treatment of primary immune thrombocytopenia, eg, romiplostim and eltrombopag. These drugs activate the thrombopoietin receptor, stimulate the production of megakaryocytes, and increase the production of platelets. Important clinical observation has been gained, such as unexpected long-term remission after stopping thrombopoietin receptor agonists. The pathophysiology of this unforeseen cure is currently the subject of discussion and is investigated in clinical trials and laboratory research projects...
April 2016: Seminars in Hematology
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"