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Immune thrombocytopenic purpura

Francisco García Angarita, Alfonso Sanjuanbenito Dehesa
Accessory splenectomy should be considered in any patient with recurrence of immune thrombocytopenic purpura, if studies (scintigraphy using heat-damaged Tc99m-labeled red blood cells) are suggestive of residual functional splenic tissue. The most common benefit after removal of accessory spleen seems to be the reduction of dose in medical treatment.
October 2016: Clinical Case Reports
Tohru Takahashi, Yumiko Maruyama, Mayuko Saitoh, Hideto Itoh, Mitsuru Yoshimoto, Masayuki Tsujisaki, Masato Nakayama
A 64 year-old woman with steroid-dependent immune thrombocytopenia developed anemia. Esophagogastroduodenoscopy revealed the presence of a tumor, which was diagnosed to be diffuse large B-cell lymphoma, in the second portion of the duodenum. (18)F-fluorodeoxy glucose positron emission tomography showed an increased uptake mass in the pelvic cavity as well as in the duodenum. Though the duodenal tumor disappeared after 4 cycles of chemotherapy, the pelvic mass did not shrink in size. As a result, laparoscopic resection of the pelvic tumor was performed and the tumor was histologically diagnosed to be a gastrointestinal stromal tumor...
2016: Internal Medicine
Charbel Chater, Louis Terriou, Alain Duhamel, David Launay, Jean P Chambon, François R Pruvot, Moshe Rogosnitzky, Philippe Zerbib
INTRODUCTION: Corticosteroids are still the standard first-line treatment for immune thrombocytopenic purpura (ITP). As second-line therapy, splenectomy and Rituximab are both recommended. The aim of our study was to compare the efficacy of Rituximab to splenectomy in persistent or chronic ITP patients. METHODS: Between January 1999 and March 2015, we retrospectively selected all consecutive patients who underwent an ITP second-line treatment: Rituximab or splenectomy...
November 2016: Annals of Surgery
S Balamurugan, S Sureshkanna, S R Subramanian, N Kalaisezhian
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
K Jana, B R Bansode, S Matey, G Thomas, A Jaiswal
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Qi Ai, Jing Yin, Sen Chen, Lijin Qiao, Na Luo
Certain studies have previously indicated that an association may exist between rotavirus infection and primary immune thrombocytopenic purpura (ITP). The present retrospective study aimed to investigate whether rotavirus may cause ITP in children. Firstly, the incidence of ITP in children with or without rotavirus diarrhea was compared. A 14.58% incident rate was observed in children with rotavirus diarrhea compared with a 7.22% incident rate in children without rotavirus diarrhea. Subsequently, the clinical features of ITP children with or without rotavirus infection were compared...
October 2016: Experimental and Therapeutic Medicine
A F Zea-Vera, B Parra
A 30-year-old Colombian woman with past history of immune thrombocytopenia (ITP) presented to the emergency room with two days of global headache, arthralgia, myalgia, and low level fever and generalized erythematous rash. Platelets dropped to 9 × 10(9)/L (fourth day of symptoms) without hemorrhagic manifestations but recovered to 30 × 10(9)/L in 24 hours (fifth day). Dengue virus infection, as well as other viral infections, was ruled out. Zika virus (ZIKV) was evaluated in serum and urine samples by real-time reverse-transcriptase polymerase chain reaction (genomic regions within E protein and NS2b protein)...
September 30, 2016: Lupus
Wenjing Cao, Huy P Pham, Lance A Williams, Jenny McDaniel, Rance C Siniard, Robin G Lorenz, Marisa B Marques, X Long Zheng
Acquired thrombotic thrombocytopenic purpura is primarily caused by deficiency of plasma ADAMTS13 activity resulting from autoantibodies against ADAMTS13. However, ADAMTS13 deficiency alone is often not sufficient to cause acute thrombotic thrombocytopenic purpura. Infections or systemic inflammation may precede acute bursts of the disease but the underlying mechanisms are not fully understood. Here, 52 patients with acquired idiopathic thrombotic thrombocytopenic purpura and 30 blood donor controls were recruited for the study...
August 4, 2016: Haematologica
V Bhatt, L Shune, E Lauer, M Lubin, S M Devlin, A Scaradavou, R Parameswaran, M A Perales, D M Ponce, S Mantha, N A Kernan, J N Barker
Autoimmune hemolysis (AH) and immune thrombocytopenic purpura (ITP) are recognized complications after cord blood transplantation (CBT). We evaluated the incidence and characteristics of AH/ITP after double-unit CBT in a day 100 landmark analysis of 152 patients (median age 36 years, range 0.9-70 years) transplanted for hematologic malignancies with myeloablative or nonmyeloablative conditioning and calcineurin inhibitor (CNI)/mycophenolate mofetil. With a median 5.2-year (range 1.6-9.7 years) survivor follow-up, 10 patients developed autoimmune cytopenias (8 AH, 1 ITP, 1 both) at a median of 10...
September 19, 2016: Bone Marrow Transplantation
Ashish H Shah, Richard A Anderson, Ali Raza Khan, Timothy D Kinnaird
Treating patients known to have immune thrombocytopenic purpura (ITP) presenting with acute coronary syndrome (ACS) pose challenges, especially if they undergo percutaneous coronary intervention and stenting, as they require certain period of dual anti-platelet medication based up on the type of stent been deployed. Co-existence of therapies to increase platelet number as well as anti-platelet efficacy at the same time appears contradictory; imbalance in antagonistic treatment approach of increasing platelet number to treat ITP and inhibiting their activity to treat ACS can result in life threatening complications...
August 20, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Arun Panigrahi, Amy Clark, John Myers, Ashok Raj
BACKGROUND: Successful treatment of both pediatric autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP), specifically those that are refractory to first-line therapies, remains unsatisfactory in terms of long-term remission and medication side effects. Here, we propose a novel combination therapy of mycophenolate mofetil (MMF), an adjunct immunosuppressive, and short-term corticosteroids for the treatment of persistent or chronic autoimmune cytopenias in children...
September 12, 2016: Pediatric Blood & Cancer
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
Salah Aref, Mohamed Sabry El-Ghonemy, Sherin Abd El-Aziz, Tarek Abouzeid, Mona Talaab, Amr El-Sabbagh
OBJECTIVES: Based on the concept of immune dysregulation in immune thrombocytopenic purpura (ITP) and that Interleukin-18 (IL-18) is an inflammatory cytokine that plays an important role in autoimmune disease by inducing interferon-γ secretion; this study aimed to assess a possible association between the IL-18 promoter polymorphisms (-607 C/A site) and genetic susceptibility to ITP and the impact of the immunoglobulins (Igs) concentrations level on disease severity and response to therapy...
September 6, 2016: Hematology (Amsterdam, Netherlands)
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
Fabian C Verbij, Eva Stokhuijzen, Paul H P Kaijen, Floris van Alphen, Alexander B Meijer, Jan Voorberg
Patients suffering from acquired thrombotic thrombocytopenic purpura (TTP) develop auto-antibodies directed towards the plasma glycoprotein ADAMTS13. Here, we studied the glycan composition of plasma-derived ADAMTS13. Purified ADAMTS13 was reduced, alkylated and processed into peptides with either trypsin or chymotrypsin. Glycopeptides were enriched using zwitterionic HILIC zip-tips and analyzed by tandem mass spectrometry employing higher-energy collision dissociation fragmentation. Upon detection of a diagnostic ion of a glycan fragment electron transfer dissociation fragmentation was performed on the same precursor-ion...
August 29, 2016: Blood
Shih-Wei Lai, Hsien-Feng Lin, Cheng-Li Lin, Kuan-Fu Liao
Little research focuses on the association between immune thrombocytopenic purpura and human immunodeficiency virus infection in Taiwan. This study investigated whether immune thrombocytopenic purpura might be an early hematologic manifestation of undiagnosed human immunodeficiency virus infection in Taiwan. We conducted a retrospective population-based cohort study using data of individuals enrolled in Taiwan National Health Insurance Program. There were 5472 subjects aged 1-84 years with a new diagnosis of immune thrombocytopenic purpura as the purpura group since 1998-2010 and 21,887 sex-matched and age-matched, randomly selected subjects without immune thrombocytopenic purpura as the non-purpura group...
August 25, 2016: Internal and Emergency Medicine
Jian-Qin Li, Shao-Yan Hu, Zhao-Yue Wang, Jing Lin, Su Jian, Yong-Chao Dong, Xiao-Fang Wu, Dai-Lan, Li-Juan Cao
BACKGROUND: The imbalance of Treg/Th17 cells is an important pathogenic factor for immune thrombocytopenic purpura (ITP). We previously reported miR-125a-5p targeted CXCL13 and participated in the process of ITP. In the present study, the role of miR-125a-5p in regulating Treg/Th17 ratio and its potential molecular mechanism were investigated. METHOD: A total of 30 adults with ITP and 30 healthy subjects were included. MEG3 expression in peripheral blood derived CD4+ T cells from ITP patients and healthy subjects were detected by real-time PCR...
August 10, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Karim R Saab, Sonia Elhadad, Dennis Copertino, Jeffrey Laurence
Before the modern era of HIV/AIDS therapeutics, which enabled a cascade of early recognition of infection, prompt initiation of effective antiretroviral therapies, and close follow-up, severe forms of microvascular clotting disorders known as thrombotic microangiopathies (TMAs) were frequent in the setting of advanced HIV disease. Their incidence was as high as 7% in the period 1984-1999, but fell dramatically, to <0.5%, by 2002. This profound change was predicated on one critical development: availability of new classes of anti-HIV drugs, enabling reduction and maintenance of HIV viral loads to undetectable levels...
August 2016: AIDS Patient Care and STDs
Terry King-Wing Ma, Stephen P McAdoo, Frederick Wai-Keung Tam
Spleen tyrosine kinase (Syk), a 72 kDa cytoplasmic non-receptor protein-tyrosine kinase, plays an important role in signal transduction in a variety of cell types. Ever since its discovery in the early 1990s, there has been accumulating evidence to suggest a pathogenic role of Syk in various allergic disorders, autoimmune diseases and malignancies. Additionally, there is emerging data from both pre-clinical and clinical studies that Syk is implicated in the pathogenesis of proliferative glomerulonephritis (GN), including anti-glomerular basement membrane disease, anti-neutrophil cytoplasmic antibody-associated GN, lupus nephritis and immunoglobulin A nephropathy (IgAN)...
2016: Nephron
K I Danishyan, O A Soboleva, G M Galstyan, A V Zvereva, O M Sorkina
The paper describes 4 cases of laparoscopic splenectomy in pregnant women with immune thrombocytopenic purpura. No complications of surgery were noted in all the patients. The postoperative period was marked by sustained clinical and hematological remission that made it possible to discontinue prednisolone therapy and to ensure an uncomplicated course of pregnancy and labor.
2016: Terapevticheskiĭ Arkhiv
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