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Immune thrombocytopenic purpura

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https://www.readbyqxmd.com/read/28906353/immunomodulatory-treatments-for-persistent-and-chronic-immune-thrombocytopenic-purpura-a-prisma-compliant-systematic-review-and-meta-analysis-of-28-studies
#1
Emmanuelle Weber, Quitterie Reynaud, Romain Fort, Stéphane Durupt, Pascal Cathébras, Isabelle Durieu, Jean-Christophe Lega
BACKGROUND: Corticosteroid sparing is required in 15% to 40% of adults with persistent or chronic primary immune thrombocytopenic purpura (ITP). Herein, the efficacy of immunomodulatory drugs (dapsone, interferon alpha, danazol, and hydroxychloroquine as second-third-line therapies in ITP is investigated. METHODS: MEDLINE was searched for studies that included patients with persistent or chronic primary ITP and published before the end of December 2014. Two investigators independently extracted data regarding study design, patient characteristics, dosage schedule, time to response, and occurrence of adverse events...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28895035/splenectomy-vs-rituximab-as-a-second-line-therapy-in-immune-thrombocytopenic-purpura-a-single-center-experience
#2
Ahmed S Al Askar, Naila A Shaheen, Mohsen Al Zahrani, Mohammed G Al Otaibi, Bader S Al Qahtani, Faris Ahmed, Mohand Al Zughaibi, Ismat Kamran, May Anne Mendoza, Altaf Khan
Immune thrombocytopenic purpura (ITP) is a common hematological disease treated primarily by corticosteroids. The aim of the present study was to compare response rate between patients, underwent splenectomy vs. rituximab as second-line therapy. Adult patients diagnosed with ITP who did not respond to corticosteroids or relapsed during the period 1990-2014 were included in a quasi-experimental study. Categorical variables were compared using Fisher exact test. Response to treatment was compared using logistic regression...
September 11, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28893804/immune-thrombocytopenic-purpura-associated-with-fingolimod
#3
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/28882075/comparative-treatment-related-adverse-event-cost-burden-in-immune-thrombocytopenic-purpura
#4
Prina Z Donga, Sara P Bilir, Gregg Little, Tim Babinchak, Julie Munakata
AIMS: Real-world evidence on the safety profile and costs associated with immune thrombocytopenic purpura (ITP) treatment in adults is lacking. This study quantifies and compares adverse event (AE) crude rates and costs associated with ITP treatments as found in claims data. MATERIALS AND METHODS: A retrospective claims-based analysis was conducted using IMS Pharmetrics Plus database. Included patients were ≥18 years old, with a diagnosis of ITP (2007-2012); an ITP-related claim for anti-D, intravenous immunoglobulin (IVIG), rituximab, romiplostim, or eltrombopag; and 1-year continuous enrollment (3-years for rituximab) during follow-up...
September 8, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28875001/immune-thrombocytopenic-purpura-and-hemolytic-anemia-secondary-to-hepatitis-a
#5
Ghasem Miri-Aliabad, Somayeh Rashidi
Hepatitis A is common in children and usually is a self-limiting disease. Although extrahepatic and hematological immune manifestations following acute hepatitis A virus (HAV) infection have rarely been reported, they are frequently observed in other viral hepatitis. In this paper, we report the case of a 3-year-old girl who developed immune thrombocytopenic purpura (ITP) and hemolytic anemia after HAV infection. She was presented with malaise, pallor, ecchymosis, petechiae and purpura on the trunk and extremities...
April 1, 2017: International Journal of Hematology-oncology and Stem Cell Research
https://www.readbyqxmd.com/read/28871669/facilitated-subcutaneous-immunoglobulin-fscig-in-autoimmune-cytopenias-associated-with-common-variable-immunodeficiency
#6
Veronica Pedini, Isabella Savore, Giovanna Maria Danieli
BACKGROUND: Common variable immunodeficiency (CVID) is the most common symptomatic primary immune deficiency of adulthood. Besides recurrent infections, autoimmune disorders-mainly cytopenias-affect 30% of patients with CVID. OBJECTIVES: To describe the efficacy and safety of facilitated subcutaneous immunoglobulin (fSCIg), which is a combination of 10% [human] SCIg with recombinant human hyaluronidase for the treatment of CVID-linked cytopenias. METHODS: We describe four women (mean age 54 years) with CVID associated with idiopathic thrombocytopenic purpura (ITP) (n=3) and autoimmune hemolytic anemia (AIHA) (n=1)...
July 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28859046/wiskott-aldrich-syndrome-misdiagnosed-as-immune-thrombocytopenic-purpura-a-case-report
#7
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/28856973/the-impact-of-fc-gamma-receptor-iia-and-iiia-gene-polymorphisms-on-the-therapeutic-response-of-rituximab-in-egyptian-adult-immune-thrombocytopenic-purpura
#8
Hend N Ellithy, Salwa H Ahmed, Gehan H Shahin, Mervat M Matter, Mohamed Talatt
BACKGROUND: In chronic immune thrombocytopenic purpura (ITP), rituximab removes the harmful autoantibodies through antibody-dependent cellular cytotoxicity. The response to rituximab in ITP is variable; the effectiveness of rituximab is influenced by the process of activation of effector fragment C gamma receptors (FcγRs). Genetic factors may affect the response to rituximab. OBJECTIVES: The influence of FcγRIIa (H131R) and FcγRIIIa (V158F) gene polymorphisms on the response to rituximab in ITP...
August 31, 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/28803714/building-capacity-for-active-surveillance-of-vaccine-adverse-events-in-the-americas-a-hospital-based-multi-country-network
#9
Pamela Bravo-Alcántara, Silvia Pérez-Vilar, Helvert Felipe Molina-León, Miriam Sturkenboom, Steven Black, Patrick L F Zuber, Christine Maure, Jose Luis Castro
New vaccines designed to prevent diseases endemic in low and middle-income countries are being introduced without prior utilization in countries with robust vaccine pharmacovigilance systems. Our aim was to build capacity for active surveillance of vaccine adverse events in the Americas. We describe the implementation of a proof-of-concept study for the feasibility of an international collaborative hospital-based active surveillance system for vaccine safety. The study was developed and implemented in 15 sentinel sites located in seven countries of the region of the Americas, under the umbrella of the World Health Organization (WHO) Global Vaccine Safety Initiative...
August 10, 2017: Vaccine
https://www.readbyqxmd.com/read/28780041/quinine-induced-thrombotic-microangiopathy-a-report-of%C3%A2-19%C3%A2-patients
#10
Evaren E Page, Dustin J Little, Sara K Vesely, James N George
BACKGROUND: Quinine can cause diverse and severe immune-mediated adverse reactions, including thrombotic microangiopathy (TMA). Our objective was to describe the presenting features and long-term outcomes of patients with quinine-induced TMA. STUDY DESIGN: A case series of 19 patients with quinine-induced TMA treated with plasma exchange. SETTING & PARTICIPANTS: Patients with quinine-induced TMA initially suspected of having thrombotic thrombocytopenic purpura (TTP) were identified among patients enrolled in the Oklahoma TTP-Hemolytic Uremic Syndrome Registry...
August 3, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28770879/incidence-and-pattern-of-thrombocytopenia-in-cardiac-surgery-patients
#11
Mohammad Hamid, Mohammad Irfan Akhtar, Hamid Iqil Naqvi, Khalid Ahsan
OBJECTIVE: To observe the incidence and pattern of thrombocytopenia in cardiac surgery patients. METHODS: This prospective, cohort study was conducted at the Aga Khan University Hospital, Karachi, from November 2014 to April 2015, and comprised adult cardiac patients. Patients with platelet count less than 150,000 x 109/L, history of malignancy, immune thrombocytopenic purpura and on chemo or radiotherapy were excluded. All information including demographics, platelet count, heparin doses, total cardiopulmonary bypass time, cross-clamp time, blood products transfused, any thromboembolic complication and the presence of infection were recorded on a pre-designed proforma...
July 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28761351/alemtuzumab-a-review-of-efficacy-and-risks-in-the-treatment-of-relapsing-remitting-multiple-sclerosis
#12
REVIEW
Cristina Guarnera, Placido Bramanti, Emanuela Mazzon
Alemtuzumab is a selective humanized monoclonal antibody directed against the CD52 antigen, and has been found to be a powerful treatment for relapsing remitting multiple sclerosis. Alemtuzumab demonstrated high efficacy in several clinical studies. The risk of relapse and sustained accumulation of disability showed significant reduction in the Phase II CAMMS223 and the Phase III clinical trials CARE MS I and CARE MS II. The data presented at the 32nd Congress of the European Committee for Treatment and Research in Multiple Sclerosis confirmed these results...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28759473/novel-therapeutic-approaches-for-thrombotic-thrombocytopenic-purpura
#13
Yvette C Tanhehco, Gowthami Arepally, Ara Metjian
PURPOSE OF REVIEW: Acquired thrombotic thrombocytopenic purpura is an immune-mediated thrombotic microangiopathy caused by antibodies to ADAMTS13 (A Disintegrin And Metalloproteinase with a ThromboSpondin type 1 motif, member 13). Standard treatment with therapeutic plasma exchange and immunosuppression with steroids results in high remission and low mortality rates. However, a number of patients remain refractory to frontline therapy and/or experience multiple relapses. This study reviews emerging therapies for thrombotic thrombocytopenic purpura...
July 28, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28757383/indications-and-outcome-of-splenectomy-in-hematologic-disease
#14
S Bonnet, A Guédon, J-A Ribeil, F Suarez, J Tamburini, S Gaujoux
Splenectomy is part of the therapeutic arsenal for benign or malignant hematological disorders that constitute the main indication for elective splenectomy. With the development of minimally invasive approaches, and in particular, laparoscopy, as well as the advent of monoclonal antibody therapy, the indications and the outcomes of splenectomy for hematologic disease have changed in recent years. Nonetheless, splenectomy has its place in hemoglobinopathies and hemolytic diseases, improves thrombocytopenia in refractory immune thrombocytopenic purpura, can reverse sequelae linked to voluminous splenomegaly secondary to myelofibrosis, or can be used for diagnostic purposes or for splenomegaly in lymphoproliferative syndromes...
July 27, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28751567/the-adamts13-1239-1253-peptide-is-a-dominant-hla-dr1-restricted-cd4-t-cell-epitope
#15
Laurent Gilardin, Sandrine Delignat, Ivan Peyron, Mathieu Ing, Yu-Chun Lone, Bagirath Gangadharan, Baptiste Michard, Yousra Kherabi, Meenu Sharma, Anastas Pashov, Jean-Baptiste Latouche, Mohamad Hamieh, Olivier Toutirais, Pascale Loiseau, Lionel Galicier, Agnès Veyradier, Srini Kaveri, Bernard Maillère, Paul Coppo, Sébastien Lacroix-Desmazes
Acquired thrombotic thrombocytopenic purpura is a rare and severe disease characterized by auto-antibodies directed against "A Disintegrin And Metalloproteinase with Thrombospondin type 1 repeats, 13th member" (ADAMTS13), a plasma protein involved in hemostasis. The implication of CD4+ T cells in the pathogenesis of the disease is suggested by the IgG isotype of the antibodies. However, the nature of the CD4+ T-cell epitopes remains poorly characterized. Here, we determined the HLA-DR-restricted CD4+ T-cell epitopes of ADAMTS13...
July 27, 2017: Haematologica
https://www.readbyqxmd.com/read/28722150/lessons-in-the-diagnosis-and-management-of-immune-thrombocytopenic-purpura-in-children
#16
Catherine Cole
No abstract text is available yet for this article.
July 19, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28719512/a-pediatric-case-of-persistent-thrombocytopenia-in-a-patient-who-developed-all
#17
Haroon Shaukat, Jessica O'Mara, Michelle Neier
Inherited thrombocytopenia is a topic that was expanded greatly over the last decade and many new genes are being identified. However, inheritance patterns are not always easy to identify because sporadic cases from de novo mutations may in fact be more common. Few studies have assessed the relationship between thrombocytopenia and malignancies, specifically acute lymphoblastic leukemia (ALL). Here we present a pediatric case of persistent thrombocytopenia associated with T-cell ALL. Our patient was initially diagnosed with immune thrombocytopenic purpura with no evidence of malignancy on bone marrow biopsy but presented shortly after with ALL...
July 17, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28702343/eb-virus-reactivation-triggers-thrombotic-thrombocytopenic-purpura-in-a-healthy-adult
#18
Satoko Oka, Masaharu Nohgawa
Thrombotic thrombocytopenic purpura (TTP) is rare but life-threatening disease, characterized typically by microangiopathic hemolytic anemia (MAHA), profound peripheral thrombocytopenia and severe deficiency in the von Willebrand factor-cleaving prortease ADAMTS13. It has been reported that acquired immune TTP is closely associated with human immunodeficiency virus infection and influenza infection or vaccination. However, it has not been reported to be associated with Epstein Barr Virus infection or reactivation...
2017: Leukemia Research Reports
https://www.readbyqxmd.com/read/28698839/dapsone-therapy-for-immune-thrombocytopenic-purpura-old-but-still-unfamiliar
#19
EDITORIAL
Jaewoo Song
No abstract text is available yet for this article.
June 2017: Blood Research
https://www.readbyqxmd.com/read/28689597/other-extrahepatic-manifestations-of-hepatitis-c-virus-infection-pulmonary-idiopathic-thrombocytopenic-purpura-nondiabetes-endocrine-disorders
#20
REVIEW
Daniel Segna, Jean-François Dufour
Extrahepatic manifestations of hepatitis C virus (HCV) infection are a rare but serious condition. This article summarizes the current literature on the association between HCV and endocrine and pulmonary manifestations, as well as idiopathic thrombocytopenic purpura (ITP). HCV may directly infect extrahepatic tissues and interact with the immune system predisposing for obstructive and interstitial lung disease, ITP, autoimmune thyroiditis, infertility, growth hormone and adrenal deficiencies, osteoporosis, and potentially lung and thyroid cancers...
August 2017: Clinics in Liver Disease
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