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Itp splenectomy

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https://www.readbyqxmd.com/read/29665925/-expression-of-hmgb1-in-spleen-of-adult-patients-with-chronic-and-refractory-immune-thrombocytopenia-and-its-significance
#1
Peng-Feng Yang, Guo-Yang Zhang, Hong-Yun Liu, Shuang-Feng Xie, Xiu-Ju Wang, Xiao-Yan Liu, Jue Wang, Xin-Yuan Chen, Shuo Yang, Li-Ping Ma
OBJECTIVE: To investigate the expression and clinical significance of high mobility group box 1(HMGB1) in spleen of adult patients with chronic and refractory immune thrombocytopenia(ITP). METHODS: Twenty chronic and refactory ITP patients received splenectomy were enrolled in ITP group and 20 cases of traumatic spleen rupture were enrolled in control group. The splenectomy efficacy in ITP patients was analyzed retrospectively. The HMGB1 expression in spleen tissue was detected by immunohistochemistry, and the correlation between different expression levels of HMGB1 and splenectomy efficacy were analysed...
April 2018: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/29659042/physician-decision-making-in-selection-of-second-line-treatments-in-immune-thrombocytopenia-in-children
#2
Rachael F Grace, Jenny M Despotovic, Carolyn M Bennett, James B Bussel, Michelle Neier, Cindy Neunert, Shelley E Crary, Yves D Pastore, Robert J Klaassen, Jennifer A Rothman, Kerry Hege, Vicky R Breakey, Melissa J Rose, Kristin A Shimano, George R Buchanan, Amy Geddis, Kristina M Haley, Adonis Lorenzana, Alexis Thompson, Michael Jeng, Ellis J Neufeld, Travis Brown, Peter W Forbes, Michele P Lambert
Immune thrombocytopenia (ITP) is an acquired autoimmune bleeding disorder which presents with isolated thrombocytopenia and risk of hemorrhage. While most children with ITP promptly recover with or without drug therapy, ITP is persistent or chronic in others. When needed, how to select second-line therapies is not clear. ICON1, conducted within the Pediatric ITP Consortium of North America (ICON), is a prospective, observational, longitudinal cohort study of 120 children from 21 centers starting second-line treatments for ITP which examined treatment decisions...
April 16, 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/29650916/-a-case-of-sigmoid-colon-cancer-with-idiopathic-thrombocytopenic-purpura
#3
Kingo Kashimoto, Kenichiro Fukuda, Yosuke Kamada, Nobuki Yamaoka
An 80-year-old man reported at our hospital with the chiefcomplaint ofconstipation. He was diagnosed with sigmoid colon cancer(T4aN0M0, Stage II). He also had steroid-resistant idiopathic thrombocytopenic purpura(ITP)since 2001. After a high dose g-globulin therapy, he underwent sigmoidectomy and splenectomy simultaneously because ofthe steroidresistant ITP. While some reports suggest that ITP is dominant when it occurs with blood cancer, others suggest that it can be immunologically dominant even when it occurs with solid tumors...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29629225/igg4-related-disease-in-the-stomach-which-was-confused-with-gastrointestinal-stromal-tumor-gist-two-case-reports-and-review-of-the-literature
#4
Ho Seok Seo, Yoon Ju Jung, Cho Hyun Park, Kyo Young Song, Eun Sun Jung
Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibro-inflammatory disorder characterized by specific pathological findings and elevated serum IgG4 level. IgG4-RD in the stomach is rare, and occasionally diagnosed as gastric subepithelial tumor (SET) by endoscopy or computed tomography scan. Two female patients in the age group of 40-50 years were diagnosed with 4 cm sized gastric SET. One underwent laparoscopic gastric wedge resection. Another one had a history of subtotal gastrectomy for early gastric cancer and idiopathic thrombocytopenic purpura with oral steroids administration...
March 2018: Journal of Gastric Cancer
https://www.readbyqxmd.com/read/29554892/immune-thrombocytopenic-purpura-presenting-in-a-patient-after-renal-transplant-for-diabetic-nephropathy
#5
Raja Muhammad Rashid, Zahid Nabi, Ahmad Zaki Ansari, Quratul-Ain Qaiser
BACKGROUND: Immune thrombocytopenic purpura (ITP) is primarily characterized by immune-mediated destruction of platelets in circulation. Major treatment options range from careful observation, steroids, immunosuppressive medications, immunoglobulins to splenectomy. Interestingly and rarely, ITP has also been reported after solid organ transplantation in patients receiving immunosuppressive medications. While the incidence of new onset ITP after solid organ transplant is comparatively well documented, new onset ITP after renal transplant has only been reported in two patients...
March 20, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29545407/splenectomy-in-itp
#6
(no author information available yet)
No abstract text is available yet for this article.
March 15, 2018: Blood
https://www.readbyqxmd.com/read/29533410/patient-was-wrongly-diagnosed-and-repeatedly-treated-for-immune-thrombocytopenia-for-50-years
#7
Honar Cherif, Andreas Greinacher, Norbert Lubenow
We report on a patient with inherited macrothrombocytopenia, MYH9 related disease (MYH9-RD). The patient was wrongly diagnosed and repeatedly treated for immune thrombocytopenia (ITP) for nearly 50 years. Cases of misdiagnosed MYH9-RD and other hereditary thrombocytopenias have been described previously. Typical clinical features such as renal failure and/or progressive loss of hearing should give grounds to suspect hereditary thrombocytopenia. Initial laboratory diagnosis can start with a simple blood smear followed by immunohistochemistry and genotyping...
March 13, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29481990/20-years-experience-with-laparoscopic-splenectomy-single-center-outcomes-of-a-cohort-study-of-500-cases
#8
Dorota Radkowiak, Anna Zychowicz, Anna Lasek, Michał Wysocki, Piotr Major, Michał Pędziwiatr, Piotr Budzyński, Jan Kulawik, Andrzej Budzyński
BACKGROUND: Laparoscopic splenectomy (LS) has become the gold standard in elective spleen surgery. Although it is considered relatively safe, treatment results vary depending on a hospital's profile and the experience of the surgeon and center. We would like to present experience of a high-volume referral center with minimally invasive operations of the spleen. MATERIAL AND METHODS: The retrospective cohort study included consecutive patients undergoing laparoscopic splenectomy in tertiary referral surgical center in 1998-2017...
February 23, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29479668/a-critical-appraisal-of-the-evidence-for-the-role-of-splenectomy-in-adults-and-children-with-itp
#9
REVIEW
Francesco Rodeghiero
In primary chronic immune thrombocytopenia, long-term response to splenectomy, with 60% of patients enjoying a treatment-free life, is higher when compared with rituximab and similar to that with continuous thrombopoietin-receptor agonists (TPO-RA) administration. Splenectomy should continue to be offered to patients failing initial treatments in the absence of increased surgery-related risks. The higher lifelong safety concerns with splenectomy (increased risk of infection, shared in part with rituximab, and of thrombosis, in common with TPO-RA) and a mortality <1-2%, justify postponing surgery to the chronic phase, when spontaneous remissions are rarer...
February 26, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29332223/long-term-efficacy-of-partial-splenic-embolization-for-the-treatment-of-steroid-resistant-chronic-immune-thrombocytopenia
#10
Emi Togasaki, Naomi Shimizu, Yuhei Nagao, Chika Kawajiri-Manako, Ryoh Shimizu, Nagisa Oshima-Hasegawa, Tomoya Muto, Shokichi Tsukamoto, Shio Mitsukawa, Yusuke Takeda, Naoya Mimura, Chikako Ohwada, Masahiro Takeuchi, Emiko Sakaida, Tohru Iseki, Hideyuki Yoshitomi, Masayuki Ohtsuka, Masaru Miyazaki, Chiaki Nakaseko
Thrombopoietin-receptor agonists have been recently introduced for a second-line treatment of immune thrombocytopenia (ITP). Splenectomy has tended to be avoided because of its complications, but the response rate of splenectomy is 60-80% and it has still been considered for steroid-refractory ITP. We performed partial splenic embolization (PSE) as an alternative to splenectomy. Between 1988 and 2013, 91 patients with steroid-resistant ITP underwent PSE at our hospital, and we retrospectively analyzed the efficacy and long-term outcomes of PSE...
April 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29297977/the-association-between-idiopathic-thrombocytopenic-purpura-and-cardiovascular-disease-a-retrospective-cohort-study
#11
J S Chandan, T Thomas, S Lee, T Marshall, B Willis, K Nirantharakumar, P Gill
Essentials We estimated the cardiovascular risk of patients with idiopathic thrombocytopenic purpura (ITP). The risk of cardiovascular disease was 38% higher in ITP patients compared with controls. Among the ITP patients, splenectomy was associated with higher cardiovascular disease. Clinicians should consider cardiovascular risk when managing ITP patients. SUMMARY: Background Idiopathic thrombocytopenic purpura (ITP) is classically characterized by a transient or persistent decrease of platelet count...
March 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29295846/splenectomy-for-immune-thrombocytopenia-down-but-not-out
#12
REVIEW
Shruti Chaturvedi, Donald M Arnold, Keith R McCrae
Splenectomy is an effective therapy for steroid-refractory or dependent immune thrombocytopenia (ITP). With the advent of medical alternatives such as rituximab and thrombopoietin receptor antagonists, the use of splenectomy has declined and is generally reserved for patients that fail multiple medical therapies. Splenectomy removes the primary site of platelet clearance and autoantibody production and offers the highest rate of durable response (50% to 70%) compared with other ITP therapies. However, there are no reliable predictors of splenectomy response, and long-term risks of infection and cardiovascular complications must be considered...
March 15, 2018: Blood
https://www.readbyqxmd.com/read/29243329/thrombopoietin-receptor-agonists-in-patients-with-persistent-or-chronic-immune-thrombocytopenia
#13
Jacopo Agnelli Giacchello, Federica Valeri, Mario Boccadoro, Alessandra Borchiellini
OBJECTIVES: To assess long-term treatment patterns and outcomes in patients with persistent or chronic immune thrombocytopenia (ITP), also considering the impact of the treatment with thrombopoietin receptor agonists (TPO-RAs) prior to splenectomy. METHODS: Medical records of all patients with persistent or chronic ITP seen at our institution between January 1985 and December 2016 were reviewed. Data on demographic and clinical characteristics were analyzed using descriptive statistics...
March 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29200102/adult-primary-immune-thrombocytopenia-spleen-histology-findings-and-outcomes-according-to-rituximab-use-based-on-analysis-of-41-cases
#14
Adeline Furudoï, Étienne Rivière, Estibaliz Lazaro, Enio Furudoï, Jean-François Viallard, Marie Parrens
Immune thrombocytopenia (ITP) is an acquired antibody-mediated disease, for which splenectomy remains a curative treatment. We analyzed histology and phenotypes of ITP-splenectomy specimens from 41 adult patients, with different previous ITP-specific treatments, including B-cell-depleting rituximab (RTX) or not, in an attempt to predict splenectomy success or failure on the basis of day 56 postoperative platelet counts. RTX-naive ITP-spleen samples, compared with those from a 20-patient control trauma cohort, contained the following nonspecific, ITP-evocative, white-pulp lesions: follicular helper T-cell (programmed death-1 and inducible T-cell COStimulator) expansion in reactive follicles (P=0...
March 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29188582/a-low-birth-weight-infant-with-no-malformations-delivered-by-a-primary-immune-thrombocytopenia-patient-treated-with-eltrombopag
#15
Naruko Suzuki, Junji Hiraga, Yumi Hariyama, Yusuke Takagi, Haruhiko Ohashi, Yasuyuki Kishigami, Hidenori Oguchi, Yoshitoyo Kagami
Primary immune thrombocytopenia (ITP) is defined by a low platelet count secondary to antibody-mediated platelet destruction or reductions in platelet production. Although eltrombopag is a thrombopoietin receptor agonist that increases platelet production in refractory or relapsed ITP, the influence on pregnancy is limited. We present the case of a pregnant 25-year-old ITP patient referred to our hospital with a history of two induced abortions. After eradication of Helicobacter pylori and with oral prednisolone at 8 mg/day, platelet count remained below 10,000/µl...
November 29, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/29101508/a-sticky-situation-myocardial-infarction-in-a-young-woman-with-immune-thrombocytopenia-on-eltrombopag-and-a-history-of-mediastinal-radiation
#16
Jennifer Teichman, Ahmed Taher, Abdulaziz Hashi, Akshay Bagai, Michelle Sholzberg
More recent immune thrombocytopenia (ITP) treatment strategies enhance platelet production with the use of thrombopoietin receptor agonists (TPO-RA) such as eltrombopag. Patients receiving TPO-RA agents may be at an increased risk of thromboembolism, however the pathophysiology and common underlying risk factors are not well understood. We present the case of a young asplenic woman on eltrombopag for chronic ITP with acute myocardial infarction involving the right coronary artery. Past medical history was significant for remote mediastinal radiation for lymphoma and splenectomy for ITP...
January 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29090586/diagnosis-and-treatment-of-myh9-rd-in-an-australasian-cohort-with-thrombocytopenia
#17
David J Rabbolini, Yenna Chun, Maya Latimer, Shinji Kunishima, Kathleen Fixter, Bhavia Valecha, Peter Tan, Lee Ping Chew, Benjamin T Kile, Rachel Burt, Kottayam Radhakrishnan, Robert Bird, Paul Ockelford, Sara Gabrielli, Qiang Chen, William S Stevenson, Christopher M Ward, Marie-Christine Morel-Kopp
MYH9-related disorders (MYH9-RDs) caused by mutation of the MYH9 gene which encodes non-muscle myosin heavy-chain-IIA (NMMHC-IIA), an important motor protein in hemopoietic cells, are the most commonly encountered cause of inherited macrothrombocytopenia. Despite distinguishing features including an autosomal dominant mode of inheritance, giant platelets on the peripheral blood film accompanied by leucocytes with cytoplasmic inclusion bodies (döhle-like bodies), these disorders remain generally under-recognized and often misdiagnosed as immune thrombocytopenia (ITP)...
November 1, 2017: Platelets
https://www.readbyqxmd.com/read/29075074/percentage-of-memory-b-lymphocytes-and-regulatory-t-lymphocytes-in-peripheral-blood-are-low-but-not-predictive-of-therapy-outcomes-in-newly-diagnosed-adult-patients-with-primary-immune-thrombocytopenia
#18
Mustafa Yilmaz, Semiha Ayhan
Although changes in the number and function of regulatory T lymphocytes have been reported in primary immune thrombocytopenia (ITP), no study has investigated whether quantification of these cell types in peripheral blood could be used as early predictive marker of treatment outcome. And, it is not clear whether any change occurs in peripheral blood memory B lymphocyte levels in ITP. Hence, the aim of this study was to investigate the percentage of regulatory T lymphocytes and memory B lymphocytes in peripheral blood of ITP patients compared to controls, and also examine whether these levels have any significant predictive value for therapy outcome...
December 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/29075071/low-dose-rituximab-in-chronic-itp-still-an-option-in-resource-limited-settings
#19
Rajan Kapoor, Rajiv Kumar, M Mahapatra, H P Pati, Suman Kumar Pramanik
The etiology of ITP remains unknown but its pathogenesis consists of loss of tolerance to platelet antigens. There is a complex dysregulation of the immune system involving both the B cells and the T cells. Splenectomy is the standard second line option in steroid refractory chronic ITP patients. However, costs of surgery and reluctance for surgery in severely thrombocytopenic patients on part of surgeons are major obstacles in resource limited settings. Rituximab has been used in both the standard doses of 375 mg/m(2) and low doses of 100 mg/m(2) with similar results...
December 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/29042367/safety-and-efficacy-of-long-term-treatment-of-chronic-persistent-itp-with-eltrombopag-final-results-of-the-extend-study
#20
Raymond S M Wong, Mansoor N Saleh, Abderrahim Khelif, Abdulgabar Salama, Maria Socorro O Portella, Paul Burgess, James B Bussel
In phase 2/3 trials, eltrombopag treatment of 6 months or less in patients with chronic/persistent immune thrombocytopenia (ITP) increased platelet counts and reduced bleeding. The open-label EXTEND study evaluated long-term safety and efficacy of eltrombopag in adults with ITP who had completed a previous eltrombopag study. For the 302 patients enrolled, median duration of eltrombopag treatment was 2.37 years (2 days-8.76 years). Median platelet counts increased to 50 × 109 /L or more by week 2 and were sustained throughout the treatment period...
December 7, 2017: Blood
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