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https://www.readbyqxmd.com/read/28432736/severe-primary-autoimmune-thrombocytopenia-itp-in-pregnancy-a-national-cohort-study
#1
A Care, S Pavord, M Knight, Z Alfirevic
OBJECTIVE: To quantify UK incidence of severe ITP in pregnancy, determine current treatment strategies and establish maternal and neonatal morbidity and mortality associated with severe ITP in pregnancy. DESIGN: A prospective national cohort study SETTING: United Kingdom POPULATION: Women with severe ITP; defined as platelets <50 x 10(9) /l in pregnancy or antenatal treatment of isolated low platelets. METHODS: Data collected via United Kingdom Obstetric Surveillance System (UKOSS) between 1(st) June 2013-31(st) January 2015 from all UK Consultant led obstetric units...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28428120/pathogenesis-of-immune-thrombocytopenia
#2
REVIEW
Sylvain Audia, Matthieu Mahévas, Maxime Samson, Bertrand Godeau, Bernard Bonnotte
Immune thrombocytopenia (ITP) is a rare autoimmune disease due to an abnormal T cell response, notably supported by splenic T follicular helper cells, that stimulates the proliferation and differentiation of autoreactive B cells. The antiplatelet autoantibodies they produce facilitate platelet phagocytosis by macrophages, essentially in the spleen. Macrophages contribute to the perpetuation of the auto-immune response as the main antigen-presenting cell during ITP. CD8(+) T cells also participate to thrombocytopenia by increasing platelet apoptosis...
April 17, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28424819/plasma-micrornas-characterising-patients-with-immune-thrombocytopenic-purpura
#3
Bin Zuo, Juping Zhai, Lifang You, Yunxiao Zhao, Jianfeng Yang, Zhen Weng, Lan Dai, Qingyu Wu, Changgeng Ruan, Yang He
Altered microRNA (miRNA) expression has been reported in patients with immune thrombocytopenic purpura (ITP). However, the detailed expression profiling of cell-free circulating miRNAs in ITP patients has not been fully investigated. In this study, we aimed to examine plasma miRNAs in ITP patients and evaluate their diagnostic values. Plasma samples from 74 ITP patients and 58 healthy controls were obtained and allocated into discovery, validation, and therapy-response sets. Initial screen with a miRNA microarray assay identified 23 miRNAs with different levels between ITP patients and healthy controls (>1...
April 20, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28419421/upregulation-of-cd72-expression-on-cd19-cd27-memory-b%C3%A2-cells-by-cd40l-in-primary-immune-thrombocytopenia
#4
Mingen Lyu, Yating Hao, Yang Li, Cuicui Lyu, Wenjie Liu, Huiyuan Li, Feng Xue, Xiaofan Liu, Renchi Yang
CD72 is a co-receptor of B cells and regulates B cell activation. Although aberrant expression of CD72 has been reported in primary immune thrombocytopenia (ITP), it is uncertain whether this aberrant expression is restricted to specific B cell subsets. Furthermore, the mechanisms that regulate CD72 expression are unknown. In this study, we found higher frequency of CD19(+) B cells, CD19(+) CD27(+) memory B cells and lower frequency of CD19(+) CD27(-) naive B cells in active ITP patients compared with controls and patients in remission...
April 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28416506/clinical-updates-in-adult-immune-thrombocytopenia-itp
#5
Michele P Lambert, Terry B Gernsheimer
Immune Thrombocytopenia (ITP) occurs in 2-4:100,000 adults and results in variable bleeding symptoms and thrombocytopenia. In the last decade changes in our understanding of the pathophysiology of the disorder have led to publication of new guidelines for the diagnosis and management of ITP, and standards for terminology. Current evidence supports alternatives to splenectomy for second line management of patients with persistently low platelet counts and bleeding. Long-term follow up data suggest both efficacy and safety, in particular for the thrombopoietin receptor agonists (TPO-RA) and the occurrence of late remissions...
April 17, 2017: Blood
https://www.readbyqxmd.com/read/28415913/characteristics-and-management-of-primary-and-other-immune-thrombocytopenias-spanish-registry-study
#6
Javier Palau, Esther Sancho, Magdalena Herrera, Sol Sánchez, María Eva Mingot, Rosa Isabel Upegui, Mª José Rodríguez Salazar, Fátima de la Cruz, Mª Cristina Fernández, Tomás José González López, José Julio Hernández, Eduardo Ríos, Mª Fernanda López-Fernández, Marta García, José-Ángel Hernández, Miguel A Sanz
BACKGROUND: The natural history and its modulation by treatments administered for immune thrombocytopenia (ITP) in the clinical practice remains unknown. In addition, little information is available on the characteristics and management of ITP in Spain. METHODS: We conducted an observational, multicenter, registry in 70 Hematology Services from Spain between 2009 and 2011, which included children from 2 months of age and adults with primary ITP or another ITP diagnosed within the last 6 months (platelet count [PC] < 100 × 10(9)/l)...
April 17, 2017: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/28413179/cyclic-thrombocytopenia-synchronizing-with-the-menstrual-cycle-showing-periodic-phases-of-thrombocytopenia-and-rebound-thrombocytosis
#7
Taro Kurihara, Masahiko Sumi, Hiroko Kaiume, Wataru Takeda, Takehiko Kirihara, Keijiro Sato, Toshimitsu Ueki, Yuki Hiroshima, Hikaru Kobayashi
A 37-year-old woman was admitted to our hospital for purpura involving the extremities and thrombocytopenia. Prednisolone (PSL) was administered based on a diagnosis of idiopathic thrombocytopenic purpura (ITP), but was not effective for maintaining her platelet count within the normal range, which showed cyclic fluctuation corresponding to the menstrual cycle. Therefore, we discontinued PSL, and cyclic thrombocytopenia (CTP) was diagnosed. CTP is a rare disease which is usually treated as ITP but with no response...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28412855/decreased-tlr4-expression-on-monocytes-may-cause-regulatory-t-cells-abnormality-in-patients-with-primary-immune-thrombocytopenia
#8
Yating Hao, Huiyuan Li, Yang Li, Mingen Lyu, Donglei Zhang, Rongfeng Fu, Yue Guan, Shixuan Wang, Boyang Sun, Xueqing Dou, Renchi Yang
Primary immune thrombocytopenia (ITP) is an autoimmune disease with many immune dysfunctions including T helper type 1 cell (Th1) polarization and regulatory T cells (Tregs) deficiency. This study aimed to determine the effects of TLR4 on Treg differentiation and the cytokine production of peripheral blood mononuclear cells (PBMCs) from patients with ITP. We found that expression of TLR4 on monocytes was significantly decreased in patients with active ITP than that in healthy controls and it had positive correlation with platelet count...
April 17, 2017: Autoimmunity
https://www.readbyqxmd.com/read/28409645/evaluation-of-platelet-function-in-thrombocytopenia
#9
Mette Tiedemann Skipper, Peter Rubak, Jesper Stentoft, Anne-Mette Hvas, Ole Halfdan Larsen
Whole blood aggregometry is a functional assay for determination of platelet function. Until now, whole blood aggregometry has not been considered feasible at low platelet counts. Hence, the objectives of the present study were to explore platelet function in thrombocytopenia using a novel index of impedance aggregometry adjusted for platelet count and evaluate the association to platelet function assessed by flow cytometry. Hirudin anticoagulated blood was collected from 20 healthy volunteers, 20 patients with primary immune thrombocytopenia (ITP), and 17 hematological cancer patients...
April 14, 2017: Platelets
https://www.readbyqxmd.com/read/28408804/spotlight-on-romiplostim-in-the-treatment-of-children-with-chronic-immune-thrombocytopenia-design-development-and-potential-place-in-therapy
#10
REVIEW
David Buchbinder, Diane Nugent, Loan Hsieh
Primary immune thrombocytopenia (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia. In approximately one-third of cases, the duration of thrombocytopenia will extend beyond 12 months consistent with a diagnosis of chronic ITP. Minor bleeding manifestations are common in chronic ITP while severe or life-threatening bleeding complications are uncommon. Moreover, spontaneous resolution occurs in the majority of children with chronic ITP necessitating treatment in only those children with ongoing bleeding manifestations or impairment in health-related quality of life (HRQOL)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28403679/levofloxacin-induced-acute-immune-mediated-thrombocytopenia-of-rapid-onset
#11
Andrew W Shih, Andy S Lam, Theodore E Warkentin
Drug-induced immune thrombocytopenia (D-ITP) typically occurs after the patient has been receiving the implicated drug for at least 1 week, due to newly forming drug-dependent antibodies ("typical-onset" D-ITP). A "rapid-onset" form of D-ITP can occur when previous sensitization has occurred, where antibodies have thus already been formed, and a precipitous platelet count fall occurs upon reexposure. Typical-onset D-ITP has been reported after levofloxacin, but the rapid-onset form with a well-documented previous exposure has not been described...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28397467/increase-of-c3a-is-associated-with-hemorrhagic-propensity-in-patients-with-immune-thrombocytopenia
#12
Jian Ge, Lihong Wang, Jing Li, Yan Hu, Qianfei Xu, Yang Chen, Ruiqin Hou, Min Ruan, Ruixiang Xia, Qingshu Zeng
BACKGROUND: Complement activation is critically involved in multiple autoimmune diseases. Immune thrombocytopenia (ITP) is a hemorrhagic condition with enhanced platelet clearance caused by antiplatelet autoantibodies. However, the roles of complements C3a, C5a, and soluble C5b-9 (sC5b-9) in the hemorrhage of ITP remain unknown. METHODS: Plasma C3a, C5a, and sC5b-9 levels in ITP patients were measured by enzyme-linked immunosorbent assay (ELISA). Antiplatelet autoantibodies (anti-GPIIb/IIIa and anti-GPIbα) were evaluated by modified monoclonal antibody immobilization of platelet antigen (MAIPA) assay...
April 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28395447/-quantity-of-treg-cells-and-th17-cells-in-spleen-of-primary-immune-thrombocytopenic-purpura-patients
#13
Y Y Yang, F Q Zhang, Y Pan, F Chen, M J Huang, D Y Zeng, H G Huang
Objective: To observe the quantity of Treg cells and Th17 cells in spleen of adult primary immune thrombocytopenic purpura (ITP) patients. Methods: 43 ITP cases with splenectomy treatment were enrolled from December 2008 to June 2016 at Union Hospital of Fujian Medical University, including 20 males and 23 females with a median age of 36 (18-76) years. The controls were thirty patients who underwent splenectomy because of pancreatic diseases or splenic impairment, including 21 males and 9 females with a median age of 47 (21-69) years...
March 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/28395446/-tryptophan-metabolism-in-patients-with-primary-immune-thrombocytopenia-with-high-dose-of-dexamethasone
#14
Z J Li, X Q Liu, J Q Xu, Y H Liu, L M Chen, X X Chu
Objective: To test whether the tryptophan metabolism was abnormal in newly diagnosed ITP patients as well as in these patients after treatment with dexamethasone. Methods: Newly diagnosed patients with ITP between Jan 2014 and May 2015 were enrolled, including 14 females and 11 males, with a median age of 57 years and a median PLT count of 16 (0-32) ×10(9)/L. All patients were treated with oral dexamethasone. The expression levels of IDO mRNA and TTS mRNA in peripheral blood mononuclear cells (PBMC) were analyzed by real-time quantitative polymerase chain reaction...
March 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/28378905/measurements-of-immature-platelets-with-haematology-analysers-are-of-limited-value-to-separate-immune-thrombocytopenia-from-bone-marrow-failure
#15
Annalina Cybulska, Lisa Meintker, Jürgen Ringwald, Stefan W Krause
Detection of immature platelets in the circulation may help to dissect thrombocytopenia due to platelet destruction from bone marrow failure (BMF). We prospectively tested the predictive value of immature platelets, measured as immature platelet fraction (IPF) on the XE-5000 (Sysmex, Kobe, Japan) or percentage of reticulated platelets (rPT) on the CD Sapphire (Abbott Diagnostics, Santa Clara, CA, USA) to separate immune thrombocytopenia (ITP) from BMF (leukaemia, myelodysplastic syndrome, aplastic anaemia)...
April 5, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28370250/using-a-standardised-protocol-was-effective-in-reducing-hospitalisation-and-treatment-use-in-children-with-newly-diagnosed-immune-thrombocytopenia
#16
R Labrosse, M Vincent, U-P Nguyen, C Chartrand, L Di Liddo, Y Pastore
AIM: Childhood immune thrombocytopenia (ITP) has been associated with low bleeding rates and a high frequency of spontaneous remission. Although current guidelines suggest that most patients are just observed, children still receive platelet-enhancing therapy for fear of bleeding complications. We hypothesised that a standardised protocol with a step-down approach would reduce hospitalisation and treatment use. METHOD: A retrospective chart review was performed on patients diagnosed with acute ITP between January 2010 and December 2014, before (n=54) and after (n=37) the standardised protocol was introduced in January 2013...
March 31, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28352325/analysis-of-clinical-effects-and-mechanism-of-recombinant-human-interleukin-11-with-glucocorticoids-for-treatment-of-idiopathic-thrombocytopenic-purpura
#17
Xifeng Wu, Lijuan Wang, Lin Sun, Tantan Li, Xuehong Ran
The aim of the present study was to evaluate the effectiveness and safety of recombinant human interleukin-11 (IL-11) with glucocorticoids for treatment of adult idiopathic thrombocytopenic purpura (ITP) and the regulatory effect on immune mechanisms. A total of 80 patients with initial diagnosis of ITP admitted to our hospital were selected. Patients were randomly divided into the control group and observation group, with 40 cases each. The control group received glucocorticoids treatment, and the observation group received IL-11 and glucocorticoids...
February 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28343991/ftransdermal-iontophoretic-delivery-of-lysine-proline-valine-kpv-peptide-across-microporated-human-skin
#18
Kasturi Pawar, Chandra S Kolli, Vijaya K Rangari, R Jayachandra Babu
Lysine-Proline-Valine (KPV) is a C-terminal peptide fragment of α-MSH with potent anti-inflammatory properties. Current study investigates various transdermal enhancement strategies such as iontophoresis (ITP), microneedles (MN) and their combination (ITP+MN) on KPV delivery across dermatomed human skin. KPV attains a positive charge at pH below 7.0, thus anodal ITP was employed. The influence of current strength, KPV concentration, and duration of current application on the KPV delivery was investigated. At defined ITP parameters, the influence of MN on KPV delivery (ITP+MN) across skin was also determined...
March 23, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28338930/expath-tool-a-system-for-comprehensively-analyzing-regulatory-pathways-and-coexpression-networks-from-high-throughput-transcriptome-data
#19
Han-Qin Zheng, Nai-Yun Wu, Chi-Nga Chow, Kuan-Chieh Tseng, Chia-Hung Chien, Yu-Cheng Hung, Guan-Zhen Li, Wen-Chi Chang
Next generation sequencing (NGS) has become the mainstream approach for monitoring gene expression levels in parallel with various experimental treatments. Unfortunately, there is no systematical webserver to comprehensively perform further analysis based on the huge amount of preliminary data that is obtained after finishing the process of gene annotation. Therefore, a user-friendly and effective system is required to mine important genes and regulatory pathways under specific conditions from high-throughput transcriptome data...
March 13, 2017: DNA Research: An International Journal for Rapid Publication of Reports on Genes and Genomes
https://www.readbyqxmd.com/read/28331458/immune-thrombocytopenia-and-obesity-predictive-relationship
#20
Ehab Hanafy, Mohammed Al Pakra
BACKGROUND: Chronic refractory immune thrombocytopenia (ITP) is defined as the failure of any modality to maintain the platelet count above 20 × 10(3)/μL for an appreciable time without unacceptable toxicity. To date, certain predictive factors have been associated with refractory ITP. However, none of the published studies has declared the possible association between obesity and refractory ITP. CASE REPORTS: We present the cases of 3 children with ITP who failed to achieve remission on different therapeutic approaches including rituximab, vincristine, and romiplostim...
2017: Ochsner Journal
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