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itp review

Sabah Saqib, Rizwan Sultan, Hasnain Zafar
Immune thrombocytopenia purpura (ITP) may need splenectomy after failure of medical treatment. The aim of this study was to explore the outcome of splenectomy in chronic ITP and to point out factors which can predict better response to splenectomy. This retrospective chart review was conducted at the Aga Khan University Hospital, Karachi, and comprised adult patients who underwent splenectomy for ITP from October 2005 to December 2015. Of the 51 patients, 37(72.5%) were females and 14(27.5%) were males. The overall median age was 32 years (interquartile range: 18-65 years)...
October 2016: JPMA. the Journal of the Pakistan Medical Association
Francisco Socola, Giovanni Insuasti-Beltran, Rodolfo Henrich Lobo, Shebli Atrash, Appalanaidu Sasapu
We report the case of a young African American male with no significant past medical history presenting with low back and bilateral leg pain; presenting CBC and chemistries revealed elevated white blood cell count of 250,000, with anemia (Hb 6.8 g/dL) and thrombocytopenia (platelets 9 K/μL), and elevated LDH, 1008. Physical examination findings were notable for diffuse lymphadenopathy and lower extremity skin nodules. Interestingly the bone marrow biopsy revealed involvement by CLL/SLL with translocation (2;14)(p16;q32) and trisomy 12...
2016: Case Reports in Oncological Medicine
Jacquelyn Zimmerman, Kelly J Norsworthy, Robert Brodsky
Immune thrombocytopenic purpura (ITP) causes thrombocytopenia through the autoimmune destruction of platelets. Corticosteroids remain the first line of therapy, and traditionally splenectomy has been the second. While the availability of thrombopoietin receptor agonists (TPO-RAs) has expanded treatment options, there is little data for the ideal management of these agents in preparation for splenectomy. Thrombocytosis has been reported after splenectomy in patients treated with TPO-RA preoperatively, with one prior case requiring plateletpheresis for symptomatic thrombocytosis...
2016: Case Reports in Hematology
Rita Consolini, Annalisa Legitimo, Maria Costanza Caparello
The natural history of the immune thrombocytopenia (ITP) is interesting and intriguing because it traces different steps underlying autoimmune diseases. The review points out the main steps that have accompanied the stages of its history and the consequential changes related to its terminology. ITP is an autoimmune disease resulting from platelet antibody-mediated destruction and impaired megakaryocyte and platelet production. However, research advances highlight that a complex dysregulation of the immune system is involved in the pathogenesis of this condition...
2016: Frontiers in Pediatrics
Moonhwan Kim, Keun Myoung Park, Woo Young Shin, Yun-Mee Choe, Keon-Young Lee, Seung-Ik Ahn
Splenectomy is the definitive second-line therapy for refractory immune thrombocytopenic purpura (ITP), and has a reported response rate of 50-80%. Medical attention should be reconsidered when there is no evidence of accessory spleen in refractory ITP patients after splenectomy. The purpose of this study was to determine whether platelet count evolution differs between patients with a successful or unsuccessful result after splenectomy for ITP. Archived records of 104 consecutive patients that underwent splenectomy for ITP were reviewed...
October 27, 2016: International Journal of Hematology
Ling-Ling Fu, Run-Hui Wu
Immune thrombocytopenia (ITP) is the most common immune-mediated acquired bleeding disorders in children. The prognosis of majority of these patient are well, with recent complete remission. However, a few patients are facing the risk of bleeding since they do not respond to the first-line therapy, and need second-line therapy. The present second-line treatments are difficult to be popularized due to their efficacy, side-effects, costs and some other factors. The pulsed high-dose dexamethasone (HDD) therapy with its good effect, small adverse effects and low cost in adults has been used as the first-line therapy in newly diagnosed ITP, which now has attracted the attention of pediatricians...
October 2016: Zhongguo Shi Yan Xue Ye Xue za Zhi
Q A Hill, L C Harrison, A D Padmakumar, R G Owen, K R Prasad, G F Lucas, P Tachtatzis
OBJECTIVE AND IMPORTANCE: Transplantation-mediated alloimmune thrombocytopenia (TMAT) occurs when leukocytes transferred in a donor organ from a patient with immune thrombocytopenia (ITP), mount a response against recipient platelets. We present the first fatal case of TMAT following liver transplantation and review its aetiology and treatment. CLINICAL PRESENTATION: The liver donor had ITP and died from an intracranial haemorrhage. The recipient platelet count fell to 2 × 10(9)/l on post-operative day 2...
October 21, 2016: Hematology (Amsterdam, Netherlands)
George Vaos, Elpis Mantadakis, Stefanos Gardikis, Michael Pitiakoudis
We present a 7-year-old boy with recurrent thrombocytopenia after primary laparoscopic splenectomy for immune thrombocytopenia (ITP). Imaging modalities (ultrasound, computed tomography scan, and scintigraphy) revealed two accessory spleens while the subsequent second laparoscopy revealed 11, which were successfully removed. The relevant medical literature is reviewed, and the value of laparoscopy for chronic ITP is highlighted.
October 2016: Journal of Indian Association of Pediatric Surgeons
María Perera, Teresa Garrido
OBJECTIVES: Classically, immune thrombocytopenia (ITP) was thought to be caused by the destruction and insufficient production of platelets, as mediated by autoantibodies. More recently other immune mechanisms that contribute to the disease have been discovered. This review attempts to address the main unresolved questions in ITP. METHODS: We review the most current knowledge of the pathophysiology of ITP. Immunological effects of available therapies are also described...
September 27, 2016: Hematology (Amsterdam, Netherlands)
S Christopher N Frontario, Anna Goldenberg-Sandau, Darshan Roy, Roy Sandau
Angiosarcoma of the spleen is a rare malignancy that arises from vascular endothelial origin. This neoplasm is highly malignant and diagnosis is often delayed due to the vague presentation of clinical symptoms. A case report and concise review of the current diagnostic criteria and surgical treatment are provided to aid in the detection and treatment of this malignancy. We present a case of a 56-year-old female who presented with massive splenomegaly secondary to angiosarcoma of the spleen. The patient suffered from longstanding symptomatic anemia and thrombocytopenia...
2016: Case Reports in Surgery
Emmanuel J Favaloro
von Willebrand Disease (VWD) is the most common inherited bleeding disorder and also arises as an acquired defect (AVWS). VWD and AVWS are due to quantitative deficiencies and/or qualitative defects in von Willebrand factor (VWF), an adhesive plasma protein with multiple activities. Diagnosis of VWD is problematic, being subject to overdiagnosis, underdiagnosis, and misdiagnosis. This is largely due to limitations in current test procedures and an over-reliance on these imperfect test systems for clinical diagnosis...
September 13, 2016: American Journal of Hematology
Valentina Llovet, Gabriel Rada
Helicobacter pylori infection has been implicated as trigger or disease modifier in immune thrombocytopenia (ITP). So, eradication treatment for this agent could have clinical benefits. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified four systematic reviews comprising 40 studies addressing the question of this article overall, including one randomized controlled trial. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach...
2016: Medwave
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
Thirachit Chotsampancharoen, Pornpun Sripornsawan, Sarapee Duangchoo, Malai Wongchanchailert, Edward McNeil
BACKGROUND: Initial clinical factors that can reliably predict a successful within-1-year resolution of childhood immune thrombocytopenia (ITP) are still unclear. This study aimed to determine factors associated with within-12-month resolution of newly diagnosed childhood ITP. METHODS: The hospital records of 417 consecutive children aged less than 15 years with ITP were reviewed retrospectively and data related to the initial presentation were noted. Logistic regression analysis was used to determine which presenting features were associated with a favorable outcome within 12 months...
August 30, 2016: Pediatric Blood & Cancer
Elisabetta Goni, Francesco Franceschi
During the past year, many articles were published on the extragastric diseases related to Helicobacter pylori infection. This supports the theory that some microorganisms may cause diseases even far from the primary site of infection by interfering with different biologic processes. The role of H. pylori on idiopathic thrombocytopenic purpura, sideropenica anemia, and vitamin B12 deficiency is well known. On the other hand, there is a growing interest in the bacterium's association with cardiovascular, neurologic, hematologic, dermatologic, head and neck, and uro-gynecologic diseases, as well as diabetes mellitus and metabolic syndrome, with very promising results...
September 2016: Helicobacter
Jose Perdomo
Romiplostim is a thrombopoietin receptor agonist (TPO-RA) used for the treatment of adult primary immune thrombocytopenia (ITP). ITP is an autoimmune condition characterized by low platelet counts due to increased destruction and reduced platelet production. First-line interventions include corticosteroids, anti-D, and intravenous immunoglobulins, while second-line therapies comprise splenectomy, rituximab, cyclosporine A, and TPO-RAs. The recognition that compromised platelet production is a critical part of the pathogenesis of ITP prompted the development of therapeutic strategies based on the stimulation of the TPO receptor...
2016: ImmunoTargets and Therapy
Anthony P Y Liu, Daniel K L Cheuk, Ana H Y Lee, Pamela P W Lee, Alan K S Chiang, S Y Ha, W C Tsoi, Godfrey C F Chan
Twenty percent of children with immune thrombocytopenia (ITP) develop a chronic course where treatment strategy is less established. Cyclosporin A (CSA) has been shown to be effective in small series of children with chronic ITP and might reduce the need for chronic steroid therapy and/or splenectomy. We reviewed consecutive patients below 18 years old with persistent or chronic ITP treated with CSA in our unit between January 1998 and June 2015. Thirty patients (14 boys and 16 girls) were included. The median age at initial diagnosis of ITP was 5 years (range 0...
October 2016: Annals of Hematology
Andrea Šlampová, Zdena Malá, Petr Gebauer, Petr Boček
The term "sample stacking" comprises a relatively broad spectrum of techniques that already form an almost inherent part of the methodology of CZE. Their principles are different but the effect is the same: concentration of a diluted analyte into a narrow zone and considerable increase of the method sensitivity. This review brings a survey of papers on electrophoretic sample stacking published approximately since the second quarter of 2014 till the first quarter of 2016. It is organized according to the principles of the stacking methods and includes chapters aimed at the concentration adjustment principle (Kohlrausch stacking), techniques based on pH changes, micellar methods, and other stacking techniques...
July 26, 2016: Electrophoresis
Zdena Malá, Petr Gebauer, Petr Boček
This review brings a survey of papers on analytical ITP published since 2014 until the first quarter of 2016. The 50th anniversary of ITP as a modern analytical method offers the opportunity to present a brief view on its beginnings and to discuss the present state of the art from the viewpoint of the history of its development. Reviewed papers from the field of theory and principles confirm the continuing importance of computer simulations in the discovery of new and unexpected phenomena. The strongly developing field of instrumentation and techniques shows novel channel methodologies including use of porous media and new on-chip assays, where ITP is often included in a preseparative or even preparative function...
July 23, 2016: Electrophoresis
Maurizio Miano, Ugo Ramenghi, Giovanna Russo, Laura Rubert, Angelica Barone, Fabio Tucci, Piero Farruggia, Angelamaria Petrone, Anna Mondino, Laura Lo Valvo, Nicoletta Crescenzio, Francesco Bellia, Irene Olivieri, Elena Palmisani, Ilaria Caviglia, Carlo Dufour, Francesca Fioredda
Mycophenolate mofetil (MMF) has been shown to be effective in children with immune thrombocytopenia (ITP) and Evans syndrome (ES), but data from larger series and details on the timing of the response are lacking. We evaluated 56 children treated with MMF for ITP (n = 40) or ES (n = 16), which was primary or secondary to autoimmune lymphoproliferative syndrome -related syndrome (ARS). Thirty-five of the 54 evaluable patients (65%) achieved a partial (18%) or complete (46%) response after a median (range) of 20 (7-137) and 37 (7-192) d, respectively...
November 2016: British Journal of Haematology
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