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https://www.readbyqxmd.com/read/28428120/pathogenesis-of-immune-thrombocytopenia
#1
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/28370285/identification-and-characterization-of-a-nationwide-danish-adult-common-variable-immunodeficiency-cohort
#2
Lena Westh, Trine Hyrup Mogensen, Lars Skov Dalgaard, Jens Magnus Bernth Jensen, Terese Katzenstein, Ann-Brit Eg Hansen, Olav Ditlevsen Larsen, Steen Terpling, Thyge Lynghøj Nielsen, Carsten Schade Larsen
In this study we identified all adults living in Denmark diagnosed with common variable immunodeficiency (CVID) and characterized them according to clinical presentation and EUROclass classification. Using a retrospective, cross-sectional design, possible CVID patients were identified in the Danish National Patient Register and Centers in Denmark treating patients with primary immunodeficiencies. The CVID diagnosis was verified by review of medical records. One-hundred-seventy-nine adults with CVID were identified...
April 2, 2017: Scandinavian Journal of Immunology
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
#3
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/28297348/inverse-treatment-planning-for-spinal-robotic-radiosurgery-an-international-multi-institutional-benchmark-trial
#4
Oliver Blanck, Lei Wang, Wolfgang Baus, Jimm Grimm, Thomas Lacornerie, Joakim Nilsson, Sergii Luchkovskyi, Isabel Palazon Cano, Zhenyu Shou, Myriam Ayadi, Harald Treuer, Romain Viard, Frank-Andre Siebert, Mark K H Chan, Guido Hildebrandt, Jürgen Dunst, Detlef Imhoff, Stefan Wurster, Robert Wolff, Pantaleo Romanelli, Eric Lartigau, Robert Semrau, Scott G Soltys, Achim Schweikard
Stereotactic radiosurgery (SRS) is the accurate, conformal delivery of high-dose radiation to well-defined targets while minimizing normal structure doses via steep dose gradients. While inverse treatment planning (ITP) with computerized optimization algorithms are routine, many aspects of the planning process remain user-dependent. We performed an international, multi-institutional benchmark trial to study planning variability and to analyze preferable ITP practice for spinal robotic radiosurgery. 10 SRS treatment plans were generated for a complex-shaped spinal metastasis with 21 Gy in 3 fractions and tight constraints for spinal cord (V14Gy<2 cc, V18Gy<0...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28287030/immediate-transient-thrombocytopenia-at-the-time-of-alemtuzumab-infusion-in-multiple-sclerosis
#5
Usha Ranganathan, Ulrike Kaunzner, Stacyann Foster, Timothy Vartanian, Jai S Perumal
BACKGROUND: Alemtuzumab is a monoclonal antibody approved for relapsing-remitting multiple sclerosis (RRMS). Although Immune thrombocytopenia (ITP) has been reported as a secondary autoimmune phenomenon following alemtuzumab infusion, immediate thrombocytopenia during the infusion has not been reported. OBJECTIVE: We report transient, reversible, self-limiting acute-onset thrombocytopenia during the first course with alemtuzumab. RESULTS AND CONCLUSION: In total, 3 of 22 paitents developed mild self-limited bruising associated with a drop in platelet count from their baseline during the intial 5-day course of alemtuzumab...
March 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28286634/the-efficacy-of-colchicine-and-dapsone-combination-therapy-in-relapsed-immune-thrombocytopenia
#6
Thanawat Rattanathammethee, Wasan Theerajangkhaphichai, Ekarat Rattarittamrong, Sasinee Hantrakool, Chatree Chai-Adisaksopha, Lalita Norasetthada, Adisak Tantiworawit
The aim of the present paper is to evaluate the efficacy and safety of colchicine and dapsone combination therapy in cases of steroid-dependent, relapsed and refractory immune thrombocytopenia (ITP). This is a retrospective study of ITP patients who attended the Hematology Clinic at Chiang Mai University Hospital (Thailand) from 1 January 2008 to 30 September 2014. Medical records and clinical data were reviewed for efficacy and adverse effects. Sixty-four ITP patients received the combination therapy. The median age was 46 years and 70...
February 23, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28284263/immune-thrombocytopenia-secondary-to-tuberculosis-a-case-and-review-of-literature
#7
S F Weber, S Bélard, S Rai, R Reddy, S Belurkar, K Saravu
Immune thrombocytopenia (ITP) is an auto-immune condition that results in isolated thrombocytopenia associated with possibly lethal haemorrhage. In its secondary form, ITP can be triggered by many infectious and non-infectious conditions. Secondary ITP associated with tuberculosis (TB) has rarely been described in the literature. We report on a 22-year-old patient presenting with hypermenorrhoea and petechiae due to ITP secondary to tuberculous lymphadenitis. Normalisation of thrombocytopenia was only achieved after initiation of anti-tuberculosis treatment following failure of thrombocyte substitution and immune-modulatory treatment...
April 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28275823/beyond-immune-thrombocytopenia-the-evolving-role-of-thrombopoietin-receptor-agonists
#8
REVIEW
Francesco Rodeghiero, Giuseppe Carli
Since its discovery, the thrombopoietin (TPO) pathway has been an important pharmaceutical target for the treatment of thrombocytopenia. The first generation of TPO mimetics included peptide agents sharing homology with endogenous TPO, but these introduced a risk of antibody formation to endogenous TPO and were not successful. However, second-generation TPO mimetics or TPO receptor agonists (RAs) are currently being used to treat thrombocytopenia associated with a number of conditions, such as immune thrombocytopenia (ITP), severe aplastic anaemia (SAA), and hepatitis C virus-associated chronic liver disease...
March 8, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28275330/is-autoimmune-thrombocytopenia-itself-the-primary-disease-in-the-presence-of-second-diseases-data-from-a-long-term-observation
#9
Nasra Aboud, Fabian Depré, Abdulgabar Salama
BACKGROUND: Dependent on the absence or presence of associated diseases, autoimmune thrombocytopenia (ITP) can be classified as primary or secondary form. The manifestation of the associated diseases is not temporally defined and may occur during observation. Thus the question which disease is the primary one remains unanswered. METHODS: All 386 patients included in this study were treated by a single primary physician between 1996 and 2015 at the Charité Berlin and met current ITP criteria...
January 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28254202/predictors-of-granulomatous-lymphocytic-interstitial-lung-disease-in-common-variable-immunodeficiency
#10
Stella Hartono, Megan S Motosue, Shakila Khan, Vilmarie Rodriguez, Vivek N Iyer, Rohit Divekar, Avni Y Joshi
BACKGROUND: A subset of patients with common variable immunodeficiency (CVID) develop granulomatous lymphocytic interstitial lung disease (GLILD), which is associated with early mortality. OBJECTIVE: To determine a set of clinical and/or laboratory parameters that correlate with GLILD. METHODS: A retrospective, nested case-control (patients with CVID diagnosed with GLILD compared with patients with CVID without a diagnosis of GLILD) medical record review was undertaken at Mayo Clinic, Rochester, MN...
February 18, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28239462/thrombocytopenia-in-patients-with-melanoma-receiving-immune-checkpoint-inhibitor-therapy
#11
Eileen Shiuan, Kathryn E Beckermann, Alpaslan Ozgun, Ciara Kelly, Meredith McKean, Jennifer McQuade, Mary Ann Thompson, Igor Puzanov, John P Greer, Suthee Rapisuwon, Michael Postow, Michael A Davies, Zeynep Eroglu, Douglas Johnson
BACKGROUND: Immune checkpoint inhibitors, including antibodies against programmed death 1 (PD-1) and cytotoxic T-lymphocyte antigen 4 (CTLA-4), are being used with increasing frequency for the treatment of cancer. Immune-related adverse events (irAEs) including colitis, dermatitis, and pneumonitis are well described, but less frequent events are now emerging with larger numbers of patients treated. Herein we describe the incidence and spectrum of thrombocytopenia following immune checkpoint inhibitor therapy and two severe cases of idiopathic thrombocytopenic purpura (ITP)...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28208757/pathogenesis%C3%A2-and%C3%A2-therapeutic%C3%A2-mechanisms%C3%A2-in%C3%A2-immune%C3%A2-thrombocytopenia%C3%A2-itp
#12
REVIEW
Anne Zufferey, Rick Kapur, John W Semple
Immune thrombocytopenia (ITP) is a complex autoimmune disease characterized by low  platelet counts. The pathogenesis of ITP remains unclear although both antibody-mediated and/or  T cell-mediated platelet destruction are key processes. In addition, impairment of T cells, cytokine  imbalances, and the contribution of the bone marrow niche have now been recognized to be  important. Treatment strategies are aimed at the restoration of platelet counts compatible with  adequate hemostasis rather than achieving physiological platelet counts...
February 9, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28195872/rethinking-our-definition-of-postoperative-success-a-comparative-analysis-of-three-upper-eyelid-retraction-repair-techniques-using-novel-metrics-to-capture-functional-and-aesthetic-outcomes
#13
Jacob A Evans, Thomas J E Clark, M Bridget Zimmerman, Richard C Allen, Jeffrey A Nerad, Keith D Carter, Erin M Shriver
PURPOSE: To compare 3 upper eyelid retraction repair techniques and introduce novel metrics, which enhance the analysis of postoperative aesthetic outcomes. METHODS: Retrospective review with Image J 1.48 digital analysis of patients who underwent repair of thyroid-related upper eyelid retraction at the University of Iowa from 1996 to 2014 via 1 of 3 surgical techniques, septum-opening levator recession with Muellerectomy, modified septum-preserving levator recession with Muellerectomy, and modified septum-preserving full-thickness blepharotomy, was conducted...
February 10, 2017: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28180979/the-influence-of-isolated-thoracoplasty-on-the-evolution-of-pulmonary-function-after-treatment-of-severe-thoracic-scoliosis
#14
Heiko Koller, Tobias L Schulte, Oliver Meier, Juliane Koller, Viola Bullmann, Wolfgang Hitzl, Michael Mayer, Tobias Lange, Jens Schmücker
INTRODUCTION AND PURPOSE: Isolated thoracoplasty (iTP) on the convex side is performed long time after scoliosis surgery has been performed. ITP is thought to cause a further decline in pulmonary function (PF); however, the amount of decline is ill defined. The objectives of this study were to examine the influence of iTP on the postoperative evolution of PF and rib hump reduction in patients that previously undergone scoliosis surgery. METHODS: Over an 11-year period, 75 patients underwent iTP...
February 8, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#15
Egidio Del Fabbro
102 Background: Intrathecal pumps (ITP) are used to manage severe malignancy related pain by delivering analgesics directly into the cerebrospinal fluid, in theory allowing for a reduced opioid dose and fewer complications. Although there is literature to support efficacy in patients with cancer, including improved survival, this mode of drug delivery also carries a risk of serious complications. Reports of complications in non-malignant pain suggest the risks and mortality related to ITP may be under-appreciated and that injury and liability occur with both ITP placement and ITP maintenance...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28034281/is-there-any-role-for-splenectomy-in-adulthood-onset-chronic-immune-thrombocytopenia-in-the-era-of-tpo-receptors-agonists-a-critical-overview
#16
Vibor Milunovic, Inga Mandac Rogulj, Slobodanka Kolonic Ostojic
Immune thrombocytopenia (ITP) in adulthood is characterized by chronic relapsing course. Despite the efficacious first line treatment (corticosteroid, intravenous immunoglobulin), majority of patients will enter the chronic phase warranting another treatment approach. Until recently, splenectomy performed in ITP chronic phase represented the standard of care with long-term remissions in more than 70% of patients, but however has never been tested in clinical trials. However, with the advances of our understanding of ITP pathophysiology and the shifting focus on megakaryocyte impairment, novel drugs were introduced in treatment paradigm, mainly trombopoietin receptor agonists (TPO-RAs); romiplostim and eltrombopag...
December 29, 2016: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28006767/a-2-year-longitudinal-prospective-study-of-the-effects-of-eltrombopag-on-bone-marrow-in-patients-with-chronic-immune-thrombocytopenia
#17
MULTICENTER STUDY
Russell K Brynes, Raymond S M Wong, Maung M Thein, Kalpana K Bakshi, Paul Burgess, Dickens Theodore, Attilio Orazi
BACKGROUND: The long-term effects of eltrombopag on bone marrow (BM) reticulin and/or collagen deposition in previously treated adults with chronic immune thrombocytopenia (ITP) were assessed. METHODS: Three BM biopsies were collected at baseline and after 1 and 2 years of eltrombopag treatment. Specimens were centrally processed, stained for reticulin and collagen, independently reviewed by 2 hematopathologists, and rated according to the European Consensus 0-3 scale of marrow fibrosis (MF)...
2017: Acta Haematologica
https://www.readbyqxmd.com/read/27991534/efficacy-and-safety-of-thrombopoietin-receptor-agonists-in-patients-with-primary-immune-thrombocytopenia-a-systematic-review-and-meta-analysis
#18
Li Wang, Zhe Gao, Xiao-Ping Chen, Hai-Yan Zhang, Nan Yang, Fei-Yan Wang, Li-Xun Guan, Zhen-Yang Gu, Sha-Sha Zhao, Lan Luo, Hua-Ping Wei, Chun-Ji Gao
Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased platelet destruction and impaired platelet production. In this study, we conducted a systematic review and meta-analysis to determine the efficacy and safety of thrombopoietin receptor agonists (TPO-RAs) in primary ITP patients. Thirteen randomized controlled trials were included in this study, the pooled results of which demonstrated that TPO-RAs significantly increased platelet response (R) and durable response (DR) rates [risk ratio (RR): 2...
December 19, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27977588/clinical-characteristics-of-immune-thrombocytopenia-associated-with-autoimmune-disease-a-retrospective-study
#19
COMPARATIVE STUDY
Yuan Liu, Shiju Chen, Yuechi Sun, Qingyan Lin, Xining Liao, Junhui Zhang, Jiao Luo, Hongyan Qian, Lihua Duan, Guixiu Shi
To clarify clinical characteristics of immune thrombocytopenia (ITP) subsets associated with autoimmune diseases (AIDs).Five thousand five hundred twenty patients were reviewed retrospectively. One hundred four ITP patients were included for analysis. Clinical manifestations at first thrombocytopenic episode were recorded.Systemic lupus erythematosus (SLE) and primary Sjogren syndrome (pSS) accounted for a large part in AIDs associated with secondary ITP. SLE-ITP, pSS-ITP, and primary ITP (pITP) patients were different in several aspects in clinical and immunological characteristics...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27958258/case-of-twin-pregnancy-complicated-by-idiopathic-thrombocytopenic-purpura-treated-with-intravenous-immunoglobulin-review-of-the-literature
#20
W X Zhao, X F Yang, J H Lin
Idiopathic thrombocytopenic purpura (ITP) is an acquired thrombocytopenia without other clear cause of thrombocytopenia. It is not common in a singleton pregnancy and less common in twin pregnancy. We report a 33-year-old ITP pluripara whose first pregnancy was uneventful. She carried twin pregnancy, complicated by recurrent very low platelets, and gave birth to preterm twins. This patient received multiple courses of intravenous immunoglobulin (IVIG) and showed a significant platelet count improvement with IVIG therapy...
January 2017: Nigerian Journal of Clinical Practice
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