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https://www.readbyqxmd.com/read/29234214/clinical-practice-updates-in-the-management-of-immune-thrombocytopenia
#1
Ayesha M Khan, Halina Mydra, Ana Nevarez
Immune thrombocytopenia (ITP), previously called idiopathic thrombocytopenia purpura, is an autoimmune disorder characterized by a severe reduction in peripheral blood platelet count. In healthy individuals, normal platelet count ranges from 150-450 × 109/L, while in thrombocytopenia counts fall to less than 100 × 109/L.1 In adults, the incidence of ITP is approximately two to four per 100,000.2,3 Bleeding risks, specifically hemorrhage and intracranial hemorrhage, represent the most serious complications for patients with ITP...
December 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29188168/igg4-related-pancreatitis-and-immune-thrombocytopenia-a-case-report-and-literature-review
#2
Claire Sakiyama, Stephen Sullivan
A patient with a prior diagnosis of IgG4-related autoimmune pancreatitis (AIP) presented four years later with severe prednisone resistant immune thrombocytopenia (ITP). Her case is reported and the scant literature of the very unusual possible association of IgG4-related AIP and ITP is reviewed. It is suggested that investigation for IgG4-related disease be part of the work-up of ITP.
September 28, 2017: Curēus
https://www.readbyqxmd.com/read/29089814/a-case-of-metastatic-prostate-cancer-and-immune-thrombocytopenia
#3
D M Betsch, S Gray, S E Zed
Prostate cancer frequently metastasizes to bone, but bone marrow involvement is relatively less common. In advanced prostate cancer, significant bone marrow infiltration can result in hematologic abnormalities such as anemia and thrombocytopenia. We report the case of a patient who presented with a new diagnosis of thrombocytopenia at the same time that he presented with prostate cancer metastatic to bone. He was found to have immune thrombocytopenia (itp) which responded to treatment with steroids. We discuss this case and review the literature on itp in the setting of advanced malignancy...
October 2017: Current Oncology
https://www.readbyqxmd.com/read/29084292/efficacy-and-safety-of-dapsone-as-second-line-therapy-for-adult-immune-thrombocytopenia-a-retrospective-study-of-42-patients
#4
Clémentine Estève, Maxime Samson, Alexandre Guilhem, Barbara Nicolas, Vanessa Leguy-Seguin, Sabine Berthier, Bernard Bonnotte, Sylvain Audia
Dapsone is recommended as a second line therapy in immune thrombocytopenia (ITP), but is underused because of its potential side effects. The medical charts of 42 ITP patients treated with dapsone (100 mg/day) were retrospectively reviewed in order to assess its efficacy and safety in daily clinical practice. The overall response rate was 54.8% (n = 22, with a complete response in 38.1%) with a median time to response of 29 days (24-41 days). Patients with complete response had shorter disease duration whereas no difference was observed between responders and non-responders regarding age, sex or previous treatments received...
2017: PloS One
https://www.readbyqxmd.com/read/29075073/moderate-to-severe-thrombocytopenia-during-pregnancy-a-single-institutional-experience
#5
Bum Jun Kim, Hyeong Su Kim, Jung Han Kim, Keun Young Lee
Most of thrombocytopenic pregnant women present mild decrease of platelet counts and have favorable outcome. However, small portion of these cases can show moderate to severe thrombocytopenia and may increase the risk of bleeding during delivery. We investigated the prevalence, causes, and outcomes of pregnancies complicated by moderate to severe thrombocytopenia. We reviewed medical records of pregnant women who were diagnosed with moderate to severe thrombocytopenia (<100 × 10(9)/L) during their pregnancies...
December 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/29046203/-clinical-effect-of-anti-d-immunoglobulin-in-treatment-of-childhood-immune-thrombocytopenia-a-meta-analysis
#6
Wei Qin, Shao-Ling Huang, Ting-Ting Li
OBJECTIVE: To investigate the clinical effect and safety of anti-D immunoglobulin (anti-D) in the treatment of children with newly diagnosed acute immune thrombocytopenia (ITP) through a Meta analysis. METHODS: PubMed, EMBASE, Cohrane Library, Ovid, CNKI, and Wanfang Data were searched for randomized controlled trials (RCTs) published up to April 2017. Review Manager 5.3 was used for the Meta analysis. RESULTS: Seven RCTs were included. The Meta analysis showed that after 72 hours and 7 days of treatment, the intravenous immunoglobulin (IVIG) group had a significantly higher percentage of children who achieved platelet count >20×10(9)/L than the anti-D group (P<0...
October 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29044634/rituximab-for-the-treatment-of-type-b-insulin-resistance-syndrome-a-case-report-and-review-of-the-literature
#7
Ken Iseri, Masayuki Iyoda, Yasuto Shikida, Takako Inokuchi, Tomoki Morikawa, Noriko Hara, Tsutomu Hirano, Takanori Shibata
BACKGROUND: Type B insulin resistance syndrome is a rare disease characterized by refractory transient hyperglycaemia and severe insulin resistance associated with circulating anti-insulin receptor antibodies. A standardized treatment regimen for type B insulin resistance syndrome has yet to be established. CASE REPORT: We report the case of a 64-year-old man undergoing haemodialysis for antineutrophil cytoplasmic antibody-associated vasculitis and diabetic nephropathy, who developed rapid onset of hyperglycaemia (glycated albumin 52...
October 16, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29037898/zika-virus-and-autoimmunity-one-step-forward
#8
REVIEW
Diana M Monsalve, Yovana Pacheco, Yeny Acosta-Ampudia, Yhojan Rodríguez, Carolina Ramírez-Santana, Juan-Manuel Anaya
Zika virus (ZIKV) infection has been associated with the development of Guillain-Barré syndrome (GBS) and idiopathic thrombocytopenic purpura (ITP). Whether ZIKV infection is related to other autoimmune diseases is unknown. Therefore, an association study to evaluate rheumatic and thyroid autoimmunity in patients with ZIKV disease was conducted through a panel of 14 autoantibodies. In addition, a literature review on ZIKV, and GBS and ITP was performed. Our results disclosed a lack of association of rheumatoid and thyroid autoimmunity with ZIKV disease...
October 14, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29018854/isotachophoresis-applied-to-biomolecular-reactions
#9
REVIEW
C Eid, J G Santiago
This review discusses research developments and applications of isotachophoresis (ITP) to the initiation, control, and acceleration of chemical reactions, emphasizing reactions involving biomolecular reactants such as nucleic acids, proteins, and live cells. ITP is a versatile technique which requires no specific geometric design or material, and is compatible with a wide range of microfluidic and automated platforms. Though ITP has traditionally been used as a purification and separation technique, recent years have seen its emergence as a method to automate and speed up chemical reactions...
October 11, 2017: Lab on a Chip
https://www.readbyqxmd.com/read/28960510/expression-of-cd-markers-in-immune-thrombocytopenic-purpura-prognostic-approaches
#10
REVIEW
Masumeh Maleki Behzad, Ali Amin Asnafi, Kaveh Jaseb, Mohammad Ali Jalali Far, Najmaldin Saki
Immune Thrombocytopenic Purpura (ITP) is a common autoimmune bleeding disorder characterized by a reduction in peripheral blood platelet counts. In this disease, autoantibodies (Auto-Abs) are produced against platelet GPIIb/GPIIIa by B cells, which require interaction with T cells. In this review, the importance of B and T lymphocytes in ITP prognosis has been studied. Relevant literature was identified by a PubMed search (1990-2016) of English-language papers using the terms B and T lymphocyte, platelet, CD markers and immune thrombocytopenic purpura...
September 28, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28947425/treatment-of-immune-thrombocytopenic-purpura-associated-with-cytomegalovirus-infection-in-a-child-with-pre-b-cell-acute-lymphoblastic-leukaemia-after-central-nervous-system-relapse
#11
Ashley R Martinez, Megan Rose Paul, Dennis John Kuo
A 13-year-old male patient with a history of pre-B cell acute lymphoblastic leukaemia (ALL) with isolated central nervous system relapse on maintenance chemotherapy presented with severe thrombocytopenia refractory to platelet transfusions. The patient showed only modest responses to two courses of intravenous immunoglobulin and steroids. He was found to be positive for cytomegalovirus (CMV) with modest viral load. His thrombocytopenia normalised with rituximab therapy and CMV treatment supporting the diagnosis of CMV-associated immune thrombocytopenic purpura (ITP)...
September 25, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28941623/post-licensure-safety-surveillance-study-of-routine-use-of-quadrivalent-meningococcal-diphtheria-toxoid-conjugate-vaccine
#12
J Hansen, L Zhang, N P Klein, C A Robertson, M D Decker, D P Greenberg, E Bassily, R Baxter
BACKGROUND: Menactra® vaccine (MenACWY-D) was licensed in the United States in 2005 for persons 11-55years of age. The aim of this study was to assess the safety of MenACWY-D administered as part of routine clinical care to patients at Kaiser Permanente Northern California (KPNC). METHODS: This was an observational, retrospective study that included all KPNC members who received MenACWY-D during the study period. We monitored all vaccine recipients for non-elective hospitalizations, emergency department visits, and selected outcomes captured in the clinic setting (Bell's palsy, seizures, neuritis, Guillain-Barré syndrome, encephalopathy, encephalitis, epilepsy, transverse myelitis, multiple sclerosis, hypersensitivity reactions, idiopathic thrombocytopenic purpura, diabetes, arthritis, hemolytic anemia, collagen-vascular disease) through 6months after vaccination...
September 20, 2017: Vaccine
https://www.readbyqxmd.com/read/28921855/utility-of-the-immature-platelet-fraction-in-pediatric-immune-thrombocytopenia-differentiating-from-bone-marrow-failure-and-predicting-bleeding-risk
#13
Alicia McDonnell, Karen L Bride, Derick Lim, Michele Paessler, Char M Witmer, Michele P Lambert
BACKGROUND: Differentiating childhood immune thrombocytopenia (ITP) from other cause of thrombocytopenia remains a diagnosis of exclusion. Additionally factors that predict bleeding risk for those patients with ITP are currently not well understood. Previous small studies have suggested that immature platelet fraction (IPF) may differentiate ITP from other causes of thrombocytopenia and in combination with other factors may predict bleeding risk. METHODS: We performed a retrospective chart review of thrombocytopenic patients with an IPF measured between November 1, 2013 and July 1, 2015...
September 17, 2017: Pediatric Blood & Cancer
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
#14
REVIEW
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/28887897/opportunistic-invasive-cutaneous-fungal-infections-associated-with-administration-of-cyclosporine-to-dogs-with-immune-mediated-disease
#15
B B McAtee, K J Cummings, A K Cook, J A Lidbury, J C Heseltine, M D Willard
BACKGROUND: Opportunistic invasive fungal infections (OIFIs) occur in dogs administered immunosuppressive medications. However, the epidemiology of OIFIs among dogs undergoing immunosuppressive treatment is poorly understood. The aims of this study were to (1) estimate the incidence of OIFIs among dogs diagnosed with certain immune-mediated diseases and treated with immunosuppressive drugs, and (2) determine if administration of particular drug(s) was a risk factor for OIFIs. HYPOTHESIS: Dogs receiving cyclosporine treatment (alone or as part of a multidrug protocol) are at higher risk of developing OIFIs...
September 9, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28871277/the-centenary-of-immune-thrombocytopenia-part-2-revising-diagnostic-and-therapeutic-approach
#16
REVIEW
Rita Consolini, Giorgio Costagliola, Davide Spatafora
Primary immune thrombocytopenia (ITP) is the most common cause of thrombocytopenia in children and adolescents and can be considered as a paradigmatic model of autoimmune disease. This second part of our review describes the clinical presentation of ITP, the diagnostic approach and overviews the current therapeutic strategies. Interestingly, it suggests an algorithm useful for differential diagnosis, a crucial process to exclude secondary forms of immune thrombocytopenia (IT) and non-immune thrombocytopenia (non-IT), which require a different therapeutic management...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28845713/thrombopoietin-receptor-agonists-for-children-with-immune-thrombocytopenia-a-systematic-review
#17
Jiaxing Zhang, Yi Liang, Yuan Ai, Juan Xie, Youping Li, Wenyi Zheng
OBJECTIVE: We conducted a systematic review to assess the efficacy and safety of Thrombopoietin-receptor agonists (TPOras) for pediatric immune thrombocytopenia (ITP). METHODS: We searched PubMed, Embase and Cochrane Library from their earliest records to January 2017. Randomized controlled trials (RCTs) were included. Primary outcomes were durable response and clinically significant bleeding. Secondary outcomes were overall response, overall bleeding events, the use of rescue medication and adverse events (AEs)...
October 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28808759/life-threatening-bleeding-episodes-in-primary-immune-thrombocytopenia-a-single-center-retrospective-study-of-169-inpatients
#18
Hiroyuki Tsuda, Takahiro Tsuji, Mayumi Tsuji, Hiroshi Yamasaki
Bleeding is the most important clinical outcome in patients with immune thrombocytopenia (ITP), and the goal of therapy in such cases is to treat or prevent bleeding. The frequency of and risk factors for bleeding events in ITP have only recently been identified in several large-scale studies. However, there is little published information about severe life-threatening bleeding in ITP. To clarify the clinical features of life-threatening bleeding in patients with primary ITP, we systematically reviewed the medical records of all ITP patients that were admitted to our hospital between January 1, 1992, and December 31, 2015...
November 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28808591/immune-thrombocytopenia-and-jak2v617f-positive-essential-thrombocythemia-literature-review-and-case-report
#19
M A Sobas, T Wróbel, K Zduniak, M Podolak-Dawidziak, J Rybka, M Biedroń, M Sawicki, J Dybko, K Kuliczkowski
We present the case where immune thrombocytopenia (ITP) and essential thrombocythemia (ET) sequentially appeared in the space of twenty-one years of follow-up. Impaired platelet production is present in both diseases, but clinical presentation and treatment are different. On the basis of this case history a possible role of autoimmunity as a predisposing factor to myeloproliferation has been discussed.
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28716661/the-prevalence-and-morphometry-of-an-accessory-spleen-a-meta-analysis-and-systematic-review-of-22-487-patients
#20
REVIEW
Jens Vikse, Beatrice Sanna, Brandon Michael Henry, Dominik Taterra, Silvia Sanna, Przemysław A Pękala, Jerzy A Walocha, Krzysztof A Tomaszewski
BACKGROUND: An accessory spleen (AS) is a lobule of splenic tissue found in ectopic locations. Identification of AS is particularly important in patients with immune thrombocytopenia (ITP) requiring splenectomy as unrecognized AS can later cause refractory symptoms. The AS can also be a source of significant intraabdominal hemorrhage. The aim of this meta-analysis was to systematically analyze the data on the prevalence, number, location, and morphometry of AS. MATERIALS AND METHODS: An extensive search of the major electronic databases was conducted to identify all studies that reported relevant data on the AS...
July 15, 2017: International Journal of Surgery
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