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https://www.readbyqxmd.com/read/28648251/immune-thrombocytopenia-of-childhood-responsive-to-tonsillectomy-in-the-setting-of-chronic-tonsillitis-a-case-report-and-literature-review
#1
Richard William Thompson, Anil Gungor
OBJECTIVES: Immune thrombocytopenia of childhood (platelet count <100,000/μL) is the most common cause of thrombocytopenia in children. Patients typically present with bruising and bleeding in the setting of thrombocytopenia. Although it is usually short-lived, some cases persist and are unresponsive to treatment. This can lead to exposure to a variety of treatment regimens including immunosuppressants and splenectomy. The goal of this report is to present a case of chronic ITP of childhood that responded to tonsillectomy addressing the tonsils as a source of chronic infection and inflammation triggering ITP...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28627134/u-s-food-and-drug-administration-approval-summary-eltrombopag-for-the-treatment-of-pediatric-patients-with-chronic-immune-idiopathic-thrombocytopenia
#2
Lori A Ehrlich, Virginia E Kwitkowski, Gregory Reaman, Chia-Wen Ko, Lei Nie, Richard Pazdur, Ann T Farrell
The U.S. Food and Drug Administration (FDA) approved eltrombopag for pediatric patients with chronic immune (idiopathic) thrombocytopenia (ITP) ages ≥6 on June 11, 2015, and ages ≥1 on August 24, 2015. Approval was based on the FDA review of two randomized trials that included 159 pediatric patients with chronic ITP who had an insufficient response to corticosteroids, immunoglobulins, or splenectomy. This manuscript describes the basis for approval of these applications. The FDA concluded that eltrombopag has shown efficacy and a favorable benefit to risk profile for pediatric patients with chronic ITP...
June 19, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28592772/current-topics-in-primary-immune-thrombocytopenia
#3
Yoshiaki Tomiyama
Primary immune thrombocytopenia (ITP) is an autoimmune disorder characterized by early platelet destruction due to antiplatelet autoantibodies. Recently, significant progress has been made regarding the pathophysiology of ITP. Nonetheless, the diagnosis of ITP in daily clinical practice is still based on differential diagnosis because of the lack of laboratory tests that can diagnose autoimmunity in ITP. In this chapter, the recent topics regarding the diagnosis and management of ITP have been reviewed.
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28537785/a-practical-guide-to-the-use-of-eltrombopag-in-children-with-chronic-immune-thrombocytopenia
#4
John D Grainger, Sharon Thind
INTRODUCTION: Pediatric immune thrombocytopenia (ITP) may be associated with significant burden on children and their parents/caregivers. Thrombopoietin (TPO) receptor agonists (RAs) have been used to treat adult patients with chronic ITP (cITP) for nearly a decade and following pediatric studies Eltrombopag has been recently approved for pediatric cITP in the United States and Europe. TPO-RA s may help reduce the risk of bleeding and the need for conventional ITP therapies. REVIEW: In this review, the clinical data demonstrating the efficacy and safety of TPO-RAs in pediatric ITP are evaluated, key recommendations regarding safe administration of eltrombopag are provided, and potential future directions in management of pediatric ITP are discussed...
May 24, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/28525829/epidemiology-and-management-of-primary-immune-thrombocytopenia-a-nationwide-population-based-study-in-korea
#5
Ji Yun Lee, Ju-Hyun Lee, Heeyoung Lee, Beodeul Kang, Ji-Won Kim, Se Hyun Kim, Jeong-Ok Lee, Jin Won Kim, Yu Jung Kim, Keun-Wook Lee, Jee Hyun Kim, Hyoung Soo Choi, Jong Seok Lee, Soo-Mee Bang
INTRODUCTION: The epidemiology of immune thrombocytopenia (ITP) is not well characterized in an Asian population. MATERIALS AND METHODS: From July 2010 to June 2014, ITP patients were identified using the Korean Health Insurance Review and Assessment Service database. RESULTS: The overall incidence rate of ITP was 5.3 per 100,000 person-years (95% CI: 5.1-5.5). The overall incidence rate ratios of children under 15years old to adults and females to males were 3...
July 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28453897/clinical-outcome-of-childhood-chronic-immune-thrombocytopenia-a-38-year-experience-from-a-single-tertiary-center-in-thailand
#6
Thirachit Chotsampancharoen, Pornpun Sripornsawan, Sarapee Duangchoo, Malai Wongchanchailert, Edward McNeil
BACKGROUND: There is limited information on long-term follow-up and prognostic factors for remission among children diagnosed with chronic immune thrombocytopenia (ITP). The aim of this study was to determine clinical outcomes and factors influencing remission in childhood chronic ITP. STUDY DESIGN: The hospital records of children aged 0-15 years diagnosed with chronic ITP were retrospectively reviewed. Kaplan-Meier curves were fit to estimate the median time to complete remission with 95% confidence intervals (CIs)...
April 28, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28440561/anterior-st-elevation-myocardial-infarction-induced-by-rituximab-infusion-a-case-report-and-review-of-the-literature
#7
K Sharif, A Watad, N L Bragazzi, E Asher, A Abu Much, Y Horowitz, M Lidar, Y Shoenfeld, H Amital
WHAT IS KNOWN AND OBJECTIVES: Rituximab is a chimeric monoclonal anti-CD20 antibody approved for the treatment of some lymphoid malignancies as well as for autoimmune diseases including rheumatoid arthritis (RA), idiopathic thrombocytopenic purpura (ITP) and vasculitis. Generally, rituximab is well tolerated; nevertheless, some patients develop adverse effects including infusion reactions. Albeit rare, these reactions may in some cases be life-threatening conditions. Rituximab cardiovascular side effects include more common effects such as hypertension, oedema and rare cases of arrhythmias and myocardial infarction...
June 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28428120/pathogenesis-of-immune-thrombocytopenia
#8
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
#9
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
#10
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 therapies 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, which 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
May 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28239462/thrombocytopenia-in-patients-with-melanoma-receiving-immune-checkpoint-inhibitor-therapy
#18
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
#19
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
#20
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
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