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primary immune thrombocytopenia

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https://www.readbyqxmd.com/read/29661452/staphylococcus-infection-associated-glomerulonephritis-in-a-kidney-transplant-patient-case-report
#1
D Cascais de Sá, L Rodrigues, L Santos, C Romãozinho, F Macário, C Marinho, J Pratas, R Alves, A Figueiredo
BACKGROUND: Staphylococcus infection-associated glomerulonephritis is a rare cause of graft dysfunction in kidney transplant. Suspicion should be high in the setting of elevation of serum creatinine, active urinary sediment, with or without hypocomplementemia, and simultaneous Staphylococcus aureus infection. A kidney biopsy is usually diagnostic. CASE REPORT: A 56-year-old man, who received a kidney transplant in 1998, with basal serum creatinine of 1.2 mg/dL and normal urinary sediment, was admitted to our kidney transplantation unit with graft dysfunction and a urinary tract infection caused by S aureus with septicemia, treated with antibiotics, in the context of recently intensified immunosuppression for a primary immune thrombocytopenia diagnosed 3 weeks earlier...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29623717/-idiopathic-thrombocytopenia-refractery-to-therapy-of-cyclosporine-a-in-clinical-practice-case-report
#2
Lucia Schwarzová, Zdenko Pirník, Natália Štecová
Primary immune thrombocytopenia (idiopathic thrombocytopenic purpura; ITP) is an autoimmune disorder characterized by isolated thrombocytopenia without abnormalities in the erythroid and myeloid/lymphoid lineages. The incidence of ITP in adults is estimated at approximately 1.6-3.9 per 100 000 persons/year. The aim of this study was to analyze a case report of a patient with diagnosed immune thrombocytopenia (D69.3) resistant to cyclosporine A therapy as well as an evaluation of factors that could contribute to an inadequate response to cyclosporine A...
2018: Ceská a Slovenská Farmacie
https://www.readbyqxmd.com/read/29619624/chinese-guidelines-for-treatment-of-adult-primary-immune-thrombocytopenia
#3
Xin-Guang Liu, Xiao-Chuan Bai, Fang-Ping Chen, Yun-Feng Cheng, Ke-Sheng Dai, Mei-Yun Fang, Jian-Ming Feng, Yu-Ping Gong, Tao Guo, Xin-Hong Guo, Yue Han, Luo-Jia Hong, Yu Hu, Bao-Lai Hua, Rui-Bing Huang, Yan Li, Jun Peng, Mi-Mi Shu, Jing Sun, Pei-Yan Sun, Yu-Qian Sun, Chun-Sen Wang, Shu-Jie Wang, Xiao-Min Wang, Cong-Ming Wu, Wen-Man Wu, Zhen-Yu Yan, Feng-E Yang, Lin-Hua Yang, Ren-Chi Yang, Tong-Hua Yang, Xu Ye, Guang-Sen Zhang, Lei Zhang, Chang-Cheng Zheng, Hu Zhou, Min Zhou, Rong-Fu Zhou, Ze-Ping Zhou, Hong-Li Zhu, Tie-Nan Zhu, Ming Hou
Primary immune thrombocytopenia (ITP) is a bleeding disorder commonly encountered in clinical practice. The International Working Group (IWG) on ITP has published several landmark papers on terminology, definitions, outcome criteria, bleeding assessment, diagnosis, and management of ITP. The Chinese consensus reports for diagnosis and management of adult ITP have been updated to the 4th edition. Based on current consensus positions and new emerging clinical evidence, the thrombosis and hemostasis group of the Chinese Society of Hematology issued Chinese guidelines for management of adult ITP, which aim to provide evidence-based recommendations for clinical decision making...
April 4, 2018: International Journal of Hematology
https://www.readbyqxmd.com/read/29580123/ethnic-and-racial-difference-in-helicobacter-pylori-infection-in-patients-with-immune-thrombocytopenia-treated-at-a-major-urban-medical-center
#4
Caitlin M O'Neill, Ilene C Weitz, Casey O'Connell, Howard A Liebman
Immune thrombocytopenia (ITP) is an autoimmune disorder with a complex immunopathology and pathogenesis characterized by thrombocytopenia and bleeding manifestations. The disorder is separated into primary (idiopathic) ITP and secondary ITP, when associated with other immune or lymphoproliferative disorders and certain chronic infections. Helicobacter pylori (H. pylori) is a recognized bacterial cause of ITP. In regions with high prevalence of infection, bacterial eradication has resulted in improvement in platelet count...
March 26, 2018: Platelets
https://www.readbyqxmd.com/read/29499727/distinct-alterations-of-cd68-cd163-m2-like-macrophages-and-myeloid-derived-suppressor-cells-in-newly-diagnosed-primary-immune-thrombocytopenia-with-or-without-cr-after-high-dose-dexamethasone-treatment
#5
Xia Shao, Boting Wu, Luya Cheng, Feng Li, Yanxia Zhan, Chanjuan Liu, Lili Ji, Zhihui Min, Yang Ke, Lihua Sun, Hao Chen, Yunfeng Cheng
BACKGROUND: Although impaired myeloid-derived suppressor cells (MDSCs) recently have been studied in immune thrombocytopenia (ITP), another myeloid-derived cell population signified as M2 macrophages has not been investigated properly in ITP patients. In the present study, we intended to determine the features of circulating M2-like macrophages, to examine its relationship with MDSCs, and to explore their prognostic values in ITP. METHODS: Peripheral blood mononuclear cells from healthy controls and primary ITP patients were isolated to test the circulating M2-like macrophages and MDSCs...
March 2, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29480036/-emerging-drugs-for-the-treatment-of-myelofibrosis
#6
Aditya Shreenivas, John Mascarenhas
INTRODUCTION: Myelofibrosis (MF) is a Philadelphia chromosome-negative myeloproliferative neoplasm (MPN). It can be sub-categorized into primary myelofibrosis, post polycythemia vera myelofibrosis and post essential thrombocythemia myelofibrosis. MF is a life-threatening hematologic malignancy characterized by dysregulation of the Janus associated kinase (JAK)/signal transducer and activator of transcription (STAT) signaling network and a heightened inflammatory state. AREAS COVERED: We cover the pathogenesis, clinical features, new prognostic models, current treatment of MF and discuss agents in development...
February 26, 2018: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/29479668/a-critical-appraisal-of-the-evidence-for-the-role-of-splenectomy-in-adults-and-children-with-itp
#7
REVIEW
Francesco Rodeghiero
In primary chronic immune thrombocytopenia, long-term response to splenectomy, with 60% of patients enjoying a treatment-free life, is higher when compared with rituximab and similar to that with continuous thrombopoietin-receptor agonists (TPO-RA) administration. Splenectomy should continue to be offered to patients failing initial treatments in the absence of increased surgery-related risks. The higher lifelong safety concerns with splenectomy (increased risk of infection, shared in part with rituximab, and of thrombosis, in common with TPO-RA) and a mortality <1-2%, justify postponing surgery to the chronic phase, when spontaneous remissions are rarer...
February 26, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29409398/immune-dysregulation-in-primary-immune-thrombocytopenia-patients
#8
Jiakui Zhang, Qiuye Zhang, Yingwei Li, Lili Tao, Fan Wu, Yuanyuan Shen, Qianshan Tao, Xuanxuan Xu, Can Wu, Yanjie Ruan, Jiyu Wang, Jeffrey Wang, Yiping Wang, Zhimin Zhai
OBJECTIVES: To explore the immunological abnormalities in patients with primary immune thrombocytopenia (ITP), and analyze its relationship with treatment. METHODS: Proportion of different immune cell subsets were detected in the peripheral blood of 124 ITP patients at different time points and 45 normal controls by flow cytometry. The treatments included glucocorticoids, intravenous IgG as first-line treatment and second-line drugs. RESULTS: Elevated CD4/CD8 ratio and decreased the proportion of NK and CD4 + CD25 + CD127low regulatory T cells (Tregs) were found in pre-treated ITP patients than healthy controls...
February 6, 2018: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/29402802/differential-expression-of-mir-106b-5p-and-mir-200c-3p-in-newly-diagnosed-versus-chronic-primary-immune-thrombocytopenia-patients-based-on-systematic-analysis
#9
Cheng Qian, Wenying Yan, Tengda Li, Qingya Cui, Peng Liu, Mingli Gu, Jie Guo, Weiwei Zhang, Chuanlu Ren, Tianqin Wu, Anmei Deng
BACKGROUND/AIMS: MicroRNAs (miRNAs) have been described to have important roles in primary immune thrombocytopenia (ITP). To gain additional understanding, we have now further evaluated the involvement of miRNAs in ITP. METHODS: Microarray experiments were performed to examine the expression profiles of miRNAs and mRNAs in samples from subjects with newly diagnosed ITP (G1), chronic ITP (G2), and normal controls. The systematic Pipeline of Outlier MicroRNA Analysis framework was applied to identify key miRNAs expressed in the G1 and G2 samples...
January 19, 2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29382894/zika-virus-infection-elicits-auto-antibodies-to-c1q
#10
Takaaki Koma, Veljko Veljkovic, Danielle E Anderson, Lin-Fa Wang, Shannan L Rossi, Chao Shan, Pei-Yong Shi, David W Beasley, Natalya Bukreyeva, Jeanon N Smith, Steven Hallam, Cheng Huang, Veronika von Messling, Slobodan Paessler
Zika virus (ZIKV) causes mostly asymptomatic infection or mild febrile illness. However, with an increasing number of patients, various clinical features such as microcephaly, Guillain-Barré syndrome and thrombocytopenia have also been reported. To determine which host factors are related to pathogenesis, the E protein of ZIKV was analyzed with the Informational Spectrum Method, which identifies common information encoded by primary structures of the virus and the respective host protein. The data showed that the ZIKV E protein and the complement component C1q cross-spectra are characterized by a single dominant peak at the frequency F = 0...
January 30, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29360249/pretreatment-with-standard-dose-intravenous-methylprednisolone-does-not-improve-outcomes-in-newly-diagnosed-immune-thrombocytopenia-itp
#11
Anaïs Essilini, Thibault Comont, Johanne Germain, Natacha Brun, Claire Dingremont, Brice Castel, Sophie Arista, Serge Madaule, Laurent Sailler, Maryse Lapeyre-Mestre, Odile Beyne-Rauzy, Bertrand Godeau, Daniel Adoue, Guillaume Moulis
OBJECTIVE: To assess the benefits and harms to initiate corticosteroids with intravenous methylprednisolone at a conventional dose (1 mg/kg/d) to treat adults with immune thrombocytopenia (ITP). METHODS: Population stemmed from the prospective multicenter CARMEN registry and included newly diagnosed hospitalized ITP adults with platelet counts<30 × 109 /L. We compared the patients treated with conventional-dose methylprednisolone (CDMP) before continuing with oral prednisone to patients treated with just conventional-dose oral prednisone (CDOP)...
January 23, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29356300/pathophysiology-of-thrombotic-thrombocytopenic-purpura-and-hemolytic-uremic-syndrome
#12
J A Kremer Hovinga, S R Heeb, M Skowronska, M Schaller
Thrombotic microangiopathies are rare disorders characterized by the concomitant occurrence of severe thrombocytopenia, microangiopathic hemolytic anemia, and a variable degree of ischemic end-organ damage. The latter particularly affects the brain, the heart, and the kidneys. The primary forms, thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS), although their clinical presentations often overlap, have distinctive pathophysiologies. TTP is the consequence of a severe ADAMTS-13 deficiency, either immune-mediated as a result of circulating autoantibodies, or caused by mutations in ADAMTS-13...
April 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29355998/prevalence-and-disease-associations-in-feline-thrombocytopenia-a-retrospective-study-of-194-cases
#13
J Ellis, R Bell, D C Barnes, R Miller
OBJECTIVES: To assess the prevalence of thrombocytopenia in a referral population of cats in the UK, to identify disease processes associated with thrombocytopenia and to assess the proportion of thrombocytopenic cats that tested positive for feline leukaemia virus or feline immunodeficiency virus. MATERIALS AND METHODS: Retrospective analysis of medical records at a UK referral hospital. Cats were grouped by mechanism of thrombocytopenia and disease process (where known)...
January 22, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29333402/interleukin-1b-il-1b-31-and-il-1b-511-and-interleukin-1-receptor-antagonist-il-1ra-gene-polymorphisms-in-primary-immune-thrombocytopenia
#14
Deependra Kumar Yadav, Anil Kumar Tripathi, Divya Gupta, Saurabh Shukla, Aloukick Kumar Singh, Ashutosh Kumar, Jyotsna Agarwal, K N Prasad
Background: Immune thrombocytopenia (ITP) is an immune-mediated disease caused by autoantibodies against platelets membrane glycoproteins GPIIb/IIIa and GPIb/IX. The etiology of ITP remains unclear. This study evaluated the association of polymorphisms in interleukin ( IL ) -1B-31 , IL-1B-511 , and IL-1Ra with ITP. Methods: Genotyping of IL-1B-31 , IL-1B-511 , and IL-1Ra was performed in 118 ITP patients and 100 controls by polymerase chain reaction restriction fragment length polymorphism and detection of variable number tandem repeats...
December 2017: Blood Research
https://www.readbyqxmd.com/read/29330464/eltrombopag-versus-romiplostim-in-treatment-of-children-with-persistent-or-chronic-immune-thrombocytopenia-a-systematic-review-incorporating-an-indirect-comparison-meta-analysis
#15
Jiaxing Zhang, Yi Liang, Yuan Ai, Xiaosi Li, Juan Xie, Youping Li, Wenyi Zheng, Rui He
In absence of direct comparison, we conducted an indirect-comparison meta-analysis to evaluate the efficacy and safety of thrombopoietin-receptor agonists(TPO-RAs) in treatment of pediatric persistent or chronic immune thrombocytopenia(ITP). PubMed, Embase, Cochrane Library, Clinical Trials.gov, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database were searched from their earliest records to May 2017. Randomized controlled trials comparing the TPO-RAs with placebo in pediatric ITP were included...
January 12, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29330115/pediatric-onset-evans-syndrome-heterogeneous-presentation-and-high-frequency-of-monogenic-disorders-including-lrba-and-ctla4-mutations
#16
Caroline Besnard, Eva Levy, Nathalie Aladjidi, Marie-Claude Stolzenberg, Aude Magerus-Chatinet, Olivier Alibeu, Patrick Nitschke, Stéphane Blanche, Olivier Hermine, Eric Jeziorski, Judith Landman-Parker, Guy Leverger, Nizar Mahlaoui, Gérard Michel, Isabelle Pellier, Felipe Suarez, Isabelle Thuret, Geneviève de Saint-Basile, Capucine Picard, Alain Fischer, Bénédicte Neven, Frédéric Rieux-Laucat, Pierre Quartier
Evans syndrome (ES) is defined by the combination of autoimmune hemolytic anemia and immune thrombocytopenia. Clinical presentation includes manifestations of immune dysregulation, found in primary immune deficiencies, autoimmune lymphoproliferative syndrome with FAS (ALPS-FAS), Cytotoxic T Lymphocyte Antigen-4 (CTLA-4) and Lipopolysaccharide-Responsive vesicle trafficking Beige-like and Anchor protein (LRBA) defects. We report the clinical history and genetic results of 18 children with ES after excluding ALPS-FAS...
March 2018: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/29298625/initial-romiplostim-dosing-and-time-to-platelet-response-in-patients-with-treatment-refractory-immune-thrombocytopenia
#17
Ryan K DasGupta, Lauren Levine, Tracy Wiczer, Spero Cataland
Background/rationale Romiplostim is a thrombopoietin receptor agonist recommended as a second-line therapy for immune thrombocytopenia. An initial dose of 1 mcg/kg/week subcutaneously with weekly 1 mcg/kg dose escalation is recommended per package labeling. Optimizing romiplostim dosing for hospitalized, corticosteroid- and intravenous immunoglobulin-refractory patients with severe thrombocytopenia secondary to immune thrombocytopenia may be critical for improving platelet responses, reducing the risk of bleeding, and decreasing hospital length of stay...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29296891/misdiagnosis-of-primary-immune-thrombocytopenia-and-frequency-of-bleeding-lessons-from-the-mcmaster-itp-registry
#18
Donald M Arnold, Ishac Nazy, Rumi Clare, Anushka M Jaffer, Brandon Aubie, Na Li, John G Kelton
Nonspecific diagnostic criteria and uncertain estimates of severe bleeding events are fundamental gaps in knowledge of primary immune thrombocytopenia (ITP). To address these issues, we created the McMaster ITP Registry. In this report, we describe the methodology of the registry, the process for arriving at the diagnosis, and the frequency of bleeding. Consecutive patients with platelets <150 × 109 /L from a tertiary hematology clinic in Canada were eligible. Patients completed a panel of investigations and were managed per clinical need...
November 28, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296878/management-of-newly-diagnosed-immune-thrombocytopenia-can-we-change-outcomes
#19
REVIEW
Cindy E Neunert
Immune thrombocytopenia resulting from antibody-mediated platelet destruction combined with impaired platelet production is a common cause of thrombocytopenia. The decision to treat newly diagnosed patients is based on several factors including ceasing hemorrhagic manifestations, increasing the platelet count, prevention of bleeding, and inducing remission. Current standard first-line therapy is a course of corticosteroids. Although this treatment paradigm increases the platelet count in the majority of patients, a high percentage relapse after discontinuation of corticosteroid therapy...
November 14, 2017: Blood Advances
https://www.readbyqxmd.com/read/29295846/splenectomy-for-immune-thrombocytopenia-down-but-not-out
#20
REVIEW
Shruti Chaturvedi, Donald M Arnold, Keith R McCrae
Splenectomy is an effective therapy for steroid-refractory or dependent immune thrombocytopenia (ITP). With the advent of medical alternatives such as rituximab and thrombopoietin receptor antagonists, the use of splenectomy has declined and is generally reserved for patients that fail multiple medical therapies. Splenectomy removes the primary site of platelet clearance and autoantibody production and offers the highest rate of durable response (50% to 70%) compared with other ITP therapies. However, there are no reliable predictors of splenectomy response, and long-term risks of infection and cardiovascular complications must be considered...
March 15, 2018: Blood
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