1,031 results match your criteria Immune Thrombocytopenia and Pregnancy


A randomized open-label trial to evaluate the efficacy and safety of triple therapy with aspirin, atorvastatin, and nicorandil in hospitalised patients with SARS Cov-2 infection: A structured summary of a study protocol for a randomized controlled trial.

Trials 2021 Jul 15;22(1):451. Epub 2021 Jul 15.

Department of Internal Medicine, Dr. Rajendra Prasad Government Medical College, Tanda, Kangra, Himachal Pradesh, 176001, India.

Objectives: The pathophysiology of SARS-Cov-2 is characterized by inflammation, immune dysregulation, coagulopathy, and endothelial dysfunction. No single therapeutic agent can target all these pathophysiologic substrates. Moreover, the current therapies are not fully effective in reducing mortality in moderate and severe disease. Read More

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Placental Complement Activation in Fetal and Neonatal Alloimmune Thrombocytopenia: An Observational Study.

Int J Mol Sci 2021 Jun 23;22(13). Epub 2021 Jun 23.

Center of Clinical Transfusion Research, Sanquin Research, 1066 CX Amsterdam, The Netherlands.

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a disease that causes thrombocytopenia and a risk of bleeding in the (unborn) child that result from maternal alloantibodies directed against fetal, paternally inherited, human platelet antigens (HPA). It is hypothesized that these alloantibodies can also bind to the placenta, causing placental damage. This study aims to explore signs of antibody-mediated placental damage in FNAIT. Read More

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Hematologic Findings in Pregnancy: A Guide for the Internist.

Cureus 2021 May 21;13(5):e15149. Epub 2021 May 21.

Hematology and Oncology, Henry Ford Health System, Detroit, USA.

Hematologic changes in pregnancy are common and can potentially lead to maternal and fetal morbidity. Here, we present various hematologic manifestations seen in pregnant women. Iron deficiency anemia (IDA) is the most common cause of anemia in pregnancy. Read More

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Use of thrombopoietin receptor agonists in pregnancy: A review of the literature.

Hematol Oncol Stem Cell Ther 2021 Jun 16. Epub 2021 Jun 16.

Comphrensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia.

The management of immune thrombocytopenic purpura (ITP) involves several lines of therapy such as corticosteroids and intravenous immunoglobulin. With the emergence of novel therapies such as thrombopoietin receptor agonists (TPO-RAs), there has been a shift in treatment modalities. Eltrombopag and romiplostim have proven to be effective in the management of ITP through clinical studies, but their safety in pregnancy remains uncertain. Read More

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Maternal and Fetal Outcomes of Pregnancy in Patients with Immune Thrombocytopenia.

J Obstet Gynaecol India 2021 Apr 18;71(2):124-130. Epub 2020 Nov 18.

Department of Maternal & Reproductive Health, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Uttar Pradesh, Lucknow, 226014 India.

Introduction: Immune thrombocytopenia (ITP) complicates 1-2 cases/10,000 pregnancies in India. Management of these patients is a challenge as it is associated with potential risks of maternal bleeding episodes and neonatal alloimmune thrombocytopenia (NAITP).

Objective: To study the maternal and fetal/neonatal outcome of pregnancy in Indian patients with ITP and identify the risk factors for NAITP. Read More

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A meta-analysis of neonatal outcomes in pregnant women with immune thrombocytopenic purpura.

J Obstet Gynaecol Res 2021 Jun 16. Epub 2021 Jun 16.

Department of Hematology, The First Affiliated Hospital of Shaoxing University, Shaoxing People's Hospital, Shaoxing, China.

Aim: Thrombocytopenia is an autoimmune disorder characterized by reduced platelet counts. Neonatal thrombocytopenia incidence has been linked with immune thrombocytopenic purpura in mothers during pregnancy, possibly because antiplatelet antibodies can cross the placental barrier. To date, no study has attempted to evaluate the actual prevalence of neonatal thrombocytopenia in infants born to mothers with immune thrombocytopenic purpura. Read More

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Loncastuximab tesirine in relapsed or refractory diffuse large B-cell lymphoma (LOTIS-2): a multicentre, open-label, single-arm, phase 2 trial.

Lancet Oncol 2021 06 11;22(6):790-800. Epub 2021 May 11.

Department of Oncology and Haematology, Humanitas Clinical and Research Center, IRCCS, Humanitas University, Milan, Italy.

Background: Patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) who do not respond to or who have progressive disease after salvage therapies have a poor prognosis. Loncastuximab tesirine is a CD19-directed antibody-drug conjugate with encouraging phase 1 single-agent antitumour activity and acceptable safety in non-Hodgkin lymphoma. We aimed to evaluate the antitumour activity and safety of loncastuximab tesirine in patients with relapsed or refractory DLBCL. Read More

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Evaluating hemostatic thresholds for neuraxial anesthesia in adults with hemorrhagic disorders and tendencies: A scoping review.

Res Pract Thromb Haemost 2021 May 4;5(4):e12491. Epub 2021 May 4.

Division of Hematology Department of Medicine and Department of Laboratory Medicine and Pathobiology St. Michael's Hospital Toronto ON Canada.

Neuraxial anesthesia can be complicated by spinal or epidural hematoma and may result in permanent neurologic injury. There is a paucity of literature characterizing this serious complication in patients with congenital and acquired hemorrhagic disorders or tendencies. The objective of this scoping review was to describe the hemostatic laboratory parameters where neuraxial anesthesia has been administered with and without spinal and epidural hematoma in patients with preexisting hemorrhagic disorders and tendencies, including immune thrombocytopenia, gestational thrombocytopenia, thrombocytopenia associated with hypertensive disorders of pregnancy, platelet function disorders, von Willebrand disease, coagulation factor deficiencies, and fibrinogen disorders. Read More

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Obstetric neuraxial anaesthesia in the setting of immune thrombocytopenia and low platelet counts: call to participate in an international registry.

Br J Anaesth 2021 07 27;127(1):e12-e13. Epub 2021 Apr 27.

Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, ON, Canada; School of Baccalaureate Nursing, St. Lawrence College, Kingston, ON, Canada.

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Safety of COVID-19 vaccines administered in the EU: Should we be concerned?

Toxicol Rep 2021 20;8:871-879. Epub 2021 Apr 20.

Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece.

The COVID-19 pandemic has had an unprecedented and devastating impact on public health, society and economics around the world. As a result, the development of vaccines to protect individuals from symptomatic COVID-19 infections has represented the only feasible health tool to combat the spread of the disease. However, at the same time the development and regulatory assessment of different vaccines has challenged pharmaceutical industries and regulatory agencies as this process has occurred in the shorter time ever though. Read More

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Clinical features and outcomes of neonatal dengue at the Children's Hospital 1, Ho Chi Minh, Vietnam.

J Clin Virol 2021 May 9;138:104758. Epub 2021 Feb 9.

School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan; Institute of Research and Development, Duy Tan University, Da Nang 550000, Viet Nam. Electronic address:

Objectives Neonatal dengue has been reported in the literature with contradictory findings of clinical characteristics and diagnosis; thereby, misdiagnosis of neonatal dengue has been frequently reported. We aim to delve into the epidemiology, clinical features, and outcomes of neonatal dengue, thus avoid misdiagnosis and obtain early intervention. Study design A retrospective study was conducted at Children's Hospital 1, Ho Chi Minh, Vietnam with laboratory-confirmed dengue in neonates by positive viral antigen nonstructural protein one rapid test (NS1) and positive IgM antibody for dengue by MAC-ELISA. Read More

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The Society for Obstetric Anesthesia and Perinatology Interdisciplinary Consensus Statement on Neuraxial Procedures in Obstetric Patients With Thrombocytopenia.

Anesth Analg 2021 06;132(6):1531-1544

Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.

Because up to 12% of obstetric patients meet criteria for the diagnosis of thrombocytopenia in pregnancy, it is not infrequent that the anesthesiologist must decide whether to proceed with a neuraxial procedure in an affected patient. Given the potential morbidity associated with general anesthesia for cesarean delivery, thoughtful consideration of which patients with thrombocytopenia are likely to have an increased risk of spinal epidural hematoma with neuraxial procedures, and when these risks outweigh the relative benefits is important to consider and to inform shared decision making with patients. Because there are substantial risks associated with withholding a neuraxial analgesic/anesthetic procedure in obstetric patients, every effort should be made to perform a bleeding history assessment and determine the thrombocytopenia etiology before admission for delivery. Read More

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New developments in fetal and neonatal alloimmune thrombocytopenia.

Am J Obstet Gynecol 2021 Apr 8. Epub 2021 Apr 8.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY; Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY.

Fetal and neonatal alloimmune thrombocytopenia, the platelet equivalent of hemolytic disease of the fetus and newborn, can have devastating effects on both the fetus and neonate. Current management of fetal and neonatal alloimmune thrombocytopenia in a subsequent affected pregnancy involves antenatal administration of intravenous immune globulin and prednisone to the pregnant woman to prevent the development of severe fetal thrombocytopenia and secondary intracranial hemorrhage in utero. That therapy has proven to be highly effective but is associated with maternal side effects and is expensive. Read More

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Thrombopoietin receptor agonist for treatment of immune thrombocytopenia in pregnancy: a narrative review.

Ther Adv Hematol 2021 19;12:20406207211001139. Epub 2021 Mar 19.

Division of Hematology and Oncology, Seidman Cancer Center, University Hospitals, 11100 Euclid Avenue, Cleveland, OH 44106, USA.

The treatment of immune thrombocytopenia (ITP) in adults has evolved rapidly over the past decade. The second-generation thrombopoietin receptor agonists (TPO-RAs), romiplostim, eltrombopag, and avatrombopag are approved for the treatment of chronic ITP in adults. However, their use in pregnancy is labeled as category C by the United States Food and Drug Administration (FDA) due to the lack of clinical data on human subjects. Read More

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[Diagnosis and management of severe neonatal thrombocytopenia due to maternal alloimmunization against fetal platelet antigens: case study and literature review].

Pan Afr Med J 2020 29;37:382. Epub 2020 Dec 29.

Department of Pediatrics, Mohammed VI University of Health Sciences, Casablanca, Morocco.

Thrombocytopenia is a common hematologic disorder in the neonatal period. It can occur in neonates hospitalized in the Intensive Care Unit and in preterm infants. It is characterized by a platelet count of less than 150. Read More

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A successfully treated case of an acute presentation of congenital thrombotic thrombocytopenic purpura (Upshaw-Schulman syndrome) with decreased ADAMTS13 during late stage of pregnancy.

J Obstet Gynaecol Res 2021 May 9;47(5):1892-1897. Epub 2021 Mar 9.

Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata City, Japan.

We herein report the case of a 28-year-old pregnant woman with an acute presentation of remarkable petechiae on her lower extremities and severe thrombocytopenia (16 000/mm ) at the 35th week of gestation. Although idiopathic thrombocytopenic purpura was initially suspected, subsequent examinations revealed that her ADAMTS13 (a Disintegrin And Metalloprotease, with ThromboSpondin type 1 repeats, member 13) titer was extremely decreased, while she was negative for antibodies against ADAMTS13. Infusion of fresh frozen plasma was immediately performed, and the platelet count was observed to increase. Read More

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Targeting the neonatal Fc receptor (FcRn) to treat autoimmune diseases and maternal-fetal immune cytopenias.

Transfusion 2021 05 2;61(5):1350-1354. Epub 2021 Mar 2.

Columbia University Irving Medical Center, New York, New York, USA.

FcRn, a non-classical Fc gamma (γ) receptor (FcγR) with near ubiquitous expression, plays key roles in disease pathogenesis and progression though immunoglobulin G (IgG) transport, IgG recycling, and IgG-immune complex clearance. FcRn function can be inhibited using IgG-based and non-IgG-based antagonists, by exploiting the pH-dependent binding affinity of FcRn for the IgG Fc region. FcRn therapeutics have shown promise in murine models and human clinical trials for autoimmune diseases and maternal-fetal immune cytopenias; they appear safe, well-tolerated, and reduce circulating IgG levels. Read More

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Primary immune thrombocytopenia in adults: Belgian recommendations for diagnosis and treatment anno 2021 made by the Belgian Hematology Society.

Acta Clin Belg 2021 Feb 26:1-14. Epub 2021 Feb 26.

Department of Hematology, Cliniques Universitaire St Luc, Bruxelles, Belgium.

The Belgian Hematology Society (BHS) updated the 2013 guidelines for diagnosis and treatment of primary immune thrombocytopenia (ITP) [1]. As knowledge about ITP pathophysiology is increasing, the mode of action of old therapies is better understood and novel drugs are introduced to target more specific pathways.Corticosteroids with or without intravenous immunoglobulins (IgIV) remain the first-line treatment. Read More

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February 2021

Prediction of postpartum hemorrhage in pregnant women with immune thrombocytopenia: Development and validation of the MONITOR model in a nationwide multicenter study.

Am J Hematol 2021 05 7;96(5):561-570. Epub 2021 Mar 7.

Peking University People's Hospital, Peking University Institute of Hematology; National Clinical Research Center for Hematologic Disease; Collaborative Innovation Center of Hematology; Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.

Globally, postpartum hemorrhage (PPH) is the leading cause of maternal death. Women with immune thrombocytopenia (ITP) are at increased risk of developing PPH. Early identification of PPH helps to prevent adverse outcomes, but is underused because clinicians do not have a tool to predict PPH for women with ITP. Read More

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Down syndrome with neonatal alloimmune thrombocytopenia due to anti-HLA A31 and B61 antibodies.

Int J Hematol 2021 Jun 11;113(6):945-949. Epub 2021 Feb 11.

Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.

Neonatal alloimmune thrombocytopenia (NAIT) arises from fetomaternal platelet incompatibility that results in transplacental passage of maternal antibodies mostly against fetal human platelet antigens (HPA), whereas NAIT due to anti-human leukocyte antigen (HLA) antibodies is extremely rare. Here, we report a case of Down syndrome (DS) with NAIT that was attributed to HLA antibodies. A boy with DS was delivered at 36 weeks' gestation. Read More

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Thrombotic Thrombocytopenic Purpura: Pathophysiology, Diagnosis, and Management.

J Clin Med 2021 Feb 2;10(3). Epub 2021 Feb 2.

Division of Hematology, Department of Medicine, The Ohio State University, Columbus, OH 43210, USA.

Thrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy characterized by microangiopathic hemolytic anemia, severe thrombocytopenia, and ischemic end organ injury due to microvascular platelet-rich thrombi. TTP results from a severe deficiency of the specific von Willebrand factor (VWF)-cleaving protease, ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13). ADAMTS13 deficiency is most commonly acquired due to anti-ADAMTS13 autoantibodies. Read More

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February 2021

Maternal Hematologic Conditions and Fetal/Neonatal Outcomes of Pregnancy.

Neoreviews 2021 02;22(2):e95-e103

Department of Obstetrics and Gynecology, Maternal and Fetal Medicine, St Johns Riverside Hospital, Yonkers, NY.

Hematologic conditions in reproductive-age women can complicate pregnancy and the neonatal period. Affected pregnancies have a higher risk of severe morbidity and mortality. Coagulation factor changes that occur in the normal state of pregnancy can delay detection and recognition of a bleeding disorder in cases without an apparent bleeding history, thus hindering the appropriate management during gestation and the neonatal period. Read More

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February 2021

Eltrombopag use for refractory immune thrombocytopenia in pregnancy: A case report.

Case Rep Womens Health 2021 Jan 26;29:e00281. Epub 2020 Dec 26.

Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY, United States of America.

Background: Immune thrombocytopenic purpura (ITP) is a rare autoimmune disorder that involves platelet destruction in the spleen. Eltrombopag (Promacta®), a thrombopoietin agonist, has been used in non-pregnant patients to manage ITP, but few cases of its use in pregnancy have been reported.

Case Presentation: We present a case of a pregnant patient at 26 weeks of gestation with severe refractory ITP. Read More

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January 2021

Update on the Use of Intravenous Immunoglobulin in Pregnancy.

Neoreviews 2021 01;22(1):e7-e24

Department of Obstetrics and Gynecology and.

Intravenous immunoglobulin (IVIG) was first administered to humans in the 1980s. The mechanism of action of IVIG is still a subject of debate but the pharmacokinetics have been well characterized, albeit outside of pregnancy. IVIG has been used in pregnancy to treat several nonobstetrical and obstetrical-related conditions. Read More

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January 2021

Are Tpo agonists an option for ITP in pregnancy?

Authors:
Howard A Liebman

Blood 2020 12;136(26):2971-2972

University of Southern California-Keck School of Medicine.

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December 2020

Update on Thrombocytopenia in Pregnancy.

Rev Bras Ginecol Obstet 2020 Dec 21;42(12):834-840. Epub 2020 Dec 21.

Universidade de Coimbra, Coimbra, Portugal.

Thrombocytopenia, defined as platelet count < 150,000 mm, is frequently diagnosed by obstetricians since this parameter is included in routine surveillance during pregnancy, with an incidence of between 7 and 12%. Therefore, decisions regarding subsequent examination and management are primordial. While most of the cases are due to physiological changes, as gestational thrombocytopenia, other causes can be related to severe conditions that can lead to fetal or maternal death. Read More

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December 2020

Investigation of the efficacy and safety of eltrombopag to correct thrombocytopenia in moderate to severe dengue patients - a phase II randomized controlled clinical trial.

EClinicalMedicine 2020 Dec 21;29-30:100624. Epub 2020 Nov 21.

Laboratory of Population Genetics, Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka 1000, Bangladesh.

Background: The dengue-infected patients with or without hemorrhagic manifestations, typically exhibit moderate to severe thrombocytopenia. A thrombopoietin receptor agonist - eltrombopag has been efficacious in correcting thrombocytopenia in patients with various pathological conditions including immune thrombocytopenia, chronic liver disease, and severe aplastic anemia. This study investigated the efficacy and safety of eltrombopag to correct dengue-mediated thrombocytopenia. Read More

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December 2020