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Case Rep Otolaryngol 2021 12;2021:9804515. Epub 2021 Apr 12.

Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan.

[This corrects the article DOI: 10.1155/2021/6612939.]. Read More

Cureus 2021 Mar 29;13(3):e14166. Epub 2021 Mar 29.

Hematology and Oncology, Hamad General Hospital, Doha, QAT.

Idiopathic thrombocytopenic purpura (ITP) is an immune disorder in which antibodies attack platelets, leading to platelet destruction and increased bleeding risk. Standard treatment is to maintain a platelet count sufficient to mitigate the bleeding risk. First-line therapies include steroids and IV immunoglobulins, and second-line therapy includes thrombopoietin receptor agonists like eltrombopag in combination with other medications (e. Read More

Br J Haematol 2021 May 2. Epub 2021 May 2.

Emergency Medicine Department, Fondazione Universitaria Policlinico A. Gemelli - IRCCS - Catholic University of Sacred Heart of Rome, Rome, Italy.

Front Immunol 2021 12;12:677572. Epub 2021 Apr 12.

Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan.

Lipopolysaccharide-responsive beige-like anchor (LRBA) deficiency is a subtype of common variable immune deficiency (CVID). Numerous case reports and cohort studies have described a broad spectrum of clinical manifestations and variable disease phenotypes, including immune dysregulation, enteropathy, and recurrent infections. Although LRBA deficiency is an autosomal recessive primary immunodeficiency resulting in a phenotype similar to CVID, it is a monogenic disease and separate from CVID. Read More

Curr Clin Pharmacol 2021 Apr 26. Epub 2021 Apr 26.

PRA Health Sciences, Real World Solutions, PA. United States.

Background: It is increasingly recognized that patients should be involved in the design of clinical trials. However, there is a lack in agreement of what patient-centricity means.

Methods: In this article a Patient Motivation Pyramid based on Maslow's theory of human motivation is introduced as a tool to identify patient needs. Read More

Acta Haematol 2021 Apr 23:1-5. Epub 2021 Apr 23.

Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.

SARS-CoV-2 has been reported as a possible triggering factor for the development of several autoimmune diseases and inflammatory dysregulation. Here, we present a case report of a woman with a history of systemic lupus erythematosus and antiphospholipid syndrome, presenting with concurrent COVID-19 infection and immune thrombotic thrombocytopenic purpura (TTP). The patient was treated with plasma exchange, steroids, and caplacizumab with initial good response to therapy. Read More

BMC Infect Dis 2021 Apr 23;21(1):380. Epub 2021 Apr 23.

Department of Neurology, The First People's Hospital of Changde City, Changde, Hunan, China.

Background: Brain abscesses caused by Nocardia farcinica are rare, and mostly occur in immunocompromised individuals. Rapid and accurate diagnosis of nocardiosis is challenging. Due to the inadequate performance of conventional diagnostic methods for Nocardia infection, metagenomics next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) has the potential to improve the diagnosis intracranial nocardiosis. Read More

World J Clin Cases 2021 Apr;9(11):2611-2618

Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.

Background: Eltrombopag is an orally administered thrombopoietin receptor agonist linked to a heightened risk of treatment-related thromboembolism. Both venous and arterial thromboses have been documented in the medical literature.

Case Summary: In the absence of nephropathy, a 48-year-old patient receiving eltrombopag for immune thrombocytopenia (ITP) developed renal vein thrombosis and pulmonary embolism. Read More

Acta Chir Belg 2021 Apr 30:1-11. Epub 2021 Apr 30.

Department of General Surgery, Fundeni Clinical Institute, Bucharest, Romania.

Background: The mechanisms that induce immunodeficiency after splenectomy remain unknown. The aim of this study was to measure the cytokine releasing capacity of the whole blood as an expression of the innate immunity after total (TS) and subtotal/partial splenectomy (S/PS) in order to assess the impact of splenectomy on the individual cytokine reactivity.

Methods: We prospectively collected blood before (D0) and at multiple time points after splenectomy (7 days - D7, 30 days - D30, 90 days - D90, 180 days - D180, and 360 days - D360) and measured the cytokines releasing capacity of IL-6, TNF-alpha and IL-10 from whole blood under LPS stimulation which we normalized to the monocytes number. Read More

Updates Surg 2021 Apr 20. Epub 2021 Apr 20.

Pediatric Surgery, Ca' Foncello Hospital, 31100, Treviso, Italy.

The laparoscopic splenectomy in pediatric patients is performed worldwide but often the disproportion between size of patients and size of organs requires an extra laparotomic access for spleen removal. The aim of the present study was to evaluate the safety and effectiveness of the Alexis system to retrieve the spleen without additional laparotomic access. The charts of all patients who underwent splenectomy at our center during the last 5 years were retrieved. Read More

Clin Appl Thromb Hemost 2021 Jan-Dec;27:10760296211005555

Department of Hematology, Zhengzhou University People's Hospital & Henan Provincial People's Hospital Henan, Zhengzhou, People's Republic of China.

Eltrombopag is an orally administered, non-peptide, thrombopoietin receptor agonist which initiates thrombopoietin signaling and stimulates the production of normally functioning platelet. We aimed to do a systematic review and meta-analysis of currently available published data to verify whether eltrombopag treatment in patients with chronic immune-mediated thrombocytopenia can prolong survival. We searched for published, randomized, controlled trials in PubMed, Cochrane and Scopus databases using the following search strategy ("Eltrombopag" OR "Benzoates" OR "Hydrazines") AND ("Idiopathic Thrombocytopenic Purpura" OR "immune thrombocytopenia" OR "Idiopathic Thrombocytopenic Purpuras" OR "Immune Thrombocytopenia" OR "Autoimmune Thrombocytopenia" OR "Werlhof"). Read More

Eur J Case Rep Intern Med 2021 30;8(3):002449. Epub 2021 Mar 30.

Hematology/Oncology, Rochester General Hospital, Rochester, New York, USA.

Blood dyscrasias associated with levetiracetam use can be difficult to identify, especially when other potential differential diagnoses are concurrently present. Here we present a 57-year-old man with metastatic adenocarcinoma of unknown primary origin on levetiracetam who initially presented with an in-stent thrombosis of the right external iliac vein and then developed worsening thrombocytopenia followed by pancytopenia. Levetiracetam was not identified as the culprit until other causes like platelet consumption, heparin-induced thrombocytopenia, idiopathic immune thrombocytopenic purpura, and bone marrow involvement by metastatic disease were ruled out. Read More

Am Surg 2021 Apr 18:31348211011128. Epub 2021 Apr 18.

Department of Surgery, Division of Pediatric Surgery, University of Mississippi Medical Center, Jackson, MS, USA.

Immune thrombocytopenic purpura (ITP) is a disorder caused by autoimmune antibodies which target glycoprotein IIb/IIIa complex or other platelet membrane antigens leading to platelet destruction. These platelets are then cleared by the spleen resulting in thrombocytopenia. Immune thrombocytopenic purpura affects about 1 to 6. Read More

Zhonghua Xue Ye Xue Za Zhi 2021 Feb;42(2):146-150

Department of Hematology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital) , Zhengzhou 450008, China.

To explore the relationship between the expression of neuropilin-1 (NRP-1) on Treg cells and its ligands semaphorins-3A (Sema3A) , transforming growth factor-β(1) (TGF-β(1)) as well as the balance of type 1 helper T cells (Th(1)) and type 2 helper T cells (Th(2)) cells. This study enrolled 62 patients with immune thrombocytopenia (ITP; 33 and 29 newly diagnosed and chronic ITP, respectively) from March 2014 to May 2015. Consequently, 30 healthy people in the same period were selected as the normal control group. Read More

J Blood Med 2021 6;12:221-224. Epub 2021 Apr 6.

The Bleeding and Clotting Disorders Institute, Peoria, IL, USA.

The rollout of the SARS-CoV-2 vaccine is underway, and millions have already been vaccinated. At least 25 reports of "immune thrombocytopenia" (ITP) or "thrombocytopenia" following the Moderna or Pfizer vaccine have been added to the Vaccine Adverse Event Reporting System (VAERS) in the US. ITP is a rare but known complication of several vaccinations. Read More

Acta Haematol 2021 Apr 13:1-9. Epub 2021 Apr 13.

Department of Clinical Laboratory Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China.

Objective: The objective of this study was to determine the expression of G protein-coupled receptors (GPCRs) in platelets from adult patients with chronic immune thrombocytopenic purpura (ITP).

Methods: Peripheral blood samples were collected from 40 patients with chronic ITP in the Second Affiliated Hospital of Shantou University Medical College, and 40 peripheral blood samples from healthy volunteers were collected; expressions of the adenosine diphosphate receptors (P2Y1 and P2Y12), alpha-2A adrenergic receptor (α2A-AR), and thromboxane A2 receptor (TP) in platelets were detected by flow cytometry. Gα protein, protease-activated receptor 1 (PAR1), and protease-activated receptor 4 (PAR4) were analyzed by Western blot and analyzed statistically. Read More

Iran J Pharm Res 2020 ;19(4):275-289

Department of Radiology, Ziyaian Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Idiopathic Thrombocytopenic Purpura (ITP) is a multifactorial disease with decreased count of platelet that can lead to bruising and bleeding manifestations. This study was intended to identify critical genes associated with chronic ITP. The gene expression profile was downloaded from the Gene Expression Omnibus database to recognize Differentially Expressed Genes (DEGs) by R software. Read More

Indian J Nephrol 2020 Nov-Dec;30(6):424-426. Epub 2020 Nov 19.

Department of Hematology, Army Hospital (Research and Referral), New Delhi, India.

Significance of antiphospholipid antibodies in immune thrombocytopenic purpura is debatable and pose a diagnostic and therapeutic dilemma. Catastrophic antiphospholipid syndrome is a rare life-threatening entity, occurring in patients with antiphospholipid syndrome, usually after a triggering event. We describe an adult lady of chronic immune thrombocytopenic purpura (in remission) with antiphospholipid antibodies, who presented with rapidly progressive renal failure and had primary antiphospholipid syndrome nephropathy. Read More

J Pediatr 2021 Apr 7. Epub 2021 Apr 7.

IRCCS Istituto Giannina Gaslini, Genoa, Italy; Università degli Studi di Genova, Genoa, Italy; Sechenov First Moscow State Medical University, Moscow, Russian Federation.

Objective: To describe the clinical characteristics, treatment, and outcomes of a multinational cohort of patients with macrophage activation syndrome (MAS) and thrombotic microangiopathy (TMA).

Study Design: International pediatric rheumatologists were asked to collect retrospectively the data of patients with the co-occurrence of MAS and TMA. Clinical and laboratory features of patients with systemic juvenile idiopathic arthritis (sJIA)-associated MAS and TMA were compared with those of an historical cohort of patients with sJIA and MAS. Read More

J Thromb Haemost 2021 Apr 9. Epub 2021 Apr 9.

Department of Pathology and Laboratory Medicine, University of Kansas, Medical Center, Kansas City, Kansas, U.S.A.

Background: Immune thrombotic thrombocytopenic purpura (iTTP) is a potentially fatal thrombotic microangiopathy, resulting from a severe deficiency of plasma ADAMTS13 activity. Immunoglobulin (Ig) G-type autoantibodies are primarily responsible for the inhibition of plasma ADAMTS13 activity. However, the mechanism underlying autoantibody-mediated inhibition is not fully understood. Read More

BMJ Case Rep 2021 Apr 7;14(4). Epub 2021 Apr 7.

James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, Norfolk, UK.

A 77-year-old man was admitted with severe acute kidney injury and nephrotic syndrome. He was started on eltrombopag for chronic idiopathic thrombocytopenic purpura 6 weeks earlier. An ultrasound of the kidneys was normal and an auto-antibody screen was negative. Read More

Anal Chem 2021 04 7;93(15):6169-6177. Epub 2021 Apr 7.

Department of Biosystems, Biosensors Group, KU Leuven, Willem De Croylaan 42, Heverlee B-3001, Belgium.

Antibody characterization is essential for understanding the immune system and development of diagnostics and therapeutics. Current technologies are mainly focusing on the detection of antigen-specific immunoglobulin G (IgG) using bulk singleplex measurements, which lack information on other isotypes and specificity of individual antibodies. Digital immunoassays based on nucleic acid amplification have demonstrated superior performance by allowing the detection of single molecules in a multiplex and sensitive manner. Read More

Front Med (Lausanne) 2021 18;8:657539. Epub 2021 Mar 18.

School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.

This study aimed to compare the economic evaluation of recombinant human thrombopoietin+rituximab (rhTPO + RTX) vs. RTX as second-line treatment for adult patients with immunologic thrombocytopenic purpura in China. The Markov model was used in our research. Read More

Cureus 2021 Feb 28;13(2):e13615. Epub 2021 Feb 28.

Internal Medicine, University of Texas Medical Branch, Galveston, USA.

A 35-year-old female was admitted to the hospital for menorrhagia and fatigue. Initial labs revealed that the patient had severe thrombocytopenia and also tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The main objective in this case is to describe the investigation that eventually led to a diagnosis of idiopathic thrombocytopenic purpura (ITP) in the setting of a SARS-CoV-2 coronavirus disease 2019 (COVID-19) infection and co-infection with Epstein-Barr virus (EBV). Read More

Zhongguo Shi Yan Xue Ye Xue Za Zhi 2021 Apr;29(2):581-585

Department of Hematology, The 901th Hospital of the Joint Logistics Support Force of PLA, Hefei 230031, Anhui Province, China,E-mail:

Objective: To investigate the effect of expression level changes of monocytic myeloid-derived suppressor cells (M-MDSC) to related immune function in the patients with primary immune thrombocytopenia (ITP).

Methods: Peripheral blood samples were collected from 53 newly diagnosed ITP patients and 30 healthy volunteers. The quantity of M-MDSC, mRNA levels of Arg-1 and iNOS were detected. Read More

Zhongguo Shi Yan Xue Ye Xue Za Zhi 2021 Apr;29(2):574-580

State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin 300020, China,E-mail:

Objective: To investigate the factors affecting the chronicity of childhood primary immune thrombo-cytopenia (ITP) and compare the efficiency of different first-line treatment regimens.

Methods: Children with ITP hospitalized in our hospital from September 2013 to October 2018 were retrospectively analyzed.

Results: Three hundred and one children (150 males and 151 females) were included in this study, with a median age of 8 (0. Read More

Cancers (Basel) 2021 Mar 26;13(7). Epub 2021 Mar 26.

Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

Autoimmune cytopenias (AICy) and autoimmune diseases (AID) can complicate both lymphoid and myeloid neoplasms, and often represent a diagnostic and therapeutic challenge. While autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP) are well known, other rarer AICy (autoimmune neutropenia, aplastic anemia, and pure red cell aplasia) and AID (systemic lupus erythematosus, rheumatoid arthritis, vasculitis, thyroiditis, and others) are poorly recognized. This review analyses the available literature of the last 30 years regarding the occurrence of AICy/AID in different onco-hematologic conditions. Read More

J Clin Med 2021 Mar 25;10(7). Epub 2021 Mar 25.

Department of Pediatrics, College of Medicine, Yeungnam University, Daegu 42415, Korea.

Immune thrombocytopenic purpura (ITP) is prevalent in children aged 2-5 years but may occur in all pediatric age groups. In 50-60% of pediatric patients, ITP is preceded by an upper respiratory tract infection 1-4 weeks before its onset. In this study, the relationship between the development of ITP and viral infections in children was assessed. Read More

Medicina (Kaunas) 2021 Mar 1;57(3). Epub 2021 Mar 1.

Hematology Unit, La Paz University Hospital-IdiPAZ, Paseo de la Castellana 261, Hospital Universitario La Paz, 28046 Madrid, Spain.

: The aim of this study was to determine the impact of the COVID-19 pandemic on the lives of patients with immune thrombocytopaenia (ITP) treated at our hospital. : The study was conducted in the Community of Madrid, which has the highest number of COVID-19 cases in Spain. We included 143 adult patients with ITP (130 with chronic ITP, 8 with persistent ITP, and 5 with newly diagnosed ITP). Read More

Ir J Med Sci 2021 Mar 31. Epub 2021 Mar 31.

Department of Emergency Medicine, Woodlands Health Campus, Singapore, Singapore.

Introduction: Based on the severity of thrombocytopenia, patients with immune thrombocytopenic purpura (ITP) are at an increased risk of mucocutaneous or major bleeding.

Discussion: There has been an increased risk of ITP after administration of various vaccines like influenza, measles-mumps-rubella, hepatitis B, and diphtheria-tetanus-pertussis. The pathogenesis of vaccine-related thrombocytopenia is not completely clear and is probably caused by molecular mimicry. Read More