4,236 results match your criteria itp patients

Incidence, characteristics and clinical profile of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in patients with pre-existing primary immune thrombocytopenia (ITP) in Spain.

Br J Haematol 2021 May 15. Epub 2021 May 15.

Hospital Universitario Virgen del Rocío, Sevilla, Spain.

Infections are one of the well-known precipitating factors for relapses in patients with immune thrombocytopenia (ITP). Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can sometimes lead to or be associated with thrombocytopenia due to an increase in peripheral platelet destruction from inflammatory hyperactivation. Currently, we do not know if SARS-CoV-2 infection modifies the natural evolution of chronic or persistent ITP or if previous immunosuppression of patients with ITP influences the incidence and severity of coronavirus disease 2019 (COVID-19) in this group. Read More

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The presence of idiopathic thrombocytopenic purpura correlates with lower rate of acute ST-elevation myocardial infarction.

Future Cardiol 2021 May 14. Epub 2021 May 14.

College of Medicine Phoenix, University of Arizona, AZ 85004, USA.

Platelets are important in the pathogenesis of myocardial infarction (MI). We hypothesize that patients with acquired thrombocytopenia such as idiopathic thrombocytopenic purpura (ITP) may have lower MI rate. The Nationwide Inpatient Sample was used for this study. Read More

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Comparative study of IgG binding to megakaryocytes in immune and myelodysplastic thrombocytopenic patients.

Ann Hematol 2021 May 13. Epub 2021 May 13.

Clinical Pathology Department, Faculty of Medicine, Minia University, Cornish Al-Nile Road, PO: 61519, Minia, Egypt.

Immune thrombocytopenia (ITP) is a disorder in which autoantibodies are responsible for destruction and decreased production of platelets. In the meantime, thrombocytopenia is frequent in patients with myelodysplastic syndromes (MDS) and immune clearance of megakaryocytes could be a reason. The aim of the present study is to evaluate and compare IgG binding to megakaryocytes in bone marrow of ITP and MDS patients to determine megakaryocytes targeting by autoantibodies in vivo as a mechanism of platelet underproduction in these disorders. Read More

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GPIbα is the driving force of hepatic thrombopoietin generation.

Res Pract Thromb Haemost 2021 May 3;5(4):e12506. Epub 2021 May 3.

Department of Laboratory Medicine and Pathobiology University of Toronto Toronto ON Canada.

Thrombopoietin (TPO), a glycoprotein hormone produced predominantly in the liver, plays important roles in the hematopoietic stem cell (HSC) niche, and is essential for megakaryopoiesis and platelet generation. Long-standing understanding proposes that TPO is constitutively produced by hepatocytes, and levels are fine-tuned through platelet and megakaryocyte internalization/degradation via the c-Mpl receptor. However, in immune thrombocytopenia (ITP) and several other diseases, TPO levels are inconsistent with this theory. Read More

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Revolution of Disturbed Bregs and Bmems Lymphocytes Homeostasis in Children With Chronic ITP After High-dose Dexamethasone Rescue Therapy.

J Pediatr Hematol Oncol 2021 May 11. Epub 2021 May 11.

Children's Hospital, Hematology Unit Department of Clinical Pathology Children's Hospital, Immunology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt.

Summary: Dexamethasone is approved as second-line therapy in pediatric chronic immune thrombocytopenic purpura (ITP). Several B-cell abnormalities have been described in ITP pathogenesis.This study assessed the effects of high-dose dexamethasone (HD-DXM) on the percentages and absolute counts of CD19+CD24hiCD38hi regulatory (Bregs) and CD19+CD27+ memory B lymphocytes (Bmems) in children with chronic ITP during active bleeding. Read More

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Fostamatinib: A Review in Chronic Immune Thrombocytopenia.

Julia Paik

Drugs 2021 May 10. Epub 2021 May 10.

Springer Nature, Mairangi Bay, Private Bag 65901, Auckland, 0754, New Zealand.

Fostamatinib (Tavalisse; Tavlesse) is the first spleen tyrosine kinase (Syk) inhibitor approved for the treatment of chronic immune thrombocytopenia (ITP) in adult patients who have had an insufficient response to previous treatment. By inhibiting Syk activation in macrophages, fostamatinib blocks autoantibody-mediated platelet phagocytosis. In the placebo-controlled phase III FIT1 and FIT2 trials, 24 weeks of oral fostamatinib therapy increased platelet count in previously treated adults with ITP. Read More

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Characterization of brain functional connectivity in treatment-resistant depression.

Prog Neuropsychopharmacol Biol Psychiatry 2021 May 4:110346. Epub 2021 May 4.

Medical Physics and Biomedical Engineering Department, Faculty of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Physical Medicine and Rehabilitation Department, Northwestern University, USA. Electronic address:

Objective: To characterize the functional connectivity (FC) of target brain regions for deep brain stimulation (DBS) in patients with treatment-resistant depression (TRD), and to evaluate its gender and brain lateralization dependence.

Methods: Thirty-one TRD patients and twenty-nine healthy control (HC) subjects participated. FC of subcallosal cingulate gyrus (SCG), ventral caudate (VCa), nucleus accumbens (NAc), lateral habenula (LHb), and inferior thalamic peduncle (ITP) were evaluated using resting-state fMRI. Read More

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Immune thrombocytopenia following multisystem inflammatory syndrome in children (MIS-C) - a case series.

Pediatr Hematol Oncol 2021 May 5:1-8. Epub 2021 May 5.

Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.

Patients with coronavirus disease 2019 (COVID-19) from novel coronavirus (SARS-CoV-2) infection may present with immune thrombocytopenia (ITP). Multisystem inflammatory syndrome in children (MIS-C) is a serious complication of SARS-CoV-2 causing systemic organ dysfunction. This case series presents the first reported cases of patients who developed ITP following MIS-C, while completing corticosteroid tapers. Read More

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Association of Immune Thrombocytopenia and Inflammatory Bowel Disease in Children.

J Clin Med 2021 Apr 30;10(9). Epub 2021 Apr 30.

UOC Oncoematologia Pediatrica-ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy.

Background: The association between inflammatory bowel disease (IBD) and immune thrombocytopenia (ITP) is still uncertain. In this multicenter retrospective study, the coexistence of both diseases was investigated in children diagnosed from 1 January 2000 to 31 December 2019.

Methods: Clinical characteristics of both IBD and ITP, onset of disorders, and patient's response to treatment were collected through a structured form sent to 55 Italian pediatric referring centers for hematological disorders. Read More

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"Indium-labelled autologous platelet sequestration studies predict response to splenectomy in immune thrombocytopenia: An Australian experience".

Intern Med J 2021 May 4. Epub 2021 May 4.

Consultant Haematologist Andrew Love Cancer Centre, University Hospital Geelong.

Background: Splenectomy is an effective intervention in primary immune thrombocytopenia (ITP). Attempts to define pre-clinical predictors of platelet response to splenectomy are inconsistent. Based on international studies defining the likelihood of platelet response using platelet sequestration, patients with relapsed/refractory ITP being considered for splenectomy at a regional Australian hospital were assessed with Indium-labelled autologous platelet sequestration (ILAPS) studies. Read More

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Regulation of Th1/Th2 and Th17/Treg by pDC/mDC imbalance in primary immune thrombocytopenia.

Exp Biol Med (Maywood) 2021 May 2:15353702211009787. Epub 2021 May 2.

Hematologic Disease Center, First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region Research Institute of Hematology, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region,830011, China.

This study investigates the regulatory effect of plasmacytoid dendritic cells (pDC)/myeloid dendritic cells (mDC) imbalance on balance of Th1/Th2 and Th17/Treg in primary immune thrombocytopenia (ITP). A total of 30 untreated ITP patients and 20 healthy controls were recruited. Compared with healthy control, the pDC proportion of ITP patients was significantly reduced ( = 0. Read More

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Efficacy and Safety of Avatrombopag in Patients with Chronic Immune Thrombocytopenia: A Systematic Literature Review and Network Meta-Analysis.

Adv Ther 2021 May 1. Epub 2021 May 1.

National Research Institute of Oncology, Kraków, Poland.

Introduction: A network meta-analysis (NMA) was performed to assess the efficacy and safety of avatrombopag, relative to eltrombopag, romiplostim, and fostamatinib, for patients with chronic immune thrombocytopenia (ITP) not responding adequately to corticosteroids.

Methods: A systematic search of publication and clinical trial databases was conducted to identify relevant randomized controlled trials (RCTs) and observational studies. Data from eligible studies were extracted and analyzed in a Bayesian framework using relative effect sizes vs placebo. Read More

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Platelet function and bleeding at different phases of childhood immune thrombocytopenia.

Sci Rep 2021 Apr 30;11(1):9401. Epub 2021 Apr 30.

National Medical Research Center of Pediatric Hematology, Oncology and Immunology Named After Dmitry Rogachev, Russian Ministry of Healthcare, 1 Samory Mashela Str, Moscow, Russia, 117997.

Immune thrombocytopenia (ITP) is believed to be associated with platelet function defects. However, their mechanisms are poorly understood, in particular with regard to differences between ITP phases, patient age, and therapy. We investigated platelet function and bleeding in children with either persistent or chronic ITP, with or without romiplostim therapy. Read More

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The Importance of Platelet Glycoside Residues in the Haemostasis of Patients with Immune Thrombocytopaenia.

J Clin Med 2021 Apr 13;10(8). Epub 2021 Apr 13.

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

Loss of sialic acid from the carbohydrate side chains of platelet glycoproteins can affect platelet clearance, a proposed mechanism involved in the etiopathogenesis of immune thrombocytopaenia (ITP). We aimed to assess whether changes in platelet glycosylation in patients with ITP affected platelet counts, function, and apoptosis. This observational, prospective, and transversal study included 82 patients with chronic primary ITP and 115 healthy controls. Read More

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Role of Thrombopoietin Receptor Agonists in Inherited Thrombocytopenia.

Int J Mol Sci 2021 Apr 21;22(9). Epub 2021 Apr 21.

Department of Hematology and Oncology, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, 30008 Murcia, Spain.

In the last decade, improvements in genetic testing have revolutionized the molecular diagnosis of inherited thrombocytopenias (ITs), increasing the spectrum of knowledge of these rare, complex and heterogeneous disorders. In contrast, the therapeutic management of ITs has not evolved in the same way. Platelet transfusions have been the gold standard treatment for a long time. Read More

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Prevalence of primary immune thrombocytopenia and related healthcare resource utilization among Texas Medicaid beneficiaries.

Curr Med Res Opin 2021 Apr 29. Epub 2021 Apr 29.

Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.

Objective: To estimate the prevalence of primary immune thrombocytopenia (ITP) and describe ITP-associated healthcare resource utilization (HRU) among Texas Medicaid beneficiaries.

Methods: A retrospective analysis using 2012-2015 Texas Medicaid claims data was conducted to estimate the annual prevalence of ITP. HRU was summarized for the 12-month period following initial ITP diagnosis. Read More

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Real-world use of thrombopoietin receptor agonists in elderly patients with primary immune thrombocytopenia.

Blood 2021 Apr 22. Epub 2021 Apr 22.

(Institute of Hematology, Bologna, Italy.

The efficacy and safety of thrombopoietin-receptor agonists (TRAs) in elderly patients with primary immune thrombocytopenia (ITP) is uncertain. In 384 ITP patients treated with TRAs when aged ≥60 years, we investigated TRAs response and switch, thrombotic/hemorrhagic risk, and sustained responses off-treatment (SROT). After 3 months, 82. Read More

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Eltrombopag-related renal vein thromboembolism in a patient with immune thrombocytopenia: A case report.

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

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Off-hour effect on time metrics and clinical outcomes in endovascular treatment for large vessel occlusion: A systematic review and meta-analysis.

Int J Stroke 2021 May 4:17474930211012545. Epub 2021 May 4.

Department of Neurology, Jinling Hospital, Medical School of Southeast University, Nanjing, China.

Background: There is an ongoing debate on the off-hour effect on endovascular treatment (EVT) for acute large vessel occlusion (LVO).

Aim: This meta-analysis aimed to compare time metrics and clinical outcomes of acute LVO patients who presented/were treated during off-hour with those during working hours.

Summary Of Review: Structured searches on the PubMed, Embase, Web of Science, and Cochrane Library databases were conducted through 23 February 2021. Read More

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Low-dose decitabine modulates T cell homeostasis and restores immune tolerance in immune thrombocytopenia.

Blood 2021 Apr 19. Epub 2021 Apr 19.

Qilu hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Our previous clinical study demonstrated that low-dose decitabine showed sustained responses in nearly half of refractory immune thrombocytopenia (ITP) patients. The long-term efficacy of decitabine in ITP is not likely due to its simple role in increasing platelet production. Whether decitabine has the potential to restore immune tolerance in ITP is unknown. Read More

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Effectiveness and Safety of Romiplostim Among Patients with Newly Diagnosed, Persistent and Chronic Immune Thrombocytopenia in European Clinical Practice.

Adv Ther 2021 May 18;38(5):2673-2688. Epub 2021 Apr 18.

NoviSci, Inc., 201 W Main St, Ste 101, Durham, NC, 27701, USA.

Introduction: Romiplostim has been approved in Europe since 2009 to treat patients with chronic primary immune thrombocytopenia (ITP). Using real-world data from seven European countries, we measured the effectiveness and safety outcomes within 24 weeks following romiplostim initiation by duration of ITP: less than 3 months ("newly diagnosed"), 3-12 months ("persistent"), and more than 12 months ("chronic").

Methods: Adults with ITP and ≥ 1 romiplostim administration between 2009 and 2012 were included. 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 Feb 4. Epub 2021 Feb 4.

From the *Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan †Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota ‡Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York §Department of Medicine, University of Washington School of Medicine, Seattle, Washington ‖Department of Medicine, Medical College of Wisconsin and Versiti, Milwaukee, Wisconsin ¶Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina #Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee **Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Langone Health, New York, New York ††Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, Liaison for the American College of Obstetricians and Gynecologists ‡‡Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts §§Taubman Health Sciences Library, University of Michigan Medical School, Ann Arbor, Michigan ‖‖Department of Medicine, University of Florida, Gainesville, Florida ¶¶Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina ##Department of Anesthesiology, Hospital for Special Surgery, Weill Cornell Medicine, New York, New York *#x002A;*Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, New York.

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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February 2021

[The involvement of neuropilin-1 in primary immune thrombocytopenia].

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

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February 2021

Preliminary Investigation about the Expression of G Protein-Coupled Receptors in Platelets from Patients with Chronic Immune Thrombocytopenic Purpura.

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

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Catastrophic Antiphospholipid Syndrome in Immune Thrombocytopenic Purpura - Beyond Tenuous Concomitance!

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

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November 2020

Clinical efficacy of high-dose dexamethasone with sequential prednisone maintenance therapy for newly diagnosed adult immune thrombocytopenia in a real-world setting.

J Int Med Res 2021 Apr;49(4):3000605211007322

Department of Hematology, Anhui Provincial Hospital, WanNan Medical College, Wuhu, China.

Objective: As first-line treatments for newly diagnosed adult immune thrombocytopenia (ITP), high-dose dexamethasone (HD-DXM) and conventional-dose prednisone achieve good initial responses, but their long-term efficacy is poor. To improve the long-term outcome of newly diagnosed ITP, we explored the efficacy and safety of HD-DXM with sequential prednisone maintenance therapy.

Methods: This retrospective study in a real-world setting assessed 72 consecutive newly diagnosed ITP patients administered first-line HD-DXM with sequential prednisone maintenance therapy from 1 June 2016 to 31 December 2019. Read More

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Indirect detection of anti-platelet antibodies in immune thrombocytopenia.

Pathology 2021 Apr 8. Epub 2021 Apr 8.

Haematology Research Unit, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia; Department of Haematology, St George Hospital, Kogarah, NSW, Australia.

Despite recent advances in the understanding and treatment of immune thrombocytopenia (ITP), its diagnosis remains clinical due to the lack of sensitive laboratory tests. The detection of anti-platelet antibodies (APA) in plasma, although highly specific, is notoriously insensitive. Specialised clinical platelet laboratories routinely perform a screening test of only one dilution for indirect APA testing by flow cytometry. Read More

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Immune cytopenias as a continuum in inborn errors of immunity: An in-depth clinical and immunological exploration.

Immun Inflamm Dis 2021 Apr 10. Epub 2021 Apr 10.

Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Background: Immune thrombocytopenia (ITP), autoimmune hemolytic anemia (AIHA), and autoimmune neutropenia (AIN) are disorders characterized by immune-mediated destruction of hematopoietic cell lineages. A link between pediatric immune cytopenias and inborn errors of immunity (IEI) was established in particular in the combined and chronic forms.

Objective: Aim of this study is to provide clinical-immunological parameters to hematologists useful for a prompt identification of children with immune cytopenias deserving a deeper immunological and genetic evaluation. Read More

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Diagnostic characteristics of immature platelet fraction for the assessment of immune thrombocytopenia.

Thromb Res 2021 Mar 29;202:125-127. Epub 2021 Mar 29.

Postgraduate Program in Pharmaceutical Sciences, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil; Department of Clinical and Toxicological Analysis, Center of Health Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil.

The diagnosis of immune thrombocytopenia (ITP) remains an exclusion, as a specific biomarker is missing. We aimed to investigate the diagnostic characteristics, establish a cut-off point for reticulated platelets, and compare it with the clinical exclusion diagnosis used in the assessment of ITP. Forty-one patients with ITP and 187 healthy individuals were enrolled in Santa Maria, Brazil. Read More

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How I treat primary ITP in adult patients who are unresponsive to or dependent on corticosteroid treatment.

Blood 2021 Apr 7. Epub 2021 Apr 7.

Massachusetts General Hospital, Boston, Mississippi, United States.

Approximately 80% of adult patients with immune thrombocytopenia (ITP) fail or become dependent on corticosteroids and require second-line therapy. Several new and effective therapies have been introduced during the last decade and our understanding of disease burden and its effect on quality of life has expanded. It is now recommended that splenectomy, the standard second-line therapy for decades, be delayed for at least 12-24 months allowing more patients to achieve remission on medical therapies before considering surgery. Read More

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