Diagnostik und Therapie der Immunthrombozytopenie

Matzdorff, Axel; Wörmann, Bernhard

doi:10.1055/a-0384-4703

Cited by 10 publications

(3 citation statements)

References 11 publications

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“…Primary immune thrombocytopenia (ITP) is an acquired organ-specific autoimmune disorder 1, characterized by transient or persistent decrease of the peripheral blood (PB) platelet count to less than 100 × 10 9 /L in the absence of conditions known to cause thrombocytopenia. The overall incidence of ITP ranges from 2.0 to 5.3 per 10 5 adults each year 2-4.…”

Section: Introductionmentioning

confidence: 99%

Disrupted balance of CD4⁺ T-cell subsets in bone marrow of patients with primary immune thrombocytopenia

Wang¹,

Li²,

Yu³

et al. 2019

Int. J. Biol. Sci.

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Disequilibrium of CD4 + T-cell subpopulations in peripheral blood (PB) of patients with primary immune thrombocytopenia (ITP) has been well established, whereas the profile of CD4 + T-cell subpopulations in bone marrow (BM) remains elusive. In the present study, the frequencies of T helper 22 (Th22), Th17, Th1, Th2, follicular T helper (Tfh) cells and regulatory T cells (Tregs) as well as their effector cytokines in BM and PB from active ITP patients and healthy controls (HCs) were determined. Results showed that the frequencies of Th22, Th17, Th1, and Tfh cells were significantly higher, but Treg number was remarkably lower in BM from ITP patients than from HCs. In the ITP group, it was notable that the numbers of BM Th22, Th17, Th1, Th2, and Tfh cells were significantly elevated compared with the matched PB counterparts, while Treg number in BM was considerably reduced compared with that in PB. In consistence with the BM Th subset pattern, plasma levels of interleukin (IL)-22, IL-17A, and interferon (INF)-γ in BM from ITP patients were significantly increased compared with that from HCs. Therefore, the balance of CD4 + T-cell subsets was disrupted in both BM and PB of ITP patients, suggesting that this might play important roles in the pathophysiological process of ITP.

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Section: Introductionmentioning

confidence: 99%

Disrupted balance of CD4⁺ T-cell subsets in bone marrow of patients with primary immune thrombocytopenia

Wang¹,

Li²,

Yu³

et al. 2019

Int. J. Biol. Sci.

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“…No minor or major bleeding was detected. Meanwhile, by requested hematology consultation and through examination of peripheral blood smear, exclusion of alternative disorders and bone marrow findings, the diagnosis of ITP was made (Table 1) [5][6][7]. Recommended ITP treatment included the intravenous infusion of γ-globulin (IG) for three days and the administration of steroids (methylprednisolone, initially 60 mg/day and subsequently 40 mg/day) as well as romiplostim (500 mcg sc weekly), to increase platelet count ( Table 2).…”

Section: Case Presentationmentioning

confidence: 99%

Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura

Iakovis

Xanthopoulos

Chamaidi

et al. 2020

Case Reports in Cardiology

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A 53-year-old man was admitted to a peripheral hospital with the diagnosis of acute myocardial infarction without ST elevation. Due to the concomitant presence of first-diagnosed thrombocytopenia (platelet count 50.000/μL), it was decided to be treated conservatively with clopidogrel. Five days later, he developed an acute myocardial infarction with ST elevation (STEMI) and was transferred to our department for primary percutaneous coronary intervention (PCI). Coronary angiography revealed threevessel disease. The left anterior descending lesion was considered culprit, and PCI was successfully performed using a drugeluting balloon. This approach was considered safer due to the risk of intolerance of prolonged dual antiplatelet therapy in case of stent implantation. Indeed, four days later, aspirin was discontinued, and the patient remained only on clopidogrel due to a platelet fall. Meanwhile, idiopathic thrombocytopenic purpura (ITP) was diagnosed by hematology consultation, and specific ITP treatment was initiated. Seven days following the procedure, the patient was transferred to the Hematology clinic, where a continuous rise of platelet count up to 115.000/μL while on clopidogrel was observed, and he was discharged from the hospital asymptomatic. Unfortunately, twenty days later, the patient died of a lung infection. In ITP patients with STEMI, primary PCI with drug-eluting balloon angioplasty may be a reasonable approach.

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“…This is a new statement for international consensus guidelines because systematic bone marrow smear was recommended in all patients older than age 60 years in the 2010 version. 3 Indeed, this recommendation is not consensual: although the ASH guidelines are in line with the new international consensus recommendations, the French and German guidelines still recommend systematic bone marrow smear in all patients older than age 60 years with typical ITP to detect associated hematologic disease, 5,6 particularly myelodysplastic syndrome (MDS), which accounts for 2.3% of incident ITP in adult patients. 7 All of these guidelines are driven by expert consensus only and the usefulness of bone marrow examination in ITP is still being discussed 8 ; data are lacking about the positivity rate of this examination in older patients with typical ITP.…”

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confidence: 99%

Positivity rate of systematic bone marrow smear in patients over 60 years old with newly diagnosed immune thrombocytopenia

et al. 2020

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Recently, Blood Advances published an updated international consensus report (ICR) by Provan et al 1 and American guidelines (supported by the American Society of Hematology [ASH]) by Neunert et al 2 on managing immune thrombocytopenia (ITP). The 2019 ICR is an update of the first report published in 2010. 3 By using the same methodology as that used in the first report, Provan et al selected those who have recognized clinical and research expertise in ITP (international adult and pediatric hematologists, experts in methodology, and a patient representative) to help with their review and report. The ICR consists of a literature search with a final review by the authors. Evidence levels for the articles were assigned recommendation grades (A, B, or C), which were determined at the end of the review and were assigned and reviewed by the authors following the same scoring system as that used in the first report.

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Diagnostik und Therapie der Immunthrombozytopenie

Cited by 10 publications

References 11 publications

Disrupted balance of CD4⁺ T-cell subsets in bone marrow of patients with primary immune thrombocytopenia

Disrupted balance of CD4⁺ T-cell subsets in bone marrow of patients with primary immune thrombocytopenia

Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura

Positivity rate of systematic bone marrow smear in patients over 60 years old with newly diagnosed immune thrombocytopenia

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Diagnostik und Therapie der Immunthrombozytopenie

Cited by 10 publications

References 11 publications

Disrupted balance of CD4+ T-cell subsets in bone marrow of patients with primary immune thrombocytopenia

Disrupted balance of CD4+ T-cell subsets in bone marrow of patients with primary immune thrombocytopenia

Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura

Positivity rate of systematic bone marrow smear in patients over 60 years old with newly diagnosed immune thrombocytopenia

Contact Info

Product

Resources

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Disrupted balance of CD4⁺ T-cell subsets in bone marrow of patients with primary immune thrombocytopenia

Disrupted balance of CD4⁺ T-cell subsets in bone marrow of patients with primary immune thrombocytopenia