Frequency and prognostic importance of thrombocytopenia in symptom-free HIV-infected individuals

Peltier, J M; Lambin, P.; Doînel, C.; Couroucé, Anne‐Marie; Rouger, P; Lefrère, Jean‐Jacques

doi:10.1097/00002030-199104000-00004

Cited by 32 publications

(16 citation statements)

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“…Chronic infections, such as Helicobacter pylori ( H. pylori ) [140], human immunodeficiency virus (HIV) [111, 141, 142], hepatitis virus [143, 144], Epstein-Barr virus [145], cytomegalovirus [146], rubella virus [147], and the recently discovered novel Bunyavirus [148], have been linked with secondary ITP. Thrombocytopenia in these infections has been mainly attributed to antigenic mimicry, whereby antibodies targeting the micropathogens cross-react with platelet glycoproteins resulting in accelerated platelet clearance [111, 149].…”

Section: Pathogenesis Of Immune-mediated Thrombocytopeniamentioning

confidence: 99%

Crosstalk between Platelets and the Immune System: Old Systems with New Discoveries

et al. 2012

Advances in Hematology

125

102

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Platelets are small anucleate cells circulating in the blood. It has been recognized for more than 100 years that platelet adhesion and aggregation at the site of vascular injury are critical events in hemostasis and thrombosis; however, recent studies demonstrated that, in addition to these classic roles, platelets also have important functions in inflammation and the immune response. Platelets contain many proinflammatory molecules and cytokines (e.g., P-selectin, CD40L, IL-1β, etc.), which support leukocyte trafficking, modulate immunoglobulin class switch, and germinal center formation. Platelets express several functional Toll-like receptors (TLRs), such as TLR-2, TLR-4, and TLR-9, which may potentially link innate immunity with thrombosis. Interestingly, platelets also contain multiple anti-inflammatory molecules and cytokines (e.g., transforming growth factor-β and thrombospondin-1). Emerging evidence also suggests that platelets are involved in lymphatic vessel development by directly interacting with lymphatic endothelial cells through C-type lectin-like receptor 2. Besides the active contributions of platelets to the immune system, platelets are passively targeted in several immune-mediated diseases, such as autoimmune thrombocytopenia, infection-associated thrombocytopenia, and fetal and neonatal alloimmune thrombocytopenia. These data suggest that platelets are important immune cells and may contribute to innate and adaptive immunity under both physiological and pathological conditions.

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Section: Pathogenesis Of Immune-mediated Thrombocytopeniamentioning

confidence: 99%

Crosstalk between Platelets and the Immune System: Old Systems with New Discoveries

et al. 2012

Advances in Hematology

125

102

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“…Consequently, even then, thrombocytopenia was recognized as one of the signs of AIDS and explained by nonspecific deposition of fractions of complement and immune complexes on PLTs [26,27,28]. …”

Section: Epidemiologymentioning

confidence: 99%

“…Peltier et al [28] followed 435 seropositive symptom-free individuals for 5 years. At baseline, 5.5% had thrombocytopenia, whereas 18% had thrombocytopenia at least once during the study.…”

Section: Epidemiologymentioning

confidence: 99%

An Overview of the Mechanisms of HIV-Related Thrombocytopenia

Passos

Treitinger²,

Spada³

2010

Acta Haematol

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The first thrombocytopenia cases related to the human immunodeficiency virus (HIV) were described even before its isolation in 1983. Subsequently, multiple mechanisms have been proposed to elucidate the etiology of thrombocytopenia. In addition to other types of cytopenia affecting patients with HIV, thrombocytopenia is observed in about 10–50% HIV patients as one of the first clinical signs of infection. Thus, in this review we aim to summarize the mechanisms proposed for thrombocytopenia since the discovery of HIV, and especially the innovations in the field in recent years. Among the different mechanisms suggested for HIV-related thrombocytopenia, there is emphasis on the accelerated destruction of platelets (PLTs) due to the action of immune complexes, and the presence of anti-PLT and anti-HIV antibodies that cross-react with the PLT membrane. There are also secondary causes of thrombocytopenia, such as the effect of drugs and opportunistic diseases associated with HIV.

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“…Bei entsprechender Anamnese ist daher ein HIV Test angezeigt [29,30]. Auch eine Hepatitis C Infektion kann zu einem AITP-ähnlichen Bild führen.…”

Section: Tests Zur Feststellung Klinisch Nicht Erkennbarer Grundkrankunclassified

Autoimmunthrombozytopenie (AITP) des Erwachsenen: Klinik, Diagnose und Therapie

Lechner

Weltermann

Pabinger

2006

Wien Klin Wochenschr

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The incidence of AITP is 20-30/million/year. The diagnosis is based on the finding of an isolated thrombocytopenia without other blood abnormalities and absence of a palpable spleen. Additional tests such as bone marrow examination, determination of platelet antibodies and of thrombopoetin are required only in special cases. The usual first line therapy in patients with bleeding tendency and a low platelet count is prednisolone at a dose of 1 mg/kg/day. Patients who have platelet counts of less than 20,000/microl 3-6 months after steroid therapy are candidates for splenectomy, in particular if more than 0.1 mg/kg/day prednisolone is required to keep the patient free of bleedings. Laparoscopic splenectomy has a low mortality (0.2%) and morbidity (10%). The risk of post-splenectomy overwhelming pneumococcal septicaemia can be minimized by preoperative vaccination. Older patients, who have low platelet counts after splenectomy, have a high bleeding risk. The most effective treatment options for these patients are cyclophosphamide, azathioprine and rituximab, but the choice of treatment should be carefully considered, since the risk of adverse effects may be greater than the risk of fatal bleeding.

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Frequency and prognostic importance of thrombocytopenia in symptom-free HIV-infected individuals

Cited by 32 publications

References 0 publications

Crosstalk between Platelets and the Immune System: Old Systems with New Discoveries

Crosstalk between Platelets and the Immune System: Old Systems with New Discoveries

An Overview of the Mechanisms of HIV-Related Thrombocytopenia

Autoimmunthrombozytopenie (AITP) des Erwachsenen: Klinik, Diagnose und Therapie

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