Immune thrombocytopenic purpura

Zainal, Abir; Salama, Amr; Alweis, Richard

doi:10.1080/20009666.2019.1565884

Cited by 28 publications

(33 citation statements)

References 9 publications

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“…Interestingly, Gialluisi et al identified platelet distribution width (PDW) as a new potential biomarker of depression and psychopathology [ 2 ], for the first time describing the relationship between thrombocytopenia and emotions. ITP is generally regarded as a primary autoimmune condition [ 3 ], yet in some cases, it is observed after other diseases, such as infections [ 4 , 5 ], chronic lymphocytic leukemia and many other autoimmune conditions [ 5 ]. Studies have found that platelet glycoprotein (GP)IIb/IIIa and GPIb/IX are the two most frequently targeted autoantigens and are associated with Fc-FcγR interactions and Fc-independent platelet activation.…”

Section: Introductionmentioning

confidence: 99%

Platelet desialylation and TFH cells–the novel pathway of immune thrombocytopenia

Chen

2021

Exp Hematol Oncol

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Immune thrombocytopenia (ITP) is an autoimmune disease characterized by immune-mediated destruction of one’s own platelets. The progression of thrombocytopenia involves an imbalance of platelet production and clearance. B cells can induce autoantibodies, and T cells contribute to the pathological progression as well. Some patients with ITP have a poor response to common first-line therapies. Recent studies have shown that a novel Fc-independent platelet clearance pathway is associated with poor prognosis in these patients. By this pathway, desialylated platelets can be cleared by Ashwell-Morell receptor (AMR) on hepatocytes. Research has demonstrated that patients with refractory ITP usually have a high level of desialylation, indicating the important role of sialylation on platelet membrane glycoprotein (GP) in patients with primary immune thrombocytopenia, and neuraminidase 1(NEU1) translocation might be involved in this process. Patients with ITP who are positive for anti-GPIbα antibodies have a poor prognosis, which indicates that anti-GPIbα antibodies are associated with this Fc-independent platelet clearance pathway. Experiments have proven that these antibodies could lead to the desialylation of GPs on platelets. The T follicular helper (TFH) cell level is related to the expression of the anti-GPIbα antibody, which indicates its role in the progression of desialylation. This review will discuss platelet clearance and production, especially the role of the anti-GPIbα antibody and desialylation in the pathophysiology of ITP and therapy for this disease.

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Section: Introductionmentioning

confidence: 99%

Platelet desialylation and TFH cells–the novel pathway of immune thrombocytopenia

Chen

2021

Exp Hematol Oncol

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“…1 Thrombocytopenia typically results in mucosal bleeding consequent to primary hemostasis defect. 1,4 As so, clinical presentation includes epistaxis, gingival bleeding or abnormal uterine bleeding; other common signs are petechiae and ecchymosis. Life-threatening bleeding is infrequent and is restricted to patients with extremely low platelet levels, presenting as hematuria, gastrointestinal bleeding and, rarely, intracranial hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Update on Thrombocytopenia in Pregnancy

Subtil

Mendes

Areia

et al. 2020

Rev Bras Ginecol Obstet

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Thrombocytopenia, defined as platelet count < 150,000 mm3, 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. Differentiating these conditions might be challenging: they can be pregnancy-specific (pre-eclampsia/HELLP syndrome [hemolysis, elevated liver enzymes, low platelets]), or not (immune thrombocytopenia purpura, thrombotic thrombocytopenic purpura or hemolytic uremic syndrome). Understanding the mechanisms and recognition of symptoms and signs is essential to decide an adequate line of investigation. The severity of thrombocytopenia, its etiology and gestational age dictates different treatment regimens.

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“…Immune thrombocytopenic purpura is an autoimmune disorder characterized by low platelet count and skin-mucosal bleeding [ 13 ].There are a variety of viruses implicated in the etiopathogenesis of ITP, especially in children, and include human immunodeficiency virus-1, hepatitis C, varicella-zoster, rubella, influenza, and Epstein-Barr virus [ 14 ]. The exact role of viruses in the pathogenesis of this disorder remains ambiguous although ITP typically shadows a viral illness in children.…”

Section: Discussionmentioning

confidence: 99%

Dengue hemorrhagic fever as a rare cause of chronic immune thrombocytopenic purpura—a pediatric case report

Thadchanamoorthy¹,

Dayasiri²

2020

Trop Med Health

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Background Dengue is a common mosquito-borne infection in tropical countries. Dengue incidence in Sri Lanka is generally showing a rising trend. Both chronic immune thrombocytopenia purpura (ITP) children and chronic ITP triggered by dengue fever in the pediatric age group are rarely reported. This unusual presentation is a diagnostic challenge to clinicians. The authors have reported a pediatric patient who presented with chronic ITP following recovery from dengue hemorrhagic fever. Case presentation A 14-year-old previously healthy boy was initially managed as for dengue hemorrhagic fever. Following initial detection of persistent thrombocytopenia at 2 weeks post-discharge, his parents defaulted follow-up for 1 year as he remained asymptomatic. However, 1 year after initial admission, the child re-presented with ecchymotic patches and a platelet count of 30 × 10 3 /cumm. Review of serial blood counts performed during previous hospital admission and by his parents themselves revealed persistent thrombocytopenia over preceding 12 months. Subsequently, the child had an in-depth evaluation. The diagnosis of ITP was confirmed by ruling out differential diagnosis and he was managed as for chronic ITP. His platelet counts showed good response to oral corticosteroids and he is currently being followed up at the pediatric hematology clinic. Conclusion While reporting, a 14-year-old boy who developed chronic ITP following dengue hemorrhagic fever, this report highlights importance of frequent monitoring of blood counts to accurately detect and manage critical phase of dengue fever. The report also highlights the value of monitoring platelet counts in post-recovery phase to ensure they have normalized.

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Immune thrombocytopenic purpura

Cited by 28 publications

References 9 publications

Platelet desialylation and TFH cells–the novel pathway of immune thrombocytopenia

Platelet desialylation and TFH cells–the novel pathway of immune thrombocytopenia

Update on Thrombocytopenia in Pregnancy

Dengue hemorrhagic fever as a rare cause of chronic immune thrombocytopenic purpura—a pediatric case report

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