ITP in Children

D’Orazio, John A.; Neely, Jessica; Farhoudi, Nina

doi:10.1097/mph.0b013e318271f457

Cited by 58 publications

(31 citation statements)

References 91 publications

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“…Approximately 80% of pediatric patients will respond to a single treatment or combination of first line therapies, which include watchful waiting, corticosteroids, IVIG, or anti-D ( 4 , 5 ). For the remaining patients, additional second line treatments are needed.…”

Section: Introductionmentioning

confidence: 99%

Use of Thrombopoietin Receptor Agonists in Childhood Immune Thrombocytopenia

Garzon

Mitchell

2015

Front. Pediatr.

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Most children with immune thrombocytopenia (ITP) will have spontaneous remission regardless of therapy, while about 20% will go on to have chronic ITP. In those children with chronic ITP who need treatment, standard therapies for acute ITP may have adverse effects that complicate their long-term use. Thus, alternative treatment options are needed for children with chronic ITP. Thrombopoietin receptor agonists (TPO-RA) have been shown to be safe and efficacious in adults with ITP, and represent a new treatment option for children with chronic ITP. One TPO-RA, eltrombopag, is now approved for children. Clinical trials in children are ongoing and data are emerging on safety and efficacy. This review will focus on the physiology of TPO-RA, their clinical use in children, as well as the long-term safety issues that need to be considered when using these agents.

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Section: Introductionmentioning

confidence: 99%

Use of Thrombopoietin Receptor Agonists in Childhood Immune Thrombocytopenia

Garzon

Mitchell

2015

Front. Pediatr.

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“…The disease is essentially antibody mediated platelet destruction [19], and manifests as acute and rapidly occurring bruising and petechiae in previously healthy children.…”

Section: Discussionmentioning

confidence: 99%

Effect of short-term, high-dose methylprednisolone on oxidative stress in children with acute immune thrombocytopenia

et al. 2016

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BackgroundImmune thrombocytopenia (ITP) is the most common cause of acquired childhood thrombocytopenia and is characterized by increased immune-mediated destruction of circulating thrombocytes. Oxidative damage may be involved in ITP pathogenesis; paraoxonase (PON) and arylesterase (ARE) enzymes are closely associated with the cellular antioxidant system. We investigated the effect of short-term high-dose methylprednisolone (HDMP) treatment on the total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), and PON and ARE enzymatic activity in children with acute ITP.MethodsThirty children with acute ITP constituted the study group and 30 healthy children constituted the control group. Children with acute ITP were treated with HDMP: 30 mg/kg for 3 days, then 20 mg/kg for 4 days. The TOS, TAC, OSI, PON, and ARE levels were determined before and after 7 days of HDMP treatment.ResultsThe TAC level (P<0.001), and PON (P<0.001) and ARE (P=0.001) activities were lower and the TOS (P=0.003) and OSI (P<0.001) levels were higher in children with acute ITP than those in healthy children in the control group. We also observed statistically significant increases in the TAC (P<0.01), PON (P<0.001) and ARE levels (P=0.001) and decreases in the TOS (P<0.05) and OSI levels (P<0.05) with 7 days of HDMP treatment compared to their values before treatment.ConclusionOur study demonstrated increased oxidative stress (OSI and TOC) and decreased antioxidant capacity (TAC), PON, and ARE in ITP patients and that steroid treatment could be effective in reducing the oxidative stress.

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“…Pediatric immune thrombocytopenia (ITP) is an acquired immune mediated disorder characterized by isolated thrombocytopenia (1)(2)(3). ITP is characterized by autoreactive antibodies that bind to platelets targeting them for phagocytosis by macrophages in the spleen and liver (4,5). Other mechanisms, including B-cell hyperreactivity, T-cell-mediated cytotoxicity and impaired platelet production, have also been demonstrated to cause ITP (6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%