Long-term management of chronic immune thrombocytopenic purpura in adults

Palau, Javier; Jarque, Isidro; Sanz, Miguel Á.

doi:10.2147/ijgm.s4722

Cited by 6 publications

(4 citation statements)

References 84 publications

(95 reference statements)

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“…Rituximab was evaluated for chronic immune thrombocytopenic purpura (ITP) in a multi-center phase II study of 60 patients, who received an IV infusion of 375 mg/m 2 once weekly for 4 doses; 40% of patients achieved a steady platelet level [15]. A few studies also suggested that low-dose treatment with 100 mg/m 2 , either alone or in combination with steroids would suffice and result in fewer AEs; however, further data on this dose are lacking [15].…”

Section: Methodsmentioning

confidence: 99%

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Biologic therapy for autoimmune diseases: an update

Rosman

Shoenfeld

Zandman‐Goddard

2013

BMC Med

202

157

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Biologic therapies for rheumatologic diseases, which are targeted at molecules involved in the mechanisms of the immune system, provide an alternative to the existing treatment methods of disease-modifying anti-rheumatic drugs and other immunosuppressive medications. However, the current drawbacks of biologic therapies, including the inconvenience of intravenous administration, the high costs of these drugs, and the adverse events associated with them, prevent their wide use as first-line medications. This review provides an update of the recent literature on the new biologic therapies available. The review concentrates on nine drugs: tocilizumab, rituximab, ofatumumab, belimumab, epratuzumab, abatacept, golimumab, certolizumab, and sifalimumab, which are used as therapies for rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus, systemic sclerosis, or vasculitis.

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Section: Methodsmentioning

confidence: 99%

“…A few studies also suggested that low-dose treatment with 100 mg/m 2 , either alone or in combination with steroids would suffice and result in fewer AEs; however, further data on this dose are lacking [15]. …”

Section: Methodsmentioning

confidence: 99%

Biologic therapy for autoimmune diseases: an update

Rosman

Shoenfeld

Zandman‐Goddard

2013

BMC Med

202

157

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“…Pathogenesis of ITP is understood mainly based on adult studies, and evidence regarding pathophysiology of pediatric chronic ITP is scarce. Chronic ITP is diagnosed when thrombocytopenia persists beyond 12 months in patients with acute ITP [ 19 ]. Persistently elevated levels of platelet associated IgG are seen with chronic ITP and support the speculation of the mechanisms of persistent immune platelet destruction.…”

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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“…The patient should be informed about the benefits and possible side effects of treatment options. It should be considered that some side effects of treatments might pose a greater risk for the patient than ITP itself [ 74 ]. Advantages and disadvantages of ITP treatments are summarized in Table 1 .…”

Section: Treatment Of Itpmentioning

confidence: 99%

Primary Immune Thrombocytopenia: Novel Insights into Pathophysiology and Disease Management

Singh¹,

Uzun²,

Bakchoul³

2021

JCM

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Immune thrombocytopenia (ITP) is an autoimmune disorder defined by a significantly reduced number of platelets in blood circulation. Due to low levels of platelets, ITP is associated with frequent bruising and bleeding. Current evidence suggests that low platelet counts in ITP are the result of multiple factors, including impaired thrombopoiesis and variations in immune response leading to platelet destruction during pathological conditions. Patient outcomes as well as clinic presentation of the disease have largely been shown to be case-specific, hinting towards ITP rather being a group of clinical conditions sharing common symptoms. The most frequent characteristics include dysfunction in primary haemostasis and loss of immune tolerance towards platelet as well as megakaryocyte antigens. This heterogeneity in patient population and characteristics make it challenging for the clinicians to choose appropriate therapeutic regimen. Therefore, it is vital to understand the pathomechanisms behind the disease and to consider various factors including patient age, platelet count levels, co-morbidities and patient preferences before initiating therapy. This review summarizes recent developments in the pathophysiology of ITP and provides a comprehensive overview of current therapeutic strategies as well as potential future drugs for the management of ITP.

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Long-term management of chronic immune thrombocytopenic purpura in adults

Cited by 6 publications

References 84 publications

Biologic therapy for autoimmune diseases: an update

Biologic therapy for autoimmune diseases: an update

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

Primary Immune Thrombocytopenia: Novel Insights into Pathophysiology and Disease Management

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