Risk factors associated with intracranial hemorrhage in adults with immune thrombocytopenia: A study of 27 cases

Melboucy‐Belkhir, Sara; Khellaf, Mehdi; Augier, A.; Boubaya, Marouane; Lévy, Vincent; Guenno, G. Le; Terriou, Louis; Lioger, Bertrand; Ebbo, Mikaël; Morin, Anne‐Sophie; Chauveheid, Marie-Paule; Michel, Marc; Belkhir, F.; About, Frédégonde; Rosé, Christian; Moulis, Guillaume; Mékinian, A.; Stirnemann, Jérôme; Papo, Thomas; Chèze, Stéphane; Rosenthal, Éric; Viallard, Jean‐François; Schleinitz, N.; Galicier, Lionel; Adoue, D.; Lambotte, Olivier; Hamidou, M.; Godeau, Bertrand; Fain, Olivier

doi:10.1002/ajh.24529

Cited by 20 publications

(24 citation statements)

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“…Male gender was also noted to be associated with higher incidence and mortality of ICH. This finding has not been previously reported [7,8,27]. Further studies need to be conducted to understand the role of gender in occurrence of ICH.…”

Section: Discussioncontrasting

confidence: 66%

“…Mortality associated with ICH in ITP patients ranges from 9.7% to 44% depending on the population studied [5,6]. Majority of prior reports on ICH have been either single center studies or limited by small sample size [7,8]. A few studies have used large administrative databases to assess pediatric and adult ITP hospitalizations; however, they were not primarily focused on ICH as an outcome and therefore lacked details of ICH incidence and outcomes trends and factors associated with it [5,6,9].…”

Section: Introductionmentioning

confidence: 99%

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Temporal Trends of Intracranial Hemorrhage Among Immune Thrombocytopenia Hospitalizations in the United States

Bhatt

Yagnik

Ayensu³

et al. 2020

Cureus

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Section: Discussioncontrasting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Temporal Trends of Intracranial Hemorrhage Among Immune Thrombocytopenia Hospitalizations in the United States

Bhatt

Yagnik

Ayensu³

et al. 2020

Cureus

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“…Exposure to anticoagulant drugs was highly associated with severe bleeding (OR 4.47, 95% CI 1.38–14.45). This association was not found in the case–control study by Melboucy‐Belkhir et al ., in which exposure to antithrombotic treatments did not differ between the group of 27 ITP cases with intracranial hemorrhage and the 54 controls . However, this study was not limited to intracranial bleeding at ITP onset, and confounders during the ITP course may explain this result (e.g.…”

Section: Discussionmentioning

confidence: 92%

Risk factors for bleeding, including platelet count threshold, in newly diagnosed immune thrombocytopenia adults

Piel-Julian

Mahévas

Germain

et al. 2018

Journal of Thrombosis and Haemostasis

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Background The aim of this cross-sectional study was to assess risk factors for bleeding in immune thrombocytopenia (ITP) adults, including the determination of platelet count thresholds. Methods We selected all newly diagnosed ITP adults included in the Cytopénies Auto-immunes Registre Midi-PyrénéEN (CARMEN) register and at the French referral center for autoimmune cytopenias. The frequencies of any bleeding, mucosal bleeding and severe bleeding (gastrointestinal, intracranial, or macroscopic hematuria) at ITP onset were assessed. Platelet count thresholds were assessed by the use of receiver operating characteristic curves. All potential risk factors were included in logistic regression models. Results Among the 302 patients, the frequencies of any, mucosal and severe bleeding were 57.9%, 30.1%, and 6.6%, respectively. The best discriminant threshold of platelet count for any bleeding was 20 × 10 L . In multivariate analysis, factors associated with any bleeding were platelet count (< 10 × 10 L versus ≥ 20 × 10 L , odds ratio [OR] 48.2, 95% confidence interval [CI] 20.0-116.3; between 10 × 10 L and 19 × 10 L versus ≥ 20 × 10 L , OR 5.2, 95% CI 2.3-11.6), female sex (OR 2.6, 95% CI 1.3-5.0), and exposure to non-steroidal anti-inflammatory drugs (NSAIDs) (OR 4.8, 95% CI 1.1-20.7). A low platelet count was also the main risk factor for mucosal bleeding. Exposure to anticoagulant drugs was associated with severe bleeding (OR 4.3, 95% CI 1.3-14.1). Conclusions Platelet counts of < 20 × 10 L and < 10 × 10 L were thresholds for major increased risks of any and mucosal bleeding. Platelet count, female sex and exposure to NSAIDs should be considered for assessment of the risk of any bleeding. Exposure to anticoagulant drugs was a major risk factor for severe bleeding.

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“…Такие факторы, как пол, возраст, низкое количе ство тромбоцитов (<30 × 10 9 / л), как возможные пре дикторы развития висцеральных кровотечений статистически достоверного подтверждения не полу чили. Наличие петехиальных кровоизлияний на коже и слизистых оболочках, наоборот, коррелировало со сниженным риском развития кровотечений, что, возможно, связано с более ранней диагностикой и ле чением [3,11,[14][15][16].…”

Section: диагностика иммунной тромбоцитопенииunclassified

Immune thrombocytopenia at the patient with a cystadenoma of the ovaries (а clinical case)

et al. 2020

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Immune thrombocytopenia is an immunosuppressed acquired disease characterized by low platelet levels in peripheral blood and an increased risk of bleeding. This pathology deserves special attention in cases of patients who are scheduled for surgery, which undoubtedly requires careful preparation of the patient for surgery and a complete laboratory analysis, including a thromboelastogram.This article describes the clinical case of successful surgical treatment of a patient with immune thrombocytopenia.

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Risk factors associated with intracranial hemorrhage in adults with immune thrombocytopenia: A study of 27 cases

Cited by 20 publications

References 4 publications

Temporal Trends of Intracranial Hemorrhage Among Immune Thrombocytopenia Hospitalizations in the United States

Temporal Trends of Intracranial Hemorrhage Among Immune Thrombocytopenia Hospitalizations in the United States

Risk factors for bleeding, including platelet count threshold, in newly diagnosed immune thrombocytopenia adults

Immune thrombocytopenia at the patient with a cystadenoma of the ovaries (а clinical case)

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