Successful treatment of bleeding with tranexamic acid in a series of 12 patients with immune thrombocytopenia

Mayer, Beate; Salama, Abdulgabar

doi:10.1111/vox.12549

Cited by 19 publications

(21 citation statements)

References 33 publications

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“…1,2 And while TXA has been studied in adults, with anecdotal evidence of its use in controlling mucosal bleeding, and a case TXA in Life-threatening Nontraumatic Hemorrhage in ITP series describing its use of TXA in chronic ITP-related bleeding, there are no studies in children. [4][5][6] When reviewing the literature, we found that TXA has been studied and used in a wide range of settings, especially in the surgical fields including orthopedic procedures, otolaryngologic surgery, obstetric bleeding and heavy menstrual bleeding, pediatric cardiac surgery, and coronary artery surgery. 2,[8][9][10][11] A large meta-analysis evaluating TXA in surgical patients showed that TXA reduced the need for blood transfusion and resulted in fewer deaths.…”

Section: Discussionmentioning

confidence: 99%

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Tranexamic Acid in a Case Report of Life-threatening Nontraumatic Hemorrhage in Immune Thrombocytopenic Purpura

Randall

Nurse

Singh

2020

Clinical Practice and Cases in Emergency Medicine

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Introduction: Immune thrombocytopenic purpura (ITP) is an autoimmune-mediated disorder in which the body produces antibodies that destroy platelets, causing an increased risk of bleeding and bruising. Tranexamic acid (TXA) is a medication that prevents clot breakdown and is used to treat uncontrolled bleeding. Case Report: We present the case of an 11-year-old female with significant epistaxis and hypotension in the emergency department. Traditional therapies were initiated; however, the patient continued to have bleeding and remained hypotensive, so intravenous TXA was given. The patient’s bleeding then resolved. Conclusion: TXA may be a safe and effective adjunct to traditional therapies for the treatment of life-threatening hemorrhage in ITP patients.

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Section: Discussionmentioning

confidence: 99%

“… 1 , 2 And while TXA has been studied in adults, with anecdotal evidence of its use in controlling mucosal bleeding, and a case series describing its use of TXA in chronic ITP-related bleeding, there are no studies in children. 4 – 6 …”

Section: Discussionmentioning

confidence: 99%

Tranexamic Acid in a Case Report of Life-threatening Nontraumatic Hemorrhage in Immune Thrombocytopenic Purpura

Randall

Nurse

Singh

2020

Clinical Practice and Cases in Emergency Medicine

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“…Antifibrinolytics (tranexamic acid and aminocaproic acid) are successfully used to control significant bleeding in patients with ITP [102][103][104]. Oral contraceptives can be used in female patients with menorrhagia.…”

Section: Treatment Of Active Bleedingmentioning

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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“…Drugs that may be useful in patients with ITP to control minor bleeding are tranexamic acid (particularly for mucocutaneous bleeds) and contraception (menorrhagia). 45,46 In life-threatening ITP bleeding emergencies, recombinant activated factor VII may be a useful supportive treatment.…”

Section: Treatments Active Bleedingmentioning

confidence: 99%

“…Tranexamic acid is described in two studies as highly effective in controlling menorrhagia and acute bleeding in female patients with ITP and should be taken into account in the treatment of female patients with chronic ITP. 45,46…”

Section: Immunomodulatorsmentioning

confidence: 99%

New Developments in the Pathophysiology and Management of Primary Immune Thrombocytopenia

2020

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Immune thrombocytopenia (ITP) is an autoimmune disease that is characterized by a significant reduction in the number of circulating platelets and frequently associated with bleeding. Although the pathogenesis of ITP is still not completely elucidated, it is largely recognized that the low platelet count observed in ITP patients is due to multiple alterations of the immune system leading to increased platelet destruction as well as impaired thrombopoiesis. The clinical manifestations and patients' response to different treatments are very heterogeneous suggesting that ITP is a group of disorders sharing common characteristics, namely, loss of immune tolerance toward platelet (and megakaryocyte) antigens and dysfunctional primary hemostasis. Management of ITP is challenging and requires intensive communication between patients and caregivers. The decision to initiate treatment should be based on the platelet count level, age of the patient, bleeding manifestation, and other factors that influence the bleeding risk in individual patients. In this review, we present recent data on the mechanisms that lead to platelet destruction in ITP with a particular focus on current findings concerning alterations of thrombopoiesis. In addition, we give an insight into the efficacy and safety of current therapies and management of ITP bleeding emergencies.

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Successful treatment of bleeding with tranexamic acid in a series of 12 patients with immune thrombocytopenia

Abstract: We recommend the use of TA in ITP patients with bleeding and/or an increased bleeding risk. Ultimately, cessation of bleeding plays a key role in the management of such affected patients. However, future studies are required to optimize dose and administration routes (intravenous or oral).

Cited by 19 publications

References 33 publications

Tranexamic Acid in a Case Report of Life-threatening Nontraumatic Hemorrhage in Immune Thrombocytopenic Purpura

Tranexamic Acid in a Case Report of Life-threatening Nontraumatic Hemorrhage in Immune Thrombocytopenic Purpura

Primary Immune Thrombocytopenia: Novel Insights into Pathophysiology and Disease Management

New Developments in the Pathophysiology and Management of Primary Immune Thrombocytopenia

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