Article
Hematology
Caroline Gabe, Emily Sirotich, Na Li, Nikola Ivetic, Ishac Nazy, James Smith, John G. Kelton, Donald M. Arnold
Summary: Misclassification of immune thrombocytopenia (ITP) is common and can undermine the value of platelet autoantibody testing. Sensitivity of platelet autoantibody testing is increased in patients with 'definite ITP', while specificity remains unchanged. High optical density values improve the specificity of platelet autoantibody testing but decrease sensitivity, suggesting that these antibodies may be most prevalent in certain patient subsets.
BRITISH JOURNAL OF HAEMATOLOGY
(2021)
Editorial Material
Hematology
Rick Kapur
Summary: Childhood immune thrombocytopenia (ITP) is a benign and self-limiting disorder, but a portion of patients develop chronic ITP with bleeding symptoms and impaired quality of life. Severe bleedings can be treated with corticosteroids, anti-D, or intravenous immunoglobulins (IVIg). A prospective study of 23 children with primary ITP suggests that IVIg may improve thrombin-induced platelet activation and enhance thrombin generation in addition to increasing platelet counts.
BRITISH JOURNAL OF HAEMATOLOGY
(2023)
Article
Medicine, General & Internal
Alex Bourguignon, Donald M. Arnold, Theodore E. Warkentin, James W. Smith, Tania Pannu, Jeffrey M. Shrum, Zainab A. A. Al Maqrashi, Anjali Shroff, Marie-Claude Lessard, Normand Blais, John G. Kelton, Ishac Nazy
Summary: The use of high-dose IVIG plus anticoagulation is recommended for the treatment of VITT, a rare side effect of adenoviral vector vaccines against Covid-19. Response to IVIG therapy in VITT patients showed reduced platelet activation and improvement in symptoms.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Medicine, General & Internal
Alex Bourguignon, Donald M. Arnold, Theodore E. Warkentin, James W. Smith, Tania Pannu, Jeffrey M. Shrum, Zainab A. A. Al Maqrashi, Anjali Shroff, Marie-Claude Lessard, Normand Blais, John G. Kelton, Ishac Nazy
Summary: High-dose intravenous immune globulin (IVIG) combined with anticoagulation is recommended for the treatment of vaccine-induced immune thrombotic thrombocytopenia (VITT), showing a good response in reducing antibody-induced platelet activation, particularly in cases of VITT induced by ChAdOx1 nCoV-19 vaccine.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Review
Pediatrics
Jule Muegge, Tatiana de Warren, Daniel Saltzman, Donavon Hess
Summary: This study analyzed 37 pediatric patients with severe thrombocytopenia who underwent surgery at a tertiary pediatric hospital from 2011 to 2016. 29 patients received preoperative platelet transfusions and no postoperative bleeding complications occurred within 30 days. Preoperative platelet transfusion volume was not a good predictor of changes in preoperative platelet count.
JOURNAL OF PEDIATRIC SURGERY
(2021)
Article
Obstetrics & Gynecology
Kavisha Khanuja, Ariel T. Levy, Rodney A. McLaren, Vincenzo Berghella
Summary: This study aimed to assess the accuracy of diagnosing gestational thrombocytopenia and immune thrombocytopenic purpura using pre- and postpregnancy platelet counts. The results showed that one-third of gestational thrombocytopenia cases met the criteria for immune thrombocytopenic purpura and were thus misdiagnosed during pregnancy. Prepregnancy platelet counts should be considered when diagnosing gestational thrombocytopenia versus immune thrombocytopenic purpura.
AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM
(2022)
Article
Hematology
Cecilia Karlstrom, Gunilla Gryfelt, Laurent Schmied, Stephan Meinke, Petter Hoglund
Summary: Prophylactic platelet transfusion is common in severely thrombocytopenic patients, but responses are variable and difficult to predict. This study found that corrected count increment (CCI) varied greatly among patients, and factors like time since last transfusion and storage time of PLT products affected transfusion response. Furthermore, the study suggests that the thrombocytopenic environment or disease-associated factors may hinder platelet responsiveness.
BRITISH JOURNAL OF HAEMATOLOGY
(2022)
Article
Hematology
Xiao-Lu Zhu, Ru Feng, Qiu-Sha Huang, Mei-Ying Liang, Ming Jiang, Hui Liu, Yi Liu, Hong-Xia Yao, Lei Zhang, Shen-Xian Qian, Tong-Hua Yang, Jing-Yu Zhang, Xu-Liang Shen, Lin-Hua Yang, Jian-Da Hu, Ren-Wei Huang, Zhong-Xing Jiang, Jing-Wen Wang, Hong-Yu Zhang, Zhen Xiao, Si-Yan Zhan, Hui-Xin Liu, Xing-Lin Wang, Ying-Jun Chang, Yu Wang, Yuan Kong, Lan-Ping Xu, Kai-Yan Liu, Xiao-Hong Zhang, Cheng-Hong Yin, Yue-Ying Li, Qian-Fei Wang, Jian-Liu Wang, Xiao-Jun Huang, Xiao-Hui Zhang
Summary: This study evaluated the safety and effectiveness of prednisone plus IVIg in pregnant patients with immune thrombocytopenia (ITP). The combination therapy showed a shorter time to response and duration of treatment compared to prednisone monotherapy. Additionally, the combination therapy had a lower predelivery platelet transfusion rate compared to IVIg alone.
THERAPEUTIC ADVANCES IN HEMATOLOGY
(2022)
Article
Hematology
Na Li, Nancy M. Heddle, Ishac Nazy, John G. Kelton, Donald M. Arnold
Summary: The platelet variability index (PVI) was developed to distinguish immune thrombocytopenia (ITP) from other causes of thrombocytopenia by capturing fluctuations in platelet count levels over time. PVI scores could help clinicians diagnose ITP among patients presenting with thrombocytopenia, with higher scores correlating with the diagnosis of definite ITP. Platelet count fluctuations alone contributed to the specificity of the overall PVI score.
Article
Hematology
Aurelien Sokal, Thomas de Nadai, Julien Maquet, Thibault Comont, Nicolas Limal, Marc Michel, Odile Beyne-Rauzy, Bertrand Godeau, Daniel Adoue, Matthieu Mahevas, Guillaume Moulis
Summary: Data on the presentation and management of primary immune thrombocytopenia (ITP) in very elderly patients (VEPs; aged >= 80 years) are lacking. This study aimed to describe ITP in this subgroup and found that VEPs have a higher likelihood of severe bleeding, with female sex and a platelet count of <20 x 10(9)/l being associated with bleeding. Exposure to anticoagulants is strongly associated with severe bleeding in VEPs.
BRITISH JOURNAL OF HAEMATOLOGY
(2022)
Article
Medicine, Research & Experimental
Oana-Viola Badulescu, Diana Popescu, Manuela Ciocoiu, Ciprian Rezus
Summary: Research on COVID-19 has focused on clinical and laboratory manifestations, as well as the biological changes induced by the virus. Patients with severe forms of COVID-19 typically develop mild thrombocytopenia, while severe thrombocytopenia is rarely reported.
EXPERIMENTAL AND THERAPEUTIC MEDICINE
(2021)
Article
Pediatrics
Xiaolu Zhang, Ruochen Che, Haisheng Xu, Guixia Ding, Fei Zhao, Songming Huang, Aihua Zhang
Summary: This study evaluated the efficacy of hemoperfusion and intravenous immunoglobulins in patients with refractory Henoch-Schonlein purpura with gastrointestinal symptoms. The study found that patients with refractory gastrointestinal involvement had higher risk of renal involvement and medical burden. Both hemoperfusion and intravenous immunoglobulins were effective in alleviating symptoms. Hemoperfusion therapy was more effective in older patients, while intravenous immunoglobulins were better suited for younger children.
Article
Oncology
Juan Wang, Pan Zhou, Yunwei Han, Hongwei Zhang
Summary: Chemoradiotherapy often leads to secondary thrombocytopenia in cancer patients, requiring platelet transfusion to prevent bleeding. However, activated platelets may promote cancer metastasis and proliferation, creating a harmful cycle of interaction between platelets and cancer cells.
TRANSLATIONAL ONCOLOGY
(2021)
Article
Medicine, General & Internal
Hazem Ayesh, Azizullah Beran, Mohammed Mhanna, Srini Hejeebu
Summary: ITP is an autoimmune disease characterized by low platelet counts. COVID-19 is a multisystemic disease caused by the coronavirus. This case demonstrates successful management of COVID-19-associated ITP in a 76-year-old female using intravenous immunoglobulin and glucocorticoids.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Article
Pharmacology & Pharmacy
Henk-Jan Boiten, Sufia Amini, Frank H. J. Wolfhagen, Peter E. Westerweel
Summary: The case study reports a 73-year-old male with Crohn's disease who developed severe thrombocytopenia while using the anti-TNF alpha agent adalimumab, which improved upon discontinuation of the medication. Regular monitoring of platelet levels after initiating anti-TNF alpha agents is recommended to prevent this potentially fatal complication.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2021)