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Maharaj D, McKillop JH. Use of intravenous immunoglobulin in severe refractory idiopathic immune thrombocytopenia. J R Soc Med 2018; 80:652-4. [PMID: 3694604 PMCID: PMC1291059 DOI: 10.1177/014107688708001021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Bannister BA, Wonke B, Clendinnen BG. Idiopathic Thrombocytopenic Purpura: A Case of Particular Historic Interest. J R Soc Med 2018; 73:828-9. [PMID: 7195428 PMCID: PMC1437923 DOI: 10.1177/014107688007301113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
Thrombotic microangiopathy can manifest in a diverse range of diseases and is characterized by thrombocytopenia, microangiopathic hemolytic anemia, and organ injury, including AKI. It can be associated with significant morbidity and mortality, but a systematic approach to investigation and prompt initiation of supportive management and, in some cases, effective specific treatment can result in good outcomes. This review considers the classification, pathology, epidemiology, characteristics, and pathogenesis of the thrombotic microangiopathies, and outlines a pragmatic approach to diagnosis and management.
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COGAN DG, KUWABARA T. FURTHER OBSERVATIONS ON LIPID CRYSTALS IN TISSUE. J Histochem Cytochem 2017; 7:80-2. [PMID: 13664942 DOI: 10.1177/7.2.80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Tchernia G. Immune thrombocytopenic purpura and pregnancy. CURRENT STUDIES IN HEMATOLOGY AND BLOOD TRANSFUSION 2015:81-9. [PMID: 3366007 DOI: 10.1159/000415427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Williams C, Buskard N, Bussel J. Plasma exchange in idiopathic thrombocytopenic purpura. CURRENT STUDIES IN HEMATOLOGY AND BLOOD TRANSFUSION 2015:131-51. [PMID: 2272199 DOI: 10.1159/000418556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Mueller-Eckhardt C. Autoimmune thrombocytopenic purpura: diagnostic and therapeutic actualities. CURRENT STUDIES IN HEMATOLOGY AND BLOOD TRANSFUSION 2015:69-80. [PMID: 2835206 DOI: 10.1159/000415426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Kiprov DD, Kwiatkowska BJ, Miller RG. Therapeutic apheresis in human immunodeficiency virus-related syndromes. CURRENT STUDIES IN HEMATOLOGY AND BLOOD TRANSFUSION 2015:184-97. [PMID: 2148717 DOI: 10.1159/000418559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Woźniak K, Urbanowska E, Snarski E. [Plasmapheresis in haematology]. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2015; 68:173-178. [PMID: 26181153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Plasmapheresis also known as a therapeutic plasma exchange (TPE) is a procedure of plasma removal with it's ineligible plasma's component. Usually it is a supportive measure used simultaneously with the treatment, but in a few diseases, e.g. in trombotictrombocytopenic purpura (TTP), it is a first-choice treatment. During the plasmapheresis plasma is mostly replaced by 20% solution of albumin or combination of 20% solution of albumin and 0.9% solution of NaCl, however in some diseases fresh frozen plasma (FFP) is used. Plasmaphereses have found a wide application in different branches of medicine: hematology, neurology, nephrology, reumatology. Plasmapheresis is an invasive procedure, but when performed by qualified staff it is rather safe and serious complications are very rare.The most common complications of plasmapheresis are mild, usually caused by electrolyte disturbances (hypokalemia, hypokalcemia) or anticoagulation. More serious complication can be associated with FFP transfusion, extracorporeal circulation or presence of intravenous catheter. The latter one is usually necessary to perform the plasmapheresis. In haematology the most common indication for plasmapheresis is the supportive treatment of multiple myeloma. The procedure is performed in patients with high protein levels endangered with hyperviscosity syndrome. Less frequent indications to plasmapheresis in haematology are: Waldenström's macroblobulynaemia, idiopathic thrombocytopenic purpura (ITP), pure red cell aplasia (PRCA), polyneuropaties connected with haematological disorders. Supportive treatment of haemofagocytic syndrome (HLH--hemophagocytic lymphohistiocytosis) is one of the new indications. Plasmaphereses are used in treatment of about 150 different diseases and more and more new needs for this method are identified.
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Sun SJ, Huang SL. [Clinical experience of Dr. Huang Shi-lin in diagnosing and treating immune thrombocytopenia]. ZHONGGUO ZHONG XI YI JIE HE ZA ZHI ZHONGGUO ZHONGXIYI JIEHE ZAZHI = CHINESE JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE 2014; 34:619-621. [PMID: 24941856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Hoque MM, Rahman M, Rahman SM, Habibullah MM, Faruki MA, Rahman KH, Mamun AA, Hossain MA. Post-transfusion increment of platelet count in thrombocytopenic patients treated with platelet concentrates. Mymensingh Med J 2013; 22:64-68. [PMID: 23416811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The Platelet (PLT) Transfusion Therapy plays an important role in the support of surgical, haematological, oncological and transplant patients. The present study was assigned to find out the post transfusion increment of platelet count among the thrombocytopenic patients in Bangladeshi population. This descriptive study was conducted at the Departments of Haematology and Transfusion Medicine, BSMMU, Dhaka. Total 42 thrmbocytopenic patients were randomly assigned to receive a transfusion when their platelet counts below 10000 per cubic millimeter or with active bleeding. Pre transfusion and post transfusion platelet count were measured in all patients. Out of 42 patients, 26(61.90%) were male and 16(38.10%) were female. Leukemia was the most common cause of thrombocytopenia (47.62%). Most of the patients (71.34%) required transfusion of multiple units of platelet and 12(28.57%) patients required double units. Before transfusion of platelet concentrate <30×10⁸/L, 30-80×10⁸/L and >80×10⁸/L platelet count were found in 30(71.43%), 08(19.05%) and 04(09.52%) patients respectively. After transfusion of platelet concentrate <50×10⁸/L, 50-100×10⁸/L and >100×10⁸/L platelet count were found in 30(71.43%), 08(19.05%) and 04(09.52%) patients respectively. In all patients post transfusion platelet count increases but 2 or multiple units of transfusion were needed.
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Cataland SR. Recent advances in the management of atypical hemolytic uremic syndrome. CLINICAL ADVANCES IN HEMATOLOGY & ONCOLOGY : H&O 2012; 10:537-539. [PMID: 23073053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Khan A, Chaudhry AA, Khan U. Falciparum--the masquerader. J PAK MED ASSOC 2012; 62:62-63. [PMID: 22352106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The case of a 23-year-old male presenting with a rash on the chest and lower limbs is presented. Work up revealed bicytopenia and plasmodium falciparum on bone marrow biopsy. Treatment with antimalarial drugs resulted in resolution of haematological abnormalities and rash.
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Chen XY, Li DY, Xu YM. [Chinese medicine treatment of refractory purpura: its advantages and clinical practice]. ZHONGGUO ZHONG XI YI JIE HE ZA ZHI ZHONGGUO ZHONGXIYI JIEHE ZAZHI = CHINESE JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE 2011; 31:1033-1035. [PMID: 21910328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Cela I, Miller IJ, Katz RS, Rizman A, Shammo JM. Successful treatment of amegakaryocytic thrombocytopenia with eltrombopag in a patient with systemic lupus erythematosus (SLE). CLINICAL ADVANCES IN HEMATOLOGY & ONCOLOGY : H&O 2010; 8:806-809. [PMID: 21326158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Kariuki N. Management of immune thrombocytopaenia in children: a review. EAST AFRICAN MEDICAL JOURNAL 2009; 86:S84-S88. [PMID: 21591515 DOI: 10.4314/eamj.v86i12.62911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To provide an overview of the various treatment options available in the rational management of ITP in children. DATA SOURCE Published original research findings and reviews. DATA SELECTION On-line searches for published data on immune thrombocytopaenia, idiopathic thrombocytopaenia, thrombocytopaenic purpura. DATA EXTRACTION Abstracts of selected articles were read and analysed to determine their relevance to this article. DATA SYNTHESIS All relevant articles were read in full and necessary contribution extracted for this review. CONCLUSION Immune thrombocytopaenic purpura is a common disorder affecting children and adults. Ongoing research into the pathogenesis is providing the basis for future treatment options. Greater consensus as to appropriate treatment strategies is needed to improve outcomes.
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Nielsen OJ, Friis-Hansen L. [Thrombotic microangiopathies]. Ugeskr Laeger 2009; 171:3614-3620. [PMID: 19954703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The thrombotic microangiopathic diseases, which include acquired and congenital TTP and HUS, are most frequently acute disease entities. Untreated, these diseases are associated with a lethal course in many cases. Deficiency of the von Willebrand cleaving enzyme, ADAMTS13, is a decisive pathophysiological defect in most cases of thrombotic microangiopathic diseases. Early recognition and a secure distinction from other conditions that resemble TMA diseases is essential in order to institute adequate treatment and to obtain a favourable outcome in terms of both survival and development of serious sequelae.
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Branehög I, Olsson KS, Weinfeld A, Domellöf L. Association of hyperthyroidism with idiopathic thrombocytopenic purpura and haemolytic anaemia. ACTA MEDICA SCANDINAVICA 2009; 205:125-31. [PMID: 569964 DOI: 10.1111/j.0954-6820.1979.tb06017.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Laursen B, Morling N, Rosenkvist J, Sørensen H, Thyme S. Post-transfusion purpura treated with plasma exchange by haemonetics cell separator. A case report. ACTA MEDICA SCANDINAVICA 2009; 203:539-43. [PMID: 566507 DOI: 10.1111/j.0954-6820.1978.tb14922.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A case of post-transfusion purpura in a 61-year-old, multiparous female with a platelet alloantibody (anti-Zwa) in her serum is reported. The patient was successfully treated with plasma exchange by means of a Haemonetics 30 cell separator and corticosteroids. Compared with other therapeutic measures, plasma exchange seems to shorten the duration of thrombocytopenia. Major surgery was possible in our patient within ten days of development of the syndrome.
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Sweeney JD, Keane FB, Freyne PJ, Temperley IJ, McCann SR. Accessory splenic tissue in a patient with relapsed idiopathic thrombocytopenic purpura. CLINICAL AND LABORATORY HAEMATOLOGY 2008; 4:309-12. [PMID: 6890886 DOI: 10.1111/j.1365-2257.1982.tb00080.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Koçak U, Aral YZ, Kaya Z, Oztürk G, Gürsel T. Evaluation of clinical characteristics, diagnosis and management in childhood immune thrombocytopenic purpura: a single center's experience. Turk J Pediatr 2007; 49:250-255. [PMID: 17990576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Diagnostic evaluation and management in childhood immune thrombocytopenic purpura (ITP) are controversial. We reviewed the files of 162 children with ITP to evaluate clinical characteristics, response to treatment and outcome. History of antecedent infection, vaccination and serologic evidence for acute viral infection were present in 48%, 5% and 17% of the patients, respectively. At diagnosis, two-thirds of the patients had a platelet count of <10,000/microl but only 10% had major bleedings. Intracranial hemorrhage was seen in two patients (1.2%) with a mortality rate of 0.6%. Sixteen percent developed chronic ITP. The rate of platelet recovery with mega-dose methylprednisolone (30 mg/kg/d for 3 and 20 mg/kg/d for 4 days) was similar to that obtained with intravenous immunoglobulin or oral prednisolone. Four of seven patients with ITP responded to splenectomy. These data show that mode of treatment has no effect on the clinical course and prognosis of childhood ITP.
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