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Kubrusly BS, Kubrusly ES, Rocha HAL, Júnior ABV, Kubrusly MS, Ribeiro LLPA, Ribeiro RDA, Duarte FB. Epidemiology of immune thrombocytopenia: study of adult patients at a referral hematology service in Northeastern Brazil. Hematol Transfus Cell Ther 2023:S2531-1379(23)02585-3. [PMID: 38177057 DOI: 10.1016/j.htct.2023.09.2363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 06/04/2023] [Accepted: 09/05/2023] [Indexed: 01/06/2024] Open
Abstract
Immune thrombocytopenia (ITP) is an acquired bleeding disorder observed in the clinical practice. Little is known about its epidemiology in Brazil. The present study was conducted at a hematology referral center which covers a population of over 8 million in 184 municipalities in the state of Ceará. The purpose of this study was to draw a demographic profile of adult ITP patients with regard to sex, age, geographical origin and distribution across the state, and the proportion of secondary ITP. Following ethics committee approval, information was collected with an ad hoc instrument. The sample consisted of 187 adult ITP patients attending the Walter Cantídio University Hospital in 2015. The median follow-up time was 67 months (range: 1 month to 29 years). Female sex (n = 154; 82.35 %) was strongly prevalent in all age brackets, with an overall female/male ratio of 4.7:1. The median age was 41 ± 16.1 with an interquartile range of 29-55.5 years; there was no difference between the genders. Secondary ITP (18/187; 9.6 %) displayed a bimodal distribution and a linear increase between 38 and >68 years of age. The results of this survey on the epidemiology of ITP in Brazil suggest that ethnic and geographical factors may have a great impact on age and sex distribution and on the distribution of secondary ITP.
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Affiliation(s)
| | - Elsie Sobreira Kubrusly
- Hospital Universitário Walter Cantídio of the Universidade Federal do Ceará, (HUWC-UFC), Fortaleza, CE, Brazil; Medicine School of the Centro Universitário Christus (UNICHRISTUS), Fortaleza, CE, Brazil
| | - Hermano Alexandre Lima Rocha
- Medicine School of the Universidade Federal do Ceará (FAMED-UFC), Fortaleza, CE, Brazil; Medicine School of the Centro Universitário Christus (UNICHRISTUS), Fortaleza, CE, Brazil
| | - Antonio Brazil Viana Júnior
- Hospital Universitário Walter Cantídio of the Universidade Federal do Ceará, (HUWC-UFC), Fortaleza, CE, Brazil; Maternidade-Escola Assis Chateaubriand, Universidade Federal do Ceará (MEAC UFC), Fortaleza, CE, Brazil
| | | | | | | | - Fernando Barroso Duarte
- Medicine School of the Universidade Federal do Ceará (FAMED-UFC), Fortaleza, CE, Brazil; Hospital Universitário Walter Cantídio of the Universidade Federal do Ceará, (HUWC-UFC), Fortaleza, CE, Brazil; Medicine School of the Centro Universitário Christus (UNICHRISTUS), Fortaleza, CE, Brazil
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Săsăran MO, Mărginean CO, Koller AM. Impact of Helicobacter pylori Infection upon the Evolution and Outcome of Pediatric Immune Thrombocytopenic Purpura: A Comprehensive Review. Diagnostics (Basel) 2023; 13:3205. [PMID: 37892026 PMCID: PMC10606204 DOI: 10.3390/diagnostics13203205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/08/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
In adults with immune thrombocytopenic purpura (ITP), the identification of H. pylori infection and its subsequent eradication proved to aid platelet recovery. Similar findings, at a smaller scale, were allegedly reported by some pediatric studies. This review's objective was to establish the influence of H. pylori infection and its eradication upon platelet count and recovery in pediatric ITP. Three databases, namely Pubmed, Scopus and Web of Science, were searched for pediatric studies which investigated a link between H. pylori infection and thrombocytopenia. The search results retrieved a number of 21 articles which complied to the inclusion and exclusion criteria. Some studies report lower platelet values among children with ITP and documented H. pylori infection, as well as an improve in platelet numbers after H. pylori treatment. However, results are controversial, as multiple authors failed to identify a higher prevalence of H. pylori among children with ITP or a lack of significant change in therapeutic outcome with the addition of an eradication regimen to standard treatment. The main limitations of current pediatric studies remain the small study samples and the short follow-up periods of the included subjects. Hence, the long-term impact of H. pylori in children with ITP is still uncertain.
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Affiliation(s)
- Maria Oana Săsăran
- Department of Pediatrics 3, University of Medicine, Pharmacy, Sciences and Technology George Emil Palade from Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Târgu Mureș, Romania;
| | - Cristina Oana Mărginean
- Department of Pediatrics 1, University of Medicine, Pharmacy, Sciences and Technology George Emil Palade from Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Târgu Mureș, Romania
| | - Ana Maria Koller
- Clinics of Pediatrics, Emergency County Clinical Hospital, Gheorghe Marinescu Street No. 50, 540136 Târgu Mureș, Romania;
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Murray NP, Minzer S, López MA, Muñoz L. Short-term dose-escalated romiplostim for preparing an adult patient with persistent newly diagnosed primary immune thrombocytopenia for splenectomy. Hematol Transfus Cell Ther 2019; 42:283-286. [PMID: 31672588 PMCID: PMC7417434 DOI: 10.1016/j.htct.2019.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 01/19/2023] Open
Affiliation(s)
- Nigel P Murray
- Hospital de Carabineros de Chile, Ñuñoa, Santiago, Chile; Faculty of Medicine, University Finis Terrae, Providencia, Santiago, Chile.
| | - Simona Minzer
- Hospital de Carabineros de Chile, Ñuñoa, Santiago, Chile
| | | | - Lorena Muñoz
- Hospital de Carabineros de Chile, Ñuñoa, Santiago, Chile
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