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Haematological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
There are acute (self-limiting) and chronic forms of immune thrombocytopenic purpura (ITP). Acute ITP is the usual form in children and often follows viral infection, remitting spontaneously as the infection is cleared. Chronic ITP mostly affects adults.
Paper 2
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Immune thrombocytopenic purpura (ITP) is usually self-limiting in children after a viral illness. Chronic ITP is more common in adults. Antiplatelet autoantibodies cause phagocytic destruction of the platelets. Bleeding, purpura and nose bleeds are common. Retinal and conjunctival haemorrhage is rare. A platelet count of <10 × 109/L, positive anti-platelet IgG autoantibodies and positive antinuclear antibodies in 40% of cases is suggestive of ITP. If symptomatic, or if the platelet count is particularly low, steroids may be used for treatment. Splenectomy may also be required.
Child protection
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
There are rare medical causes for bruising and bleeding that may need to be excluded before a diagnosis of non-accidental injury is made. A thorough medical history and baseline blood tests including a full blood count (FBC) and clotting studies can exclude rare bleeding disorders such as von Willebrand disease or immune thrombocytopenic purpura (ITP).
The incidence and clinical burden of immune thrombocytopenia in pediatric patients in the United States
Published in Platelets, 2020
Jaime Shaw, Karynsa Kilpatrick, Melissa Eisen, Michael Tarantino
To estimate the incidence of ITP, patients who were enrolled in MarketScan at any point between 1 January 2011 and 31 December 2016 and under 18 years of age at the first date of enrollment were included. Patients who were enrolled in MarketScan prior to 2011 were excluded if they had a history of ITP, defined by any claim prior to 2011 carrying the ICD-9 (International Classification of Diseases – 9th Revision) code 287.31 or ICD-10 (10th Revision) code D69.3 for “immune thrombocytopenic purpura” (see Appendix A in Supplementary Material). During follow-up, a diagnosis of ITP was defined as at least 1 inpatient claim or 2 outpatient claims separated by ≥30 days but <365 days, between 1 January 2011 and 31 December 2016, carrying the relevant ICD-9 or ICD-10 code. Patients were followed from the first date of enrollment in MarketScan between 1 January 2011 and 31 December 2016, until the earliest of the following: 1) date of ITP diagnosis; 2) disenrollment from MarketScan; 3) death; or 4) end of the study period (31 December 2016).
Efficacy and safety of thrombopoietin receptor agonists in children with chronic immune thrombocytopenic purpura: meta-analysis
Published in Platelets, 2019
Joyce Tumaini Massaro, Yanhui Chen, Zhongling Ke
Immune thrombocytopenic purpura (ITP), formerly known as idiopathic thrombocytopenia purpura, is an autoimmune disorder in which both adults and children can be affected. In a small number of children, estamated about 1 in 20,000,1-4wk after exposure to a common viral infection, an autouantibody directed against the platelet surface develops with resultant sudden onset of thrombocytopenia(from“Nelaon Textbook of Pediatrics”) It’s incident in children is approximately 1.9 to 6.4 cases per 100,000 per year. ITP involves increased destruction of platelets and impaired platelet production, resulting in decreased platelet counts (<100 × 109/L) [1,2]. Patients may present without symptom, with petechiae and ecchymoses, or with intracranial hemorrhage due to severe bleeding that can be fatal. ITP is classified into newly diagnosed ITP (<3 months), persistent ITP (3–12 months), and chronic ITP (>12 months) by duration [3]. In children, most cases are acute and self-limited without need of treatment, commonly after viral infections; only less than 20% of children with ITP may progress to chronic state [4].
Successful treatment of a patient with refractory immune thrombocytopenic purpura in systemic lupus erythematosus with rituximab
Published in Immunological Medicine, 2019
Kazuya Abe, Yuichi Ishikawa, Junichi Ishikawa, Michio Fujiwara, Yasuhiko Kita
Immune thrombocytopenic purpura (ITP) is a thrombocytopenia caused by autoantibodies against platelet antigens and is classified into primary and secondary forms [1]. Secondary ITP may occur with systemic lupus erythematosus (SLE), viral infections, including the human immunodeficiency and hepatitis C viruses, and chronic lymphocytic leukemia. Approximately 5%–20% of SLE patients develop ITP [2,3]. Usually, SLE-associated ITP (SLE-ITP) is treated with corticosteroids (CSs) and has a relatively good therapeutic response; however, some patients are CS-resistant [4]. In such cases, intravenous immune globulin (IVIG) and splenectomy can be utilized, similar to that in primary ITP [5], but this has not been well-studied in SLE-ITP. Recently, the efficacy of rituximab (RTX) for SLE-associated cytopenias, including ITP, has been reported [6]. Here we report a case of CS-resistant SLE-ITP in a patient who was successfully treated with RTX. Hospital ethics committee approved these treatments. Written informed consent was obtained from the patient for the use of immunosuppressive agents and publication of this case report.