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Immune thrombocytopenic purpura (ITP) is an acquired immune-mediated bleeding disorder characterized by isolated low platelet (PLT) counts. Immune thrombocytopenic purpura pathogenesis involves multiple immune mechanisms causing PLT destruction and inadequate production. Owing to impaired immune homeostasis, ITP patients can develop other than anti-PLT autoantibodies even in the absence of clinical signs of autoimmune disease, such as anti-thyroglobulin (TG) and anti-thyroperoxidase (TPO) antibodies.

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Intramural pregnancy (IMP) is an extremely rare form of ectopic pregnancy (EP), typically associated with previous uterine trauma, adenomyosis, or assisted reproductive technology (ART), such as embryo transfer (ET). Despite its potentially life-threatening nature, the absence of definitive preoperative diagnostic criteria for IMP complicates its early detection and management, especially in patients without known risk factors. Additionally, management becomes more challenging when there is an elevated risk of hemorrhage.

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To assess efficacy and safety of dapsone in adult immune thrombocytopenia (ITP), a multicenter randomized controlled trial (RCT) and a real-word study cohort were performed. Participants were adults with primary ITP, transient response to corticosteroids ± intravenous immunoglobulin, and a platelet count ≤ 30x109/L (or ≤ 50x109/L with bleeding). Patients in the RCT were randomized in arm A (prednisone x3weeks+dapsone for 12 months) or arm B (prednisone alone).

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Fostamatinib had superior efficacy to a placebo and acceptable safety profiles for at least 1 year in a phase 3 study of Japanese patients with primary immune thrombocytopenia. Here, we report the 3-year safety and efficacy of fostamatinib in that study. Data from 33 patients who received at least one dose of fostamatinib were analyzed.

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The ITP diagnostic challenge.

Br J Haematol

January 2025

Hematology Department, Hospital Universitario de Burgos, Burgos, Spain.

Despite numerous advances, the diagnosis of immune thrombocytopenia (ITP) remains a diagnosis of exclusion. This commentary analyses and contextualizes the recent report from Garabet et al. that MicroRNA-199a-5p could be used as a diagnostic marker for ITP.

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