The indication for splenectomy in chronic idiopathic thrombocytopenic purpura (ITP) remains a controversial subject. The mortality rate of persistent thrombocytopenia is very low, except in severe cases. Conversely, the risks of splenectomy are significant (in the present series, morbidity: 4.1% mortality: 1.4%), with a success rate of only 60-75%. It is therefore useful to define a parameter able to predict the efficacy or failure of splenectomy. An analysis of 578 cases of chronic ITP, where the site of platelet destruction has been determined, is presented. 268 of these cases had been splenectomized. When platelet destruction was splenic, 96% of subjects aged 5-30 years and 91% of cases over the age of 30 years obtained a remission. Conversely, when platelet destruction was hepatic or diffuse, failure or incomplete results were observed in 92% of cases. The site of platelet destruction therefore constitutes a parameter which can help the clinician to make the decision to perform splenectomy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1046/j.1365-2141.1997.832723.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
How I use noninvasive prenatal testing for red blood cell and platelet antigens.
Blood
December 2024
Sanquin, Amsterdam, Netherlands.
Alloimmunization during pregnancy occurs when a mother produces antibodies against fetal antigens, leading to complications like hemolytic disease of the fetus and newborn (HDFN) and fetal and neonatal alloimmune thrombocytopenia (FNAIT). HDFN involves destruction of fetal red blood cells, potentially causing severe anemia, hydrops fetalis, and fetal death. FNAIT affects fetal platelets and possibly endothelial cells, resulting in risk of intracranial hemorrhage and brain damage.
View Article and Find Full Text PDFImmune Thrombocytopenic Purpura Secondary to Cytomegalovirus (CMV) Infection: A Clinical Case.
Cureus
December 2024
General and Family Medicine, Câmara de Lobos Health Center, Serviço de Saúde da Região Autónoma da Madeira, Entidade Pública Empresarial da Região Autónoma da Madeira (SESARAM, EPERAM), Câmara de Lobos, PRT.
Immune thrombocytopenic purpura (ITP) is an autoimmune condition characterized by a reduced platelet count due to enhanced peripheral destruction and impaired platelet production. While thrombocytopenia is a well-documented complication of various viral infections, cytomegalovirus (CMV), a member of the Herpesviridae family, is primarily associated with infections in immunocompromised patients and is rarely implicated in causing severe thrombocytopenia in immunocompetent patients. This article aims to highlight the importance of considering CMV as a significant etiological factor in ITP, particularly in cases of asymptomatic thrombocytopenia.
View Article and Find Full Text PDFBaricitinib in pediatric chronic immune thrombocytopenia and associated autoimmune conditions: a case report.
Front Pediatr
December 2024
Pediatric Hematology and Oncology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
Immune thrombocytopenia (ITP) is a disease characterized by platelet destruction, presenting substantial challenges in clinical practice. The classic first line therapeutic management includes corticosteroids and intravenous immunoglobulins. Although it is less frequent in children than in adults, there is a significant percentage of patients, up to 47% according to the Pediatric and Adult Registry on Chronic ITP, who require second-line or further treatment, due to non-response to the first line treatment or persistence of disease, among other reasons.
View Article and Find Full Text PDFReactive oxygen species: Orchestrating the delicate dance of platelet life and death.
Redox Biol
January 2025
School of Basic Medical Sciences, Southwest Medical University, Luzhou, 646000, China; Key Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, (Collaborative Innovation Center for Prevention of Cardiovascular Diseases), Institute of Cardiovascular Research, Southwest Medical University, Luzhou, 646000, China. Electronic address:
Article Synopsis
- Platelets play a critical role in blood clotting and the immune response, relying on a balanced relationship between their production and destruction influenced by reactive oxygen species (ROS).
- Moderate levels of ROS enhance platelet production and function, aiding in processes like collagen binding and thrombus formation, but high levels can lead to platelet apoptosis and increased risk of thrombosis.
- The review emphasizes the need for further research into specific ROS signaling pathways, which could lead to new therapies for platelet-related disorders by leveraging the beneficial aspects of ROS while managing their harmful effects.
Therapeutic potential of roxadustat in immune thrombocytopenia: A Mendelian randomization analysis.
J Thromb Haemost
January 2025
Hematology Department, Beijing Key Laboratory of Pediatric Hematology Oncology; National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China. Electronic address:
Background: Immune thrombocytopenia (ITP) is characterized by immune-mediated platelet destruction and impaired megakaryocyte maturation. Hypoxia-inducible factor-1 alpha (HIF-1α), pivotal in the development of megakaryocytes and immune regulation, is downregulated in ITP. Roxadustat, which stabilizes HIF-1α, has emerged as a potential therapeutic drug for ITP that acts by enhancing HIF-1α-mediated megakaryocyte development and modulating immune responses.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!