Platelet Count Normalization Following Romosozumab Treatment for Osteoporosis in Patient with Immune Thrombocytopenic Purpura: A Case Report and Literature Review.

Romosozumab, which is approved for the treatment of osteoporosis, has a dual-action mechanism that promotes bone formation and inhibits bone resorption. However, its association with an increased risk of major adverse cardiovascular events, as highlighted in the ARCH I study, raises concerns. The underlying pathophysiological mechanisms, possibly involving changes in platelet dynamics, are yet to be fully elucidated.

Exosomal miR-146a-5p derived from bone marrow mesenchymal stromal cells regulate Th1/Th2 balance and alleviates immune thrombocytopenia in pregnancy.

Immune thrombocytopenia (ITP) is a common hematological disorder. Our previous study has found that exosomal miR-146a-5p derived from bone marrow mesenchymal stromal cells (BMSCs) regulate Th17/Treg balance to alleviate ITP. This work further investigated the role of miR-146a-5p in ITP with pregnancy.

Successful rituximab treatment in a seronegative rheumatoid arthritis patient with concurrent cold agglutinin syndrome and immune thrombocytopenia.

Cold agglutinin disease, a subtype of cold-type autoimmune hemolytic anemia, is referred to as cold agglutinin syndrome (CAS) when it develops secondary to other conditions. Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by the peripheral destruction of platelets. While both CAS and ITP can occur in patients with rheumatoid arthritis (RA), their concurrent manifestation in a single patient has not been reported, leaving the optimal treatment strategy for such a complex case unclear.

Complex immunogenicity assessment in caplacizumab-treated patients with immune-mediated thrombotic thrombocytopenic purpura who have received plasma exchange.

Background: International Society on Thrombosis and Haemostasis guidelines for immune-mediated thrombotic thrombocytopenic purpura (iTTP) treatment recommend concurrent therapeutic plasma exchange (TPE), immunosuppressive therapy (IST), and caplacizumab. TPE can complicate antidrug antibody (ADA) measurements by transferring pre-existing antibodies (pre-Abs) into patients via donor plasma and/or diluting treatment-emergent (TE) ADAs.

Objectives: To assess the presence of ADAs in patients with iTTP who received caplacizumab.

Intravenous immunoglobulin therapy: usage patterns and response to treatment in Qatar over ten years.

Background: IVIg is a blood-derived antibody product initially designed as a replacement therapy in inborn errors of immunity (IEIs). However, over the last 50 years, IVIg has been used to treat a growing range of autoimmune, autoinflammatory, and secondary immunodeficiency disorders. The US FDA has licensed IVIg for use in the treatment of nine clinical indications; although, IVIg global usage extends to off-label indications with variable treatment responses.

Pathophysiology of oral lesions subsequent to SARS-CoV-2 vaccination: A systematic review.

Amidst worldwide reports of adverse oral lesions subsequent to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, the current systematic review planned to determine the prevalence of adverse oral events in adult individuals (≥18 years) after SARS-CoV-2 vaccination, emphasizing upon the type and dose of vaccine, time of onset, and underlying pathophysiology. The registered protocol (PROSPERO CRD42023421307), conforming with PRISMA guidelines, included an all-inclusive literature search through online databases, consisting of Scopus, PubMed/MEDLINE, Web of Science, Lilacs, Livivo, and PROSPERO, completed on 2 May 2023, followed by assessment of risk of bias by Joana Briggs Institute Evaluation Checklist. Due to the paucity of literature, case reports and case series were included.

The role of eosinophil counts and megakaryocyte nuclei for distinction of acute and chronic immune thrombocytopenic purpura.

Objective: Immune thrombocytopenic purpura (ITP), the most common cause of thrombocytopenia, is clinically classified as acute and chronic. This study aimed to distinguish between acute/chronic ITP parameters examined at diagnosis via complete blood count (CBC), peripheral blood (PB) and bone marrow aspirate (BMA) smears. It would also contribute to early treatment options, cost-effective policies, and the life quality of patients.

Rare Delayed Immune Thrombocytopenic Purpura Associated With Neoadjuvant Immunotherapy.

Background: Immunotherapy targeting the PD-L1/PD-1 checkpoint pathway with monoclonal antibodies has demonstrated significant and durable efficacy across various malignancies. However, these immunotherapies can induce adverse reactions, collectively referred to as immune-related adverse events (irAEs). Most irAEs occur during immunotherapy.

On the horizon: upcoming new agents for the management of ITP.

Treatment of immune thrombocytopenia (ITP) has evolved over the last 20 years in response to our increased understanding of the pathophysiology of this complex immune disorder. New treatments in development have taken advantage of our evolving understanding of the biology of this disease to target new mechanisms and expand the available ways in which to approach patients with this disorder. This review focuses on novel therapeutics in the ITP pipeline and discusses the pathophysiology of ITP that has led to their development.

Demystifying autoimmune HIT: what it is, when to test, and how to treat.

Antibodies to platelet factor 4 (PF4) have been primarily linked to classical heparin-induced thrombocytopenia (cHIT). However, during the rollout of the COVID-19 vaccine program a new condition, vaccine-induced thrombocytopenia and thrombosis (VITT), was identified, related to adenoviral-based COVID-19 vaccines. The differences between these 2 conditions, both clinically and in laboratory testing, set the scene for the development of a new rapid anti-PF4 assay that is not linked with heparin (as relevant for cHIT).

ITP in pregnancy: diagnostics and therapeutics in 2024.

Thrombocytopenia will occur in 10% of pregnancies-ranging from the clinically benign to processes that can threaten both mother and fetus. Accurately identifying the specific etiology and appropriate clinical management is challenging due to the breadth of possible diagnoses and the potential of shared features among them. Further complicating diagnostic certainty is the lack of confirmatory testing for most possible pathophysiologies.

Common variable immunodeficiency: autoimmune cytopenias and advances in molecular diagnosis.

Common variable immunodeficiency (CVID) is one of the most common groups of human inborn errors of immunity. In addition to infections resulting from insufficient levels of immunoglobulins and antibodies, a significant proportion of patients develop autoimmune cytopenias, especially immune thrombocytopenia, hemolytic anemia, or neutropenia. They may be the initial manifestation of CVID in a patient who has not had significant infections, and similar episodes may recur at intervals over time.

COVID-19-Associated Immune Thrombocytopenic Purpura in a Hemodialysis Patient.

Background: Severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection has been a global threat since the end of 2019. Although the main clinical manifestation of coronavirus disease 2019 (COVID-19) is respiratory, its range of clinical manifestation is extensive and may include various systems, including hematological disorders, such as lymphopenia, thrombotic events, thrombocytopenia and immune thrombocytopenic purpura (ITP). The present case was the first one that aimed to raise awareness of ITP induced by COVID-19 in patients undergoing maintenance hemodialysis.

Air pollution, residential greenspace, and the risk of incident immune thrombocytopenic purpura: a prospective cohort study of 356,482 participants.

This study investigated the associations of air pollution and residential greenspace with immune thrombocytopenic purpura (ITP) risk, along with their combined effects, in a cohort of 356,482 UK Biobank participants free of ITP at baseline. Ambient PM2.5, PMcoarse, PM10, NO2, and NOx exposures were estimated by land-use regression models and residential greenspace was calculated using land use data, defined as the percentage of outdoor greenspace surrounding each participant's home location.

Case report: Pediatric patient with severe clinical course of CTLA-4 insufficiency treated with HSCT.

Background: Cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) insufficiency is a rare disease belonging to inborn errors of immunity. Most cases of patients with CTLA-4 insufficiency are diagnosed in adults, therefore it is not a common problem in the clinical practice of pediatricians. However, it is worth noticing that most cases described in the literature show the first symptoms of the disease before the age of 18, but the phenotypic variability of patients complicates and delays the diagnostic process.

Immune Thrombocytopenic Purpura (ITP) With Ulcerative Colitis (UC).

Inflammatory bowel disease (IBD) includes ulcerative colitis (UC) and Crohn's disease. A relapsing, immune-modulated illness, it causes inflammation of the small and large intestines.  UC is sometimes associated with extra-intestinal manifestations, including autoimmune cytopenias.

A case report of refractory immune thrombocytopenia: Challenges in choice of therapies in resource limiting center.

Introduction And Importance: Refractory immune thrombocytopenic purpura (ITP) is a rare but serious condition causing significant morbidity and mortality due to inadequate response to standard treatments, resulting in persistent thrombocytopenia and increased bleeding risk.

Case Presentation: An 18-year-old female patient, diagnosed with ITP two years prior following excessive vaginal bleeding and fatigue, was initially treated with oral prednisolone for two months and discharged in improved condition. Eighteen months after treatment cessation, she presented with recurrent excessive vaginal bleeding, intermittent bilateral nasal bleeding, skin rash, blurred vision, fatigue, tinnitus, vertigo, and intermittent headaches (one-month duration).

CpG can induce the proliferation and differentiation of B10 cells in the peripheral blood of children with immune thrombocytopenic purpura.

Immune thrombocytopenic purpura (ITP) is a disease with a pathogenesis that remains unclear. Accordingly, this study aims to explore the role of B10 cells in ITP pathogenesis and provide a potential novel target for ITP treatment. We selected 42 children diagnosed with ITP and 29 age- and sex-matched healthy children as study objects.

A Case of Autoimmune Neutropenia That Responded to Rituximab.

Autoimmune neutropenia (AIN) refers to the immune-mediated destruction of neutrophils. It is a rare condition with an estimated prevalence of less than 1 case per 100,000 per year. Typical treatment involves supportive care with granulocyte colony-stimulating factor (G-CSF) and management of secondary infections with antibiotics.