Characteristics of the Clinical Findings in Patients with Idiopathic Thrombocytopenic Purpura Who are Positive for Anti-phospholipid Antibodies.

Funauchi, Masanori; Hamada, Kinya; Enomoto, Hiroshi; Ikoma, Shinya; Ohno, Motoki; Kinoshita, Koji; Horiuchi, Atsushi

doi:10.2169/internalmedicine.36.882

Cited by 23 publications

(22 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These investigators also reported that LAC was an independent risk factor for thrombosis with a hazard ratio of 3.1 and 9.9 in the univariate and multivariate analysis, respectively. 44 Finally, in an earlier study of 27 patients, Funauchi et al 42 reported that 5 of 7 (71%) ITP patients with aPL had a tendency for recurrent fetal loss and thrombosis. From these studies totaling 623 patients with ITP, we can conclude that 33 of 48 (69%) patients with thrombosis had serum aPL with a sensitivity of 0.69 (95% CI, 0.54-0.81) and a specificity of 0.72 (95% CI, 0.68-0.76) of aPL for thrombosis in ITP (OR, 5.71; 95% CI, 2.90-11.34; P Ͻ .0001).…”

Section: Discussionmentioning

confidence: 94%

“…In 742 patients with ITP from 9 published series, the frequency of aPL varied from 25% to 67% (mean, 43%). 9,32,42 In only 4 of these reports did the authors address the issue of whether aPL confers a risk for thrombosis in patients with ITP. 28,[42][43][44] In a prospective study of 149 patients with ITP, Stasi et al 43 reported that 69 (46%) were positive for aPL.…”

Section: Discussionmentioning

confidence: 99%

“…9,32,42 In only 4 of these reports did the authors address the issue of whether aPL confers a risk for thrombosis in patients with ITP. 28,[42][43][44] In a prospective study of 149 patients with ITP, Stasi et al 43 reported that 69 (46%) were positive for aPL. These authors found that after a mean follow-up of approximately 2.5 years, none of their patients developed thrombosis despite the unusually high frequency of LAC (44%) compared with normal healthy control patients (3/174, 1.7%).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Antiphospholipid-associated thrombocytopenia or autoimmune hemolytic anemia in patients with or without definite primary antiphospholipid syndrome according to the Sapporo revised classification criteria: a 6-year follow-up study

Comellas-Kirkerup

Hernández-Molina

Cabral

2010

Blood

View full text Add to dashboard Cite

The updated Sapporo classification criteria for antiphospholipid syndrome (APS) only include thrombosis or pregnancy morbidity as clinical criteria. To test this notion, we studied 55 patients (80% women) with hematologic manifestations. All fulfilled the laboratory criteria for primary APS. Thirty-five patients (64%) had thrombocytopenia, 14 (25%) had autoimmune hemolytic anemia, and 6 (11%) had both. Twenty-five patients (22 women, 88%) also fulfilled one clinical criterion for APS after a median followup of 13.2 years (range, 1.45-37 years), whereas the remaining 30 patients (22 women, 73%) have not had any thrombotic event nor pregnancy morbidity after a median follow-up of 5.4 years (range, 0.12-24 years). No patient developed systemic lupus erythematosus during followup. The hematologic manifestation was asynchronous with the APS onset in 84% of patients. The response to treatment was similar regardless of the APS status. Patients with definite APS were more frequently positive for the lupus anticoagulant (63%) than lupus anticoagulantpositive patients without APS (30%; odds ratio, 3.5; 95% confidence interval, 1.07-11.4; P < .02). Anticardiolipin or anti-␤ 2 -glycoprotein-I antibodies were highly prevalent among the study groups. Our study suggests that, depending upon their antiphospholipid profile, patients with hemocytopenias appear to comprise a peculiar subset of patients with APS; some develop thrombotic and/or obstetric APS whereas others continue with hematologic APS. (Blood. 2010;116(16):3058-3063)

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Antiphospholipid-associated thrombocytopenia or autoimmune hemolytic anemia in patients with or without definite primary antiphospholipid syndrome according to the Sapporo revised classification criteria: a 6-year follow-up study

Comellas-Kirkerup

Hernández-Molina

Cabral

2010

Blood

View full text Add to dashboard Cite

show abstract

“…Renal thrombotic intravascular lesions related to antiphospholipid antibodies have been described [21]. Thrombotic thrombocytopenic purpura, a disease very similar to HUS, has also been associated with aCL antibodies [21,22]. However, in a recent study no correlation between aCL antibodies and the thrombotic microangiopathy seen in adult HUS after transplantation could be demonstrated, unless the patient had a hepatitis C infection [23].…”

Section: Discussionmentioning

confidence: 99%

Anticardiolipin antibodies in D+ hemolytic uremic syndrome

Loo

Velden

Onland

et al. 2002

Pediatric Nephrology

View full text Add to dashboard Cite

The diarrhea-associated form of the hemolytic uremic syndrome (D+ HUS) is characterized by a triad of symptoms, namely thrombocytopenia, hemolytic anemia, and acute renal failure. Histopathological studies of patients with D+ HUS show microthrombi in arterioles and glomeruli of the kidney. Recently, it was suggested that antiphospholipid antibodies might play a pathogenic role in D+ HUS. However, an epiphenomenon could not be excluded. In this study we investigated the relationship between antiphospholipid antibodies and clinical symptoms in 22 patients with the classical form of HUS (D+ HUS). The first sample was obtained on the day of admission. The next samples were taken on day 7 and 14. We measured anticardiolipin (aCL) antibodies (IgM, IgA, and IgG) in the samples using an ELISA. A significant increase in IgM (60%) and IgG (41%) aCL antibodies was seen in patients versus controls. No relationship between aCL antibody levels and severity of renal failure could be demonstrated. These data suggest that antiphospholipid antibodies are increased, but have not been shown to have a role in the pathogenesis of the microangiopathy seen in D+HUS.

show abstract

“…If during the course of treatment or monitoring atypical features develop-for example, abnormalities in the white blood cell count, lymphadenopathy, multiple cytopenias-then the diagnosis of ITP should be reassessed. As in childhood ITP, we found insufficient evidence to recommend or suggest the routine use of antiplatelet, [61][62][63][64][65][66][67][68][69][70][71] antiphospholipid [72][73][74][75] and antinuclear antibodies, 13,76 thrombopoietin levels, 64,65,77 or platelet parameters obtained on automated analyzers 64,65,[78][79][80][81][82][83][84] in the evaluation of patients with suspected ITP.…”

Section: Question: What Testing Is Required To Confirm the Diagnosis mentioning

confidence: 99%

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

Neunert

Lim

Crowther

et al. 2011

Blood

1,664

1,783

View full text Add to dashboard Cite

Immune thrombocytopenia (ITP) is commonly encountered in clinical practice. In 1996 the American Society of Hematology published a landmark guidance paper designed to assist clinicians in the management of this disorder. Since 1996 there have been numerous advances in the management of both adult and pediatric ITP. These changes mandated an update in the guidelines. This guideline uses a rigorous, evidence-based approach to the location, interpretation, and presentation of the available evidence. We have endeavored to identify, abstract, and present all available methodologically rigorous data informing the treatment of ITP. We provide evidence-based treatment recommendations using the GRADE system in those areas in which such evidence exists. We do not provide evidence in those areas in which evidence is lacking, or is of lower quality-interested readers are referred to a number of recent, consensus-based recommendations for expert opinion in these clinical areas. Our review identified the need for additional studies in many key areas of the therapy of ITP such as comparative studies of "front-line" therapy for ITP, the management of serious bleeding in patients with ITP, and studies that will provide guidance about which therapy should be used as salvage therapy for patients after failure of a first-line intervention. (Blood. 2011;117(16):4190-4207)

show abstract

Characteristics of the Clinical Findings in Patients with Idiopathic Thrombocytopenic Purpura Who are Positive for Anti-phospholipid Antibodies.

Cited by 23 publications

References 8 publications

Antiphospholipid-associated thrombocytopenia or autoimmune hemolytic anemia in patients with or without definite primary antiphospholipid syndrome according to the Sapporo revised classification criteria: a 6-year follow-up study

Antiphospholipid-associated thrombocytopenia or autoimmune hemolytic anemia in patients with or without definite primary antiphospholipid syndrome according to the Sapporo revised classification criteria: a 6-year follow-up study

Anticardiolipin antibodies in D+ hemolytic uremic syndrome

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

Contact Info

Product

Resources

About