Diagnosis and management of immune thrombocytopenia in childhood

Kühne, Thomas

doi:10.5482/hamo-16-06-0017

Cited by 43 publications

(26 citation statements)

References 89 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many retrospective and prospective studies also confirmed a similar or higher efficacy of splenectomy in children with chronic ITP. For example, data from 153 children with a median follow‐up of 2 years showed immediate platelet response in 86% with 80% maintaining their response in the following 4 years (Kuhne et al , ; Kuhne, ).…”

Section: Consolidated Results Of Splenectomymentioning

confidence: 99%

A critical appraisal of the evidence for the role of splenectomy in adults and children with ITP

Rodeghiero

2018

Br J Haematol

View full text Add to dashboard Cite

In primary chronic immune thrombocytopenia, long-term response to splenectomy, with 60% of patients enjoying a treatment-free life, is higher when compared with rituximab and similar to that with continuous thrombopoietin-receptor agonists (TPO-RA) administration. Splenectomy should continue to be offered to patients failing initial treatments in the absence of increased surgery-related risks. The higher lifelong safety concerns with splenectomy (increased risk of infection, shared in part with rituximab, and of thrombosis, in common with TPO-RA) and a mortality <1-2%, justify postponing surgery to the chronic phase, when spontaneous remissions are rarer. Patients failing initial treatment with corticosteroids/intravenous immunoglobulin may use TPO-RA (or rituximab in selected cases) as a bridge to surgery if they prefer to reconsider splenectomy later on, in case of no response, adverse effects or if sustained response after stopping TPO-RA is not attained. Special considerations apply in children aged ≤5 years, with splenectomy playing a marginal role. The recent approval of TPO-RA in children may represent a major advancement.

show abstract

Section: Consolidated Results Of Splenectomymentioning

confidence: 99%

A critical appraisal of the evidence for the role of splenectomy in adults and children with ITP

Rodeghiero

2018

Br J Haematol

View full text Add to dashboard Cite

show abstract

“…The standard first-line therapy for ITP consist in corticosteroids and intravenous immunoglobulins (IVIG). 2,3 Childhood ITP is a heterogeneous disease, which can coexist with several autoimmune diseases, 3 especially in the chronic forms associated with systemic lupus erythematosus (SLE), autoimmune thyroiditis, and hemolytic anemia. 4,5 The combination of immune thrombocytopenia with thyroid autoimmune diseases is an infrequent but well-known condition.…”

Section: Hematology // Endocrinologymentioning

confidence: 99%

Immune Thrombocytopenia in an Adolescent with Hashimoto’s Thyroiditis – Case Report

Kelemen

Papp

Horváth

2019

Journal of Interdisciplinary Medicine

View full text Add to dashboard Cite

Introduction: In childhood, thrombocytopenia caused by transient antibody-mediated thrombocyte destruction is most frequently diagnosed as immune thrombocytopenic purpura (ITP). We report the case of a girl with ITP associated with autoimmune thyroiditis. Case presentation: A 11-year-old female patient with Hashimoto’s thyroiditis presented with clinical signs of petechiae and ecchymoses on the extremities. Laboratory tests showed remarkable thrombocytopenia with a platelet count of 44,500/μL, hence she was referred to a hematologic consultation. The peripheral blood smear showed normal size platelets in very low range. The bone marrow examination exposed hyperplasia of the megakaryocyte series with outwardly morphologic abnormalities. The patient was diagnosed with ITP, and her first-line treatment was pulsed steroid and immunoglobulin therapy. The thrombocytopenia was refractory to these first-line medications. After 6 months of corticotherapy and a period of severe menorrhagia, azathioprine immunosupression was initiated as a second-line treatment. Her platelet count rapidly increased, and the evolution was good, without bleeding complications. Conclusion: In case of a medical history of autoimmune diseases and treatment-resistant ITP, attention must be focused on detecting coexisting autoimmune diseases and adjusting the treatment in accordance with the chronic evolution of the disease.

show abstract

“…Dexamethason wurde erstmals in den 1990er Jahren in der Zweitlinientherapie der therapierefraktären, chronischen ITP eingesetzt [68] [5,74,75].…”

Section: Prednison Versus Dexamethasonunclassified

Immunthrombozytopenie - aktuelle Diagnostik und Therapie: Empfehlungen einer gemeinsamen Arbeitsgruppe der DGHO, ÖGHO, SGH, GPOH und DGTI

Matzdorff

Meyer²,

Ostermann³

et al. 2018

Oncol Res Treat

Self Cite

View full text Add to dashboard Cite

Diagnosis and management of immune thrombocytopenia in childhood

Cited by 43 publications

References 89 publications

A critical appraisal of the evidence for the role of splenectomy in adults and children with ITP

A critical appraisal of the evidence for the role of splenectomy in adults and children with ITP

Immune Thrombocytopenia in an Adolescent with Hashimoto’s Thyroiditis – Case Report

Immunthrombozytopenie - aktuelle Diagnostik und Therapie: Empfehlungen einer gemeinsamen Arbeitsgruppe der DGHO, ÖGHO, SGH, GPOH und DGTI

Contact Info

Product

Resources

About