Dysplastic changes in idiopathic thrombocytopenic purpura and the effect of corticosteroids to increase dysplasia and cause hyperdiploid macropolycytes

Yenicesu

Ersoy

2005

Self Cite

Immune thrombocytopenia (ITP) is a frequently encountered disease in childhood. Recent reports pointed to the benefit of high-dose steroid in ITP treatment since it resulted in a better outcome in a shorter time than IV immunoglobulin therapy. In the authors' clinic, mainly after 1984, megadose methyl prednisolone (MDMP) has been used for ITP treatment. There is no report that includes an extensive immune system examination of megadose steroid effect in childhood ITP. The purpose of this study is to determine the effects of MDMP therapy on the immune system in childhood ITP for serum immunoglobulins, absolute lymphocyte and lymphocyte subclass counts, and in vitro blastogenic responses to mitogens. The authors have demonstrated that lymphocyte subtypes (CD3, CD4, CD8, CD19) and serum immunoglobulin G, A, M increased after a short-course MDMP therapy in comparison to pretreatment values in mixed group (acute + chronic) of childhood ITP patients. Also blastic transformation function of lymphocytes with Conca-A and phytohemaglutinin showed an upward trend in 6 of the 9 patients. Steroid are thought to have a suppressive effect on the immune system but this study suggests that short-course MDMP may not be hazardous to the immune system.

Section: Discussionmentioning

confidence: 69%

The Effects of Megadose Methylprednisolone Therapy on the Immune System in Childhood Immune Thrombocytopenia

Yenicesu

Ersoy

2005

Self Cite

“…It might be suggested that even the stem cells are affected by PVB19. Three lineage dysplasia in ITP has been reported, and may be the result of PVB19 stem cell effect [27].…”

Section: Discussionmentioning

confidence: 97%

Human Parvovirus B19 Associated With Idiopathic Thrombocytopenic Purpura

Aktepe

Olcay

et al. 2004

Self Cite

Although human parvovirus B19 (PVB19) is mainly known to be the causative agent of fifth disease, it is also important in the etiopathogenesis of various hematologic disorders. Recently, its role in the occurrence of chronic anemia and pancytopenia in immunocompromised patients has been revealed. In this study, the authors searched for the presence of PVB19 in a group of patients with idiopathic thrombocytopenic purpura (ITP). The PVB19 DNA was determined by nested PCR, and serologic responses to the virus were evaluated by ELISA. Viral genome was detected by PCR in the sera of 9 of the 19 patients. The IgM and IgG positivities were 57 and 73% in the patients, respectively. These results suggest that PVB19 is associated with ITP nearly in half of the patients and its pathogenetic role in the cases of ITP needs further consideration.

“…Myelodysplastic changes refer to abnormal morphology of the BM and/or peripheral blood and this feature is commonly seen in MDS. Myelodysplasia in peripheral blood and BM can also be seen in different conditions such as autoimmune diseases, infections, especially viral infections, immunosuppressive drugs, chromosomal abnormalities, and DNA abnormalities [9][10][11][12][13][14][15][16][17][18][19][20]. Iron deficiency results in cellular metabolic enzyme changes, alterations in cellular growth, DNA, RNA, and protein structure, and also increased susceptibility to infections [1,2,21].…”

Section: Discussionmentioning

confidence: 99%

“…Giant platelets were not related to an associated autoimmune disease [13] or bleeding history and the patients were also examined for the presence of blood in the stool, which may cause consumption of plateles.…”

Section: Discussionmentioning

confidence: 99%

Dysplasia and Disorder of Cell Membrane Entirety in Iron-Deficiency Anemia

Aslan

Ünal

et al. 2008

Self Cite

Peripheral blood smears of 43 patients (26 males, median age 18 months, range: 6-180 months) with nutritional iron-deficiency anemia (IDA) were examined for the presence of trilineage hematological dysplasia. Twelve patients were reexamined for dysplastic findings after achieving a normal Hb and hematocrit level for age by the end of 2-3 months of iron treatment. A control group of 17 age-matched healthy children were also included. Neutrophils with loss of membrane entirety and protrusions were remarkable in 34/43 (79%) in the IDA group versus 1/12 (8%) after iron treatment and none of the control group. Microspherocytes were seen in 9/43 (21%) of IDA patients. Additionally, trilienage dysplasia was observed in the bone marrow samples available in 3 of the patients. It has been shown that iron-deficiency results in cellular DNA and RNA alterations, cell-cycle G1/S phase arrest, and apoptosis. Rac GTPases have been shown to control actin cytoskeleton, influencing cell polarity, microtubule dynamics, and the cytoskeletal organization of hematopoietic cells. Thus, the findings described above in neutrophils and red cells suggest a plausible link between iron and the Rac GTPase gene family. It may be a new avenue for iron waiting for proof.