Idiopathic thrombocytopenic purpura

Kayal, L; Jayachandran, S; Singh, Khushboo

doi:10.4103/0976-237x.137976

Cited by 29 publications

(19 citation statements)

References 12 publications

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“…In ITP, the overall number of platelets is affected rather than their function. The incidence of ITP is nearly 50 to 100 cases per million per year, with children accounting for half of that number [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-γ in pediatric immune thrombocytopenia

et al. 2023

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Background: Immune thrombocytopenia (ITP) is an acquired autoimmune disease characterized by abnormalities of T cells subsets. Programmed death-1 (PD-1) is a co-signaling inhibitory molecule in T cells that is involved in many autoimmune diseases.Purpose: Here we aimed to measure changes in PD-1 expression and serum interferon-γ (IFN-γ) levels before and 1 month after treatment in pediatric patients with newly diagnosed ITP.Methods: We measured PD-1+ CD4+ T cells percentages using flow cytometry and the serum IFN-γ levels by enzyme-linked immunosorbent assay in 40 pediatric patients with ITP and 20 healthy controls.Results: Compared with healthy controls, the PD-1+ CD4+ T cells percentages and serum IFN-γ levels were significantly higher in ITP patients before and 1 month after therapy. A correlation study revealed that PD-1+ CD4+ T cells percentage was negatively associated with platelet count and positively associated with IFN-γ level in patients with ITP. Furthermore, serum IFN-γ levels were significantly decreased in patients after treatment, but no significant change was detected in the percentage of PD-1+ CD4+ T cells before or 1 month after therapy.Conclusion: PD-1+ CD4+ T cells expression and IFN-γ levels were increased in patients with ITP. These preliminary data suggest a potential role of PD-1+ CD4+ T cells as mediators of ITP. We also found a correlation between PD-1+ CD4+ T cells and both platelet counts and IFN-γ levels. These findings suggest a potential role of PD-1+ CD4+ T cells and IFN-γ in the pathogenesis of ITP. Further studies investigating PD-1 expression in different T-cell subsets, serum IFN-γ concentrations, and antiplatelet antibodies levels over a longer duration after therapy initiation could delineate the precise role of PD-1 in ITP pathogenesis. Consequently, novel nontraditional therapeutic strategies for ITP patients may become available.

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Section: Introductionmentioning

confidence: 99%

Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-γ in pediatric immune thrombocytopenia

et al. 2023

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“…Platelet counts below 50,000/mcL increase the risk of bleeding from trauma and counts below 20,000/mcL may cause spontaneous bleeding. ITP may be either acute or chronic.. 2 Incidence of ITP is around 3/100,000 person-years, both persistent (more than 3 months duration after diagnosis) and chronic ITP (more than 12months duration after diagnosis) affect 70% of adult patients. 3 In acute ITP cases patients usually suffer from bruising; petechiae, bleeding gums and epistaxis (in patients having the platelet count below 20,000/ mcL).…”

Section: Introductionmentioning

confidence: 99%

Ayurvedic management of immune thrombocytopenic purpura - a case report

Gupta¹,

Mamidi²

2023

IJCAM

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Immune thrombocytopenic purpura (ITP) is a bleeding disorder characterized by isolated thrombocytopenia. The course is more chronic in adults associated with higher mortality in older patients. In extreme cases of ITP, serious complications such as bleeding into the lungs, brain, or other vital organs can occur. Clinical manifestations include purpura, petechiae and ecchymosis. Majority of ITP patients are not getting reliable and durable remissions with modern medicine. The present case report deals with an elderly patient having chronic ITP with multiple comorbidities (obesity, schizophrenia, UTI and T2DM) approached for Ayurvedic treatment. Patient came with ecchymotic patches on both upper extremities with extremely low platelet counts (9700/mcL) was diagnosed as Tiryaggata Raktapitta and Ayurvedic treatment has been provided. Ayurvedic formulations (Putapakwa Vishama Jwarantaka Loha, Raktastambhaka Vati, Samshamani Vati etc) have improved the platelet counts (from the lowest count of 9700/mcL to highest count of 50000/mcL), hematological indices and quality of life in present case. Ecchymotic patches were completely disappeared without any further recurrences. The present case of ITP (Raktapitta) is a good example for Nidaanaarthakara Roga as it has manifested due to the consequences of malarial fever (Vishama Jwara). Ayurvedic treatment seems to be promising in the management of chronic ITP and generates hope for those patients who are having extreme thrombocytopenia, multiple comorbidities, reluctant (or unfit) for corticosteroids and invasive diagnostic procedures like bone marrow biopsy, and not satisfied with the available therapy from other systems of medicine. Further clinical trials with large sample size are required to substantiate the present case study findings.

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“…In chronic type, low platelet counts persist for more than 6 months [3]. Numerous studies have been done in recent decades on the prevalence, diagnosis, and treatment of ITP [6], [7], [8], but are still open for further investigation and identification of predictive factors. In recent years, therapeutic indications for reducing intravenous immunoglobulin (IVIG) consumption from severe thrombocytopenia (<20,000) have led to treatment only under conditions of bleeding.…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of Risk Factors for Chronic Idiopathic Thrombocytopenic Purpura in Patients with Acute Type of Disease

Bahoush

Ghasemi

Razavi

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: Immune thrombocytopenic purpura (ITP) is an autoimmune disease in which autoantibodies react with platelet surface antigens and results in mild to severe thrombocytopenia due to decreased platelet count or inhibition of platelet production. Given the relatively high prevalence of ITP among children and the lack of standard diagnostic testing for the diagnosis of chronic disease, this study evaluated the predictive value of risk factors for chronic ITP in hospitalized patients. METHODS: This prospective cohort study was performed on 65 children with ITP who referred to Ali Asghar and Rasool Akram Hospitals in Tehran, Iran, during the years 2017 and 2018. Relationships between different risk factors, including age of diagnosis, gender, white cell count, primary platelet count, mean platelet volume (MPV), history and type of the previous patient infection, FCG gene mutation, and type of FCG mutation with a chronic disease incidence were investigated using multiple logistic regression model. RESULTS: Of 65 patients, 31 (47.69%) were male and 34 (52.31%) were female included in the study. Twenty-eight patients (43.08%) had acute ITP and 37 (56.92%) had chronic ITP. Frequency of FCG gene mutation in patients with chronic and acute type ITP was 16.36% and 7.27%, respectively (p = 0.51). No association was found between the history of the previous infection and its type with the chronic incidence of ITP. The multiple logistic regression model showed that three factors, including the absolute number of lymphocytes, age of diagnosis, and primary white blood cells (WBC) count were directly linked to chronic ITP. Furthermore, three factors of platelet, sex, and MPV were indirectly related to chronic ITP. In addition, the absolute number of lymphocytes, age of diagnosis and primary WBC count were significantly associated with chronic ITP. The receiver operating characteristic analysis showed that the cutoff rate of these factors was 0.31. Further analysis of these risk factors in comparison with the gold standard demonstrated that the diagnostic sensitivity and specificity of these risk factors for chronic ITP were 73.08% and their specificity was 88.57%, indicating the high importance and predictive power of these risk factors. CONCLUSIONS: According to the results of this study, for the first time in Iran, six risk factors, including the absolute number of lymphocytes, age at diagnosis, sex, MPV level, platelet level at time of diagnosis, and primary WBC count were considered as the most important risk factors affecting the incidence of chronic ITP. Of course, more comprehensive studies can definitely lead to more comprehensive models.

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Idiopathic thrombocytopenic purpura

Cited by 29 publications

References 12 publications

Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-γ in pediatric immune thrombocytopenia

Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-γ in pediatric immune thrombocytopenia

Ayurvedic management of immune thrombocytopenic purpura - a case report

Predictive Value of Risk Factors for Chronic Idiopathic Thrombocytopenic Purpura in Patients with Acute Type of Disease

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