جستجوی مقالات مرتبط با کلیدواژه "idiopathic thrombocytopenic purpura" در نشریات گروه "پزشکی"

This study aimed to report the case of a 3-year-old child with Idiopathic Thrombocytopenic Purpura (ITP) presented with massive bilateral spontaneous suprachoroidal hemorrhage.

Case report:

 A three-year-old boy with a history of ITP was referred with acute painful vision loss from 2 days ago. Visual acuity was No Light Perception (NLP) for the Right Eye (RE) and Light Perception (LP) for the Left Eye (LE). Anterior segment examination showed bilateral red eye, mild corneal edema, as well as relatively shallow and symmetric anterior chamber. Bilateral massive suprachoroidal hemorrhage with retinal apposition was apparent in B-scan ultrasonography. The patient underwent bilateral SCH drainage through four sclerotomy windows, one in each quadrant of each eye. In the last follow-up examination, one week after the surgery, the visual acuity was light perception and hand motion in RE and LE, respectively. Serial B-scan sonography indicated the reduction of hemorrhage in the suprachoroidal space.

Spontaneous Supra-choroidal Hemorrhage (SSCH) is an extremely rare condition that can occur in the case of ITP. Despite the anatomical recovery of the patient following suprachoroidal drainage surgery, the visual outcome remained poor.

Idiopathic Thrombocytopenic Purpura (ITP) is a multifactorial disease with decreased count of platelet that can lead to bruising and bleeding manifestations. This study was intended to identify critical genes associated with chronic ITP. The gene expression profile GSE46922 was downloaded from the Gene Expression Omnibus database to recognize Differentially Expressed Genes (DEGs) by R software. Gene ontology and pathway analyses were performed by DAVID. The biological network was constructed by Cytoscape. Molecular Complex Detection (MCODE) was applied for detecting module analysis. Transcription factors were identified by the PANTHER classification system database and the gene regulatory network was constructed by Cytoscape. 132 DEGs were screened from comparison newly diagnosed ITP than chronic ITP. Biological process analysis revealed that the DEGs were enriched in terms of positive regulation of autophagy and prohibiting apoptosis in the chronic phase. KEGG pathway analysis showed that the DEGs were enriched in the ErbB signaling pathway, mRNA surveillance pathway, Estrogen signaling pathway, and Notch signaling pathway. Additionally, the biological network was established, and five modules were extracted from the network. ARRB1, VIM, SF1, BUB3, GRK5, RHOG were detected as hub genes that also belonged to the modules. SF1 also was identified as a hub-TF gene. To sum up, microarray data analysis could perform a panel of genes that provides new clues for diagnosing chronic ITP.

Immune Thrombocytopenia (ITP) is an autoimmune disease in which platelet destruction causes thrombocytopenia. Due to the known steroid toxicities, alternative agents have been evaluated for the treatment of these patients. We aimed to review the literature and find evidences regarding the potential benefits of hydroxychloroquine (HCQ) as a steroid‑sparing agent in the treatment of ITP. We searched English language articles within Web of Science, PubMed, and Scopus. Cohorts, clinical trials, case reports, conference papers, and letters were included. We excluded papers which either focused on administration of HCQ for non‑ITP conditions or studies on other treatment modalities for ITP. In total, 54 ITP cases with either primary or systemic lupus erythematosus (SLE)‑associated ITP were included in four studies (SLE‑associated ITP; n = 23). All patients have received corticosteroids previously and >90% received other agents with HCQ concomitantly. Overall response was achieved in more than 60% of patients. Sustained response in 18 (33.3%) patients was associated with no treatment or HCQ alone. One of the studies reported a significantly better response in patients with definite SLE compared to those with positive antinuclear antibody and no definite SLE. Similarly, another study found a nonsignificant trend toward better long‑term response in patients with definite SLE compared to incomplete SLE. The included articles reported the efficacy of the HCQ with acceptable safety. Available data regarding the use of HCQ for this indication are spare and more studies are needed in ITP with different severity. It seems that HCQ can be considered as an option in the treatment of SLE‑associated ITP, and although promising, currently, the place of HCQ in the treatment of ITP continues to evolve.

Different studies have investigated the link between helicobacter pylori and extra digestive diseases such as idiopathic thrombocytopenic purpura. However, the relationship between ITP and H pylori is less clear. Most of the studies have focused on H pylori eradication in chronic ITP, so we focused on the effect of H pylori eradication on chronicity of ITP in adult patients with ITP.

Eighty five patients with acute ITP whose platelet count were less than 30x109/L were enrolled to the study. Urea breath test (UBT) was carried out for all the patients and based on its results; the patients were divided into 3 groups: Group I: H pylori positive patients who underwent standard triple therapy. Evaluation of H pylori eradication for this group was carried out one month and six months after the treatment. Group II: ITP patients negative for H pylori and Group III: ITP patients' positive for H pylori but without eradication therapy.

52(61.2%) patients were female and 33(38.8%) were male with mean age of 34.8±12.2 years. There was no significant difference between the mean age and gender in different groups. No significant difference was seen in mean platelet count at the baseline among the groups, but there was a significant statistical difference in mean platelet between the groups at the end of the first month. However, a significant difference was not seen in mean platelet count in months 2 to 6. Chronicity in group I was statistically less than the group III. Also, the chronicity rate in non-infected ITP patients was lower than the H pylori positive patients (P=0.03). Likewise, the chronicity rate was lower in the intervention group than in the control group (P=0.035).

Our results show that eradication of H pylori can reduce the chronicity rate in adult patients with ITP. Further studies on larger number of patients with longer follow-up are recommended.

Idiopathic thrombocytopenia purpura (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia and mucocutaneous bleeding. The former has a primary role in the diagnosis and treatment of ITP. One of the leading causes of miscounted platelets in patients who suffer from ITP is giant platelets which may indicate factitiously a severe false thrombocytopenia. Here, a case of macrothrombocytopenia is presented in an ITP patient. Giant platelets of this patient not only resulted in miscounting platelets but also falsely increased reading of RBC counts. By counting platelets through peripheral blood smear and hemocytometer, the patient was saved from an unnecessary splenectomy.

Idiopathic thrombocytopenic purpura (ITP) is one of the common causes of thrombocytopenia in the first and second trimesters of pregnancy. Herein, we report a pregnant woman with ITP with the aim to review the latest evaluation and treatment methods for ITP in the third trimester of pregnancy. Case description: The patient was a 23-year-old G2 P1 woman with gestational age of 33 weeks and 4 days, who was referred to hospital due to reduced platelet count (21,000) in the pregnancy screening tests. The patient was subjected to splenectomy after 3 weeks at gestational age of 36 weeks and 4 days, and cesarean section was performed concurrently to terminate the pregnancy. The patient was transferred to the ICU after surgery and was stable. The wound site was normal. Within a few days after the surgery, platelet levels increased to 80,000. Finally, the patient was discharged in a good general condition two weeks after the cesarean section, and was prescribed to take 5 mg prednisolone daily. ITP should be considered in all patients who are first diagnosed with single thrombocytopenia during pregnancy, especially if the condition is detected before the third trimester and with platelet count of less than 50,000. Depending on the course of the disease, patients should be thoroughly monitored for platelet levels for timely treatment

Idiopathic thrombocytopenic purpura is a common disease in children and young adults, as well as being the most common cause of acute thrombocytopenia in patients with good general health status.
The case is a 23-year-old woman with no history of disease or any type of temperament disorder. She was referred to the haematology and oncology specialists in October 2014, following a sudden drop in platelet count, and complaints regarding numerous ecchymosis lesions in the upper and lower limbs. She was admitted to the Imam Reza Hospital in Tabriz. Due to the repeated reduction of platelet count in the patient, the oncologist ordered splenectomy, which is the removal of spleen. In December 2014, she was brought to the traditional medicine clinic. Her platelet count was 17,000. The patient received health and nutritional considerations. Pharmaceutical measures, including administering medical herbs and combination drugs, were taken with the patient’s temperament and the disease status driving the course. Several practices, including cupping, massage, blood-letting, meditation, and yoga, and eventually rose water incense, were part of a compiled programme for the patient. In subsequent sessions, the platelet level considerably increased and after a month, was almost close to the normal level. After 40 days of treatment, the platelet count reached the normal level, and finally in July 2015, with full recovery of the patient, the corticosteroids and herbal medicines were completely stopped. As is evident from the monthly monitoring of the patient until September 2016, she showed no clinical or laboratory symptoms explaining thrombocytopenia, and her platelet count was at normal level. Due to the absence of signs of ecchymosis and normal level of blood platelets in paraclinical testing, it seems that the combination of modern and Iranian traditional medicine can pave the way for the treatment of a number of diseases. Hence, further studies are required in order to find a cure for different diseases, according to the doctrines of Iranian effective medicine.

self- esteem is defined as the reliance of one's own abilities. Decrees of self- esteem may lead to fail to solve the problems not being able to use ones abilities. So, this study was done to compare TIP patient's self- esteem with healthy cases. The conduction of this investigation seems to be important, because this disease a chronic type.
This is a descriptive- comparative study in which 64 patients having ITP and referring to Isfahan's Seiyedo-shohada hospital and 65 healthy people who were neighbors of these patients. They were also selected randomly. The data collection method included questionnaire of Cooper Smiths self- esteem which was completed by the cases. The data analyzed through Spss version 15, and by use of T-independent, K-Squer and Man Withny test.
This study's results showed that 64.1, 59.4 and 53.1 percent of the cases in both group were, in turn, over 35 years old. Females and graduated from primary school. T-independent test, showed significant difference between both groups self-esteem average. (p Since the self-esteem of the patients is low and patient's decision making ability and their controls over the disease affect their self-esteem important, health and treatment staffs are supposed to recognize significant factors affecting self- valuing feeling and help the patient to promote their self- esteem.

Homeopathy can be applied to treat various diseases and conditions such as cancer, allergy, mood disorders, headache and pain. This case showed that homeopathic medicine can be a treatment modality for idiopathic thrombocytopenic purpura (ITP), an autoimmune-mediated hematologic disorder.
The patient was a 5.5–year-old child with ITP who referred to the homeopathic clinic with extensive petechiae and purpura on her body. Her platelet count was 15000/mcL and her anti-dsDNA and ANA were negative on her first visit. Her disease had first been diagnosed at the age of 2.5 years. She had undergone routine therapy for ITP; however, despite 15 months of corticosteroid therapy and IVIG injections, her platelet count was still low. After treatment with homeopathic remedies, her platelet count increased and signs of ITP disappeared.
Homeopathic remedies can be considered as complementary and alternative medicines for ITP treatment protocols.

Idiopathic thrombocytopenic purpura is an autoimmune blood disorder in which platelet destruction is mediated by anti-platelet antibodies. There are two forms of ITP: acute and chronic. The aim of the present study was to evaluate the clinical variables in adult patients with acute ITP in west of Iran. Patients and Medical records of adult patients with diagnosis of acute ITP referring to Hematology Clinic of Kermanshah from year 2004-2014 were analyzed. Demographic and hematologic data and status of H pylori infection of the patients were extracted. There were records of fifty-three patients diagnosed with acute ITP. Mean age at diagnosis was 39. 1 years (±13. 3) ranging from 14-68 years. Twenty patients (37. 7%) were male. Out of 53 patients، 25 cases (47. 2%) were positive for H pylori infection. There was significant association between Hb and platelet with sex of the patients (P≤0. 05). Mean age of adult patients with acute ITP was more than figures expected in chronic ITP patients. In addition، Prevalence of H pylori infection in acute ITP patients was more than chronic ITP patients.

Mental stress and daily crises comprise a part of physical and mental threats. Perceived stress is a physical and mental threat, as well. Perceived stress is a psychological process during which the individual considers his/ her physical and psychological welfare as being threatened. Since idiopathic thrombocytopenic purpura (ITP) is one of the chronic diseases being able to affect patients'' perceived stress, this study was conducted to compare perceived stress in ITP patients and healthy people. This is a descriptive-comparative study with control and case groups. In this study, 64 ITP patients referring Seyed Al-Shohada Hospital and the same number of healthy individuals from the patients'' neighborhood, as the control group, were selected randomly and compared. The Kohen Perceived Stress Standard Questionnaire was used to collect the data. The data were analyzed by SPSS and Student’s independent t-test, chi-square, and Mann-Whitney test. 64.1%, 59.4% and 53.1% of participants in case group were older than 35 years old, female and had elementary education. 78.1% of case group had severe perceived stress. 70.3% of participants in control group experienced mild perceived stress. Mann-Whitney test showed significant difference between two groups in level of stress (p<0.001). In ITP patients, perceived stress was considerable. Planning interventional measures to determine stress-making agents and subside or at least control them is very essential.

Quality of life has been used as an important tool to understand illnesses impact in recent decades. Idiopathic thrombocytopenic purpura is a chronic disease which affects the individuals’ quality of life. The present study was conducted to compare the quality of life among idiopathic thrombocytopenic purpura patients’ with healthy people. Patients and This was a descriptive-comparative study with case and control groups. In this study, 64 randomly selected idiopathic thrombocytopenic purpura patients referred to Seyed Al-Shohada Hospital, Isfahan, Iran, and the same number of healthy people from the patients’ neighborhood as the control group, were compared considering their quality of life. The data collection tool used was the World Health Organization Quality of Life- BREF questionnaire. Our study results showed that 64.1% of studied cases were older than 35 years of age, 59.4% were women, and most of them had primary educational level (53.1%). The mean scores of physical, mental, and environmental dimensions of quality of life and the total mean score of quality of life were significantly lower among idiopathic thrombocytopenic purpura patients (P < 0.001). However, there was no significant difference between the two groups in terms of the mean score of the social dimension of quality of life (P = 0.2). Since quality of life among idiopathic thrombocytopenic purpura patients is lower than that of healthy people, interventional therapeutic and care measures to promote quality of life among these patients seem necessary.

Children with idiopathic thrombocytopenic purpura who are treated with intravenous immunoglobulin therapy might experience a decline in their absolute neutrophil count. The aim of this study was to investigate the incidence of neutropenia following intravenous immunoglobulin therapy in children with idiopathic thrombocytopenic purpura undergoing intravenous immunoglobulin therapy. Patients and This was a retrospective cross sectional study. Patients with idiopathic thrombocytopenic purpura admitted to Ali-Asghar hospital from October 2003 to June 2010 with no immunosuppressive diseases negative coombs test and no sign of other infections before the admission entered the study and their neutrophil count before the intravenous immunoglobulin therapy, and in days1, 2, and 3 after the initiation of therapy was recorded. From eighty nine patients 51 patients (57.3%) were male and 38 patients (42.7%) were female. Neutropenia was seen in 13 patients (14.6%) after treatment, but there was no statically significant difference between the mean absolute neutrophil count before and 1, 2, and 3 days after the start of the treatment (P=0.922). Intravenous immunoglobulin can lead to neutropenia in a few number of patients which is transient and self limited and most patients get benefits from intravenous immunoglobulin therapy as induced platelets count.

Primary immune thrombocytopenia is an acquired bleeding disorder with no clinically apparent cause of thrombocytopenia. Clinical indicators of ITP include easy bruising of the skin, prolonged bleeding on injury, mucocutaneous lesions such as petechiae and ecchymosis, epistaxis, gastrointestinal bleeding, hematuria and bleeding from the gums. It is important for a dentist to be aware of the clinical manifestations of ITP as it may not only lead to successful management of the patient, but in some cases it may even lead to formation of a provisional diagnosis of the condition in previously undetected cases. However, very few cases of ITP have been reported in dental practice making it difficult for a dentist to identify the disorder when a patient suffering from ITP reports for dental treatment. A case report of a female patient with ITP is thus described with emphasis on the importance of periodontal health in such patients to prevent consequent unwanted sequelae. It is followed by discussion of oral manifestations of the disorder and dental management of such patients.

Idiopathic thrombocytopenic purpura (ITP) is a disease that commonly affects women of reproductive age and is associated with maternal and fetal complications. The aim of the present study was to report the perinatal outcome in pregnant women with ITP. Twenty one pregnant women with ITP admitted in a teaching hospital in Tehran, from October 2008 to February 2010, were enrolled in this prospective historical cohort study; course and perinatal outcome of pregnancies were studied. Seven (33.3%) cases had been diagnosed before pregnancy, while the other fourteen (66.7%) were diagnosed during pregnancy. During hospitalization, thirteen (62%) patients required treatment, eight (61.5%) of them with steroids, two (15.3%) received intravenous immunoglobulin (IVIG), and three (23%) were treated with steroids and IVIG. Three babies were delivered vaginally (14.3%), seventeen (81%) through cesarean section and one patient aborted her fetus. Nine mothers (42.9%) had platelet counts <50000/ml at the time of delivery; but postpartum hemorrhage occurred in 4 (19%) women and one women received platelet transfusion during cesarean section. Six (28.6%) women developed gestational diabetes. Pregnancy was complicated by preeclampsia in one woman and by abruptio placenta in another. One pregnancy terminated in intrauterine fetal death. Seventeen infants (89.5%) had normal platelet counts, and two (10.5%) had moderate thrombocytopenia. No infant showed signs of hemorrhage, but 2 neonates (10.5%) were diagnosed with intrauterine growth restriction. Rate of gestational diabetes in pregnant women with ITP is higher than the general population. Rate of gestinational diabetes is 3-5% and postpartum hemorrhage is 5-7% in general. Postpartum hemorrhage is common in these women. Severe thrombocytopenia and bleeding in the newborns are uncommon.