• Title/Summary/Keyword: ITP

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Changes in Mean Platelet Volume and Platelet Distribution Width after Therapy in Childhood Idiopathic Thrombocytopenic Purpura (소아 특발성 혈소판 감소성 자반증 환아에서 치료경과에 따른 평균 혈소판용적과 혈소판용적 분포폭의 변동)

  • Kim, Jong Tai;Lee, Kyung Won;Kim, Soon Nam;Kim, Moon Kyu
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.505-511
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    • 2002
  • Purpose : Mean platelet volume(MPV) and platelet distribution width(PDW) are useful parameters in evaluating disorders of platelets. In cases with idiopathic thrombocytopenic purpura(ITP), they change as platelet count increases. In this study, we compared the values of MPV and PDW in ITP patients at diagnosis with those of normal children. We also studied whether the early changes in MPV may predict the clinical course. Methods : From December 1995 to May 2001, 71 patients with ITP were admitted to Ajou University Hospital. They were treated with IVIg 400 mg/kg for five days and MPV, PDW, platelet count were analysed. Normal control group(n=38) was compared. The study group was divided into acute and chronic forms, and also divided into group A, good early responders whose platelets increased more than $100,000/{\mu}L$ within 5 days and group B who did not. Results : Mean value of MPV at diagnosis in ITP patients was lower than the normal control group(P<0.05). In group A, MPV was abruptly increased on the first day after IVIg and then started to decrease. But in group B, MPV was steadily increased until the fourth day after IVIg. In the normal control group, there were inverse correlations between platelet count and MPV(r=-0.415, P<0.05), but in ITP patients, there were positive relationships between platelet count and MPV(r=0.646, P<0.05) at diagnosis. Conclusions : MPV at diagnosis of ITP was lower than the normal control. MPV and PDW could not predict the course of ITP patients, but MPV could distinguish good early responders. More research is needed to find out the reasons of decreased MPV at diagnosis of ITP.

Characterisation of multiple substrate-specific (d)ITP/(d)XTPase and modelling of deaminated purine nucleotide metabolism

  • Davies, Oluwafemi;Mendes, Pedro;Smallbone, Kieran;Malys, Naglis
    • BMB Reports
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    • v.45 no.4
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    • pp.259-264
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    • 2012
  • Accumulation of modified nucleotides is defective to various cellular processes, especially those involving DNA and RNA. To be viable, organisms possess a number of (deoxy)nucleotide phosphohydrolases, which hydrolyze these nucleotides removing them from the active NTP and dNTP pools. Deamination of purine bases can result in accumulation of such nucleotides as ITP, dITP, XTP and dXTP. E. coli RdgB has been characterised as a deoxyribonucleoside triphosphate pyrophosphohydrolase that can act on these nucleotides. S. cerevisiae homologue encoded by YJR069C was purified and its (d)NTPase activity was assayed using fifteen nucleotide substrates. ITP, dITP, and XTP were identified as major substrates and kinetic parameters measured. Inhibition by ATP, dATP and GTP were established. On the basis of experimental and published data, modelling and simulation of ITP, dITP, XTP and dXTP metabolism was performed. (d)ITP/(d)XTPase is a new example of enzyme with multiple substrate-specificity demonstrating that multispecificity is not a rare phenomenon

A Case of Idiopathic Thrombocytopenic Purpura (특발성 혈소판 감소성 자반증에 대한 고찰 및 증례 1예)

  • Hong, Sang-Hoon
    • The Journal of Internal Korean Medicine
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    • v.21 no.4
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    • pp.677-682
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    • 2000
  • Idopathic thrombocytopenic purpura(ITP) is the most common autoimmune hematologic disorder. The use of glucocorticoids and splenectomy have been the mainstays of treatment of ITP Some studies have shown that chinese herbal medicine treatment increase platelet count level of ITP patients. However, there is a lack of research considering oriental herbal medicine with ITP, in korea. A 33-year-old female who had diagnosed ITP on Mar 1999, was treated herbal medicine for decreased platelet count level$(34000/{\mu}l)$ that was identified on regular follow-up. this patient's platelet count level was get to normal$(139000/{\mu}l)$ by BuQiSheXue(補氣攝血) pattern herbal medicine that composed with Radix Astragali(黃?), Herba Agrimoniae(仙鶴草), Rhizoma Atractylodis Macrocephalae(白朮), Radix codonopsis(黨參), etc. I report the case with a review of literature.

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Life-threating outcomes after dental implantation in patient with idiopathic thrombocytopenic purpura: a case report and review of literature

  • Lee, Sung-Tak;Kim, Jin-Wook;Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.39.1-39.7
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    • 2018
  • Background: Patients with chronic ITP (idiopathic thrombocytopenia) frequently do not require comprehensive medication for daily life. Usually, it had been regarded that postoperative bleeding after a simple or surgical extraction is easily controlled by simple local measures even in patients with ITP. This lack of regular medication usage can sometimes lead practitioners or patients to underestimate the potential life-threatening risk of ITP. There had been no report on postoperative hemorrhage in a patient with ITP related to dental implant surgery. Case presentation: This report presented a life-threatening postoperative hemorrhage after dental implant surgery in an adult with chronic ITP and subsequent emergency management after severe bleeding and airway compromise. Conclusion: The presented case emphasizes the thorough hematological evaluation of the patients even for patients who do not take any specific medications for asymptomatic, chronic ITP.

Clinical course and prognostic factors of childhood immune thrombocytopenia: single center experience of 10 years

  • Jung, Jae Yeob;O, A Rum;Kim, Je Keong;Park, Meerim
    • Clinical and Experimental Pediatrics
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    • v.59 no.8
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    • pp.335-340
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    • 2016
  • Purpose: This study aimed to evaluate the clinical course of childhood immune thrombocytopenia (ITP) and to assess the risk factors for developing chronic ITP Methods: The records of 64 children diagnosed with ITP from November 2005 and December 2014 at single center were retrospectively analyzed. Results: The median age at diagnosis and the median platelet count were 1 year (range, 1 month to 15 years) and $9{\times}10^9/L$ (range, $0-84{\times}10^9/L$), respectively. No patient experienced severe bleeding. Nineteen children (29.7%) spontaneously recovered their platelet count to ${\geq}100{\times}10^9/L$ at a median of 10 days. In total 45 patients (70.3%) received intravenous immunoglobulin (IVIG) as first-line therapy, and showed platelet recovery at 1 week. The final diagnosis of 55 (85.9%) and 9 patients (14.1%) was acute and chronic ITP, respectively. Older age, absence of prior infection and insidious onset of symptoms were significantly associated with the development of chronic ITP. Among the patients who received IVIG, those with platelet count <$45{\times}10^9/L$ at 1 month after IVIG showed a significantly higher incidence of chronic ITP compared to those with platelet count ${\geq}45{\times}10^9/L$ (88.8% vs. 44.4%, P<0.01). Conclusion: In most patients, ITP runs a benign course and approximately 86% of them recover within 1 year of their initial diagnosis. The potential impact of the risk factors of chronic ITP on clinical practice needs to be explored and further studies are warranted to determine whether IVIG influences the course of ITP.

CFD based simulations of flutter characteristics of ideal thin plates with and without central slot

  • Zhu, Zhi-Wen;Chen, Zheng-Qing;Gu, Ming
    • Wind and Structures
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    • v.12 no.1
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    • pp.1-19
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    • 2009
  • In this paper, the airflow around an ideal thin plate (hereafter referred to as ITP) with various ratios of central slot is simulated by using the finite-difference-method (FDM)-based Arbitrary-Lagrangian-Eulerian descriptions for the rigid oscillating body. The numerical procedure employs the second-order projection scheme to decouple the governing equations, and the multigrid algorithm with three levels to improve the computational efficiency in evaluating of the pressure equation. The present CFD method is validated through comparing the computed flutter derivatives of the ITP without slot to Theodorsen analytical solutions. Then, the unsteady aerodynamics of the ITP with and without central slot is investigated. It is found that even a smaller ratio of central slot of the ITP has notable effects on pressure distributions of the downstream section, and the pressure distributions on the downstream section will further be significantly affected by the slot ratio and the reduced wind speeds. Continuous increase of $A_2^*$ with the increase of central slot may be the key feature of the slotted ITP. Finally, flutter analyses based on the flutter derivatives of the slotted ITP are performed, and moreover, flutter instabilities of a scaled sectional model of a twin-deck bridge with various ratios of deck slot are investigated. The results confirm that the central slot is effective to improve bridge flutter stabilities, and that the flutter critical wind speeds increase with the increase of slot ratio.

Advances in management of pediatric chronic immune thrombocytopenia: a narrative review

  • Jae Min Lee
    • Journal of Yeungnam Medical Science
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    • v.40 no.3
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    • pp.241-246
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    • 2023
  • Immune thrombocytopenia (ITP) is a disease in which thrombocytopenia occurs because of immune-mediated platelet destruction and decreased platelet production. Although many pediatric patients with ITP experience spontaneous remission or reach remission within 12 months of first-line therapy, approximately 20% progress to chronic ITP. Patients who do not respond to first-line treatment or experience frequent relapses are of great concern to physicians. This review summarizes recent treatments for second-line treatment of pediatric chronic ITP.

Prevalence and clinical significance of the positive antinuclear antibody in children with idiopathic thrombocytopenic purpura (소아 특발혈소판감소 자색반병 환자에서 항핵항체 검사의 양성률 및 임상적 의의)

  • Jun, So Eun;Park, Seong Sik;Lim, Young Tak
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1217-1221
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    • 2008
  • Purpose : An association between idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE) has been recognized for decades because thrombocytopenia is the first manifestation in some patients with SLE. However, the risk of later development of SLE in childhood ITP is currently unknown. We retrospectively evaluated the incidence and clinical significance of the positive antinuclear antibody (ANA) in children with acute ITP. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics in 77 children diagnosed to have acute ITP and admitted to the Pusan National University Hospital between January 2003 and December 2006. Patients tested positive for ANA were regularly followed-up for at least 12 months for symptoms indicative of SLE. Results : Seventy-seven children were included in the study; 38 males (49.4%) and 39 females (50.5%), the mean age was 4.5 years. Sixteen (20.8%) ITP patients had a positive ANA, with a median titer of 1:320. The mean age of the patients with positive ANA was 9.3 years, which is much older than 3.3 years for patients with negative ANA (P<0.05). The positive ANA group was predominantly female (81.3%) compared to the negative ANA group (P<0.05). There was no statistically significant difference in mean platelet counts between both groups. No statistically significant difference was found in ANA positivity and progression to chronic ITP or SLE. After the median follow-up of 32 months, SLE was diagnosed only in one ITP patient with positive ANA. Conclusion : Our data demonstrated that ANA positivity is often found in children with acute ITP. Large-scale studies should be considered to determine the significance of ANA positivity in childhood ITP for the later development of SLE.

Clinical Significance of Antibodies Against Platelet HLA Class I in Children with Idiopathic Thrombocytopenic Purpura (소아 특발성 혈소판 감소증에서 항-HLA Class I항체의 임상적 의미)

  • Lee, Hong Jun;Yeom, Jung-Sook;Park, Ji Sook;Park, Eun Sil;Seo, Ji-Hyun;Lim, Jae Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang
    • The Korean Journal of Blood Transfusion
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    • v.24 no.3
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    • pp.233-240
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    • 2013
  • Background: A previous history of transfusion has been known to be associated with production of anti-HLA class I antibodies. However, platelet glycoproteins are the main target of idiopathic thrombocytopenic purpura (ITP). The mechanism of antibody production is known to differ significantly between glycoproteins and anti-HLA class I. The aim of this study was to evaluate the clinical significance of anti-HLA class I antibodies in childhood ITP. Methods: Enrollment for the normal control group targeted 48 people who visited Gyeongsang National University Hospital from 1990 to 2010, and 48 young children with ITP. Anti-glycoproteins and anti-HLA class I antibodies were tested using the Modified Antigen Capture Enzyme-linked immunosorbent assay (MACE) kit. Results: The positive rate of anti-HLA antibodies was significantly different [36/39 (92.3%) vs 29/46 (63%)] [ITP group vs normal control group] (P=0.002). The mean positive S/C ratio of anti-HLA antibodies was also significantly different (3.55 vs 1.51) [ITP group vs normal control group] (P=0.0000). The positive rate of anti-HLA did not differ significantly between the transfused group and the non-transfused group [12/12 (100%) vs 24/27 (88%)] [transfused ITP vs non-transfused ITP]. The mean positive S/C ratio of anti-HLA antibodies did not differ significantly between the transfused ITP group and the non-transfused ITP group (4.30 vs 3.25) [transfused ITP vs non-transfused ITP]. Consecutive testing showed that positive rate and positive S/C ratio of anti-HLA antibodies did not change significantly between sampling times in both groups [transfused ITP vs non-transfused ITP] (P=1.00 and P=0.15). Conclusion: Anti-HLA class I antibodies may be involved in childhood ITP. Transfusion did not affect the course of childhood ITP.

Eight Constitution Acupuncture Effect on Thrombocytopenia After Splenectomy at Idiopathic Thromobocytopenic Purpura as First Manifestation of Systemic Lupus Erythematosus Lupus (SLE환자에서 ITP 진단으로 비장적출술 후 혈소판감소를 팔체질침으로 호전시킨 치험례)

  • Seo, Yong-Won;Ko, Heung
    • Journal of Acupuncture Research
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    • v.23 no.4
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    • pp.219-224
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    • 2006
  • Idiopathic thrombocytopenic purpura(ITP) is characterized by the development of a specific anti-platelet autoantibody immune response mediating the development of thrombocytopenia. Systemic lupus erythematosus(SLE) is an autoimmune disease characterized by the production of a wide variety of autoantibodies. We experienced SLE patient whose initial symptoms were related to idiopathic thrombocytopenic purpura(ITP). She has a thrombocytopenia after Splenectomy and Steroid therapy on ITP and SLE. After she took Eight constitution Acupuncture treatment, thrombocytopenia has improved. We think Acupuncture will be effective treatment at autoimmune disease.

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