Perioperative Management of the Patient with Immune Thrombocytopenic Purpura De Novo and the Thrombocytopenia of Antiphospholipid Antibody Syndrome

2012 ◽  
pp. 129-135
Author(s):  
Raja S. Bobba ◽  
Mark A. Crowther
Keyword(s):  
Immune Thrombocytopenic Purpura ◽  
Perioperative Management ◽  
De Novo ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Thrombocytopenic Purpura

scholarly journals DENGUE FEVER: A TRIGGERING FACTOR FOR IMMUNE THROMBOCYTOPENIC PURPURA IN ADULT FEMALE- A RARE CASE REPORT

2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Arth Shah ◽  
D.C Kumawat
Keyword(s):  
Lupus Erythematosus ◽  
Immune Thrombocytopenic Purpura ◽  
Viral Infections ◽  
Lymphoproliferative Disorders ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Thrombocytopenic Purpura ◽  
Rare Case Report ◽  
Triggering Factor ◽  
Secondary Form

Immune thrombocytopenic purpura (ITP) can be both primary and secondary. The secondary form of this disease may occur in association with systemic lupus erythematosus, antiphospholipid antibody syndrome, immunodeficient states, lymphoproliferative disorders, viral infections and using drugs such as quinidine, sulfa and heparin.

De novo infantile primary antiphospholipid antibody syndrome

Lupus ◽  
2010 ◽  
Vol 19 (13) ◽  
pp. 1565-1568 ◽  
Author(s):  
J. Alshekaili ◽  
G. Reynolds ◽  
MC Cook
Keyword(s):  
De Novo ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome

“APS pregnancy – The offspring”

Lupus ◽  
2020 ◽  
Vol 29 (11) ◽  
pp. 1336-1345
Author(s):  
Viktoria Bitsadze ◽  
Cecilia Nalli ◽  
Jamilya Khizroeva ◽  
Daniele Lini ◽  
Laura Andreoli ◽  
...  
Keyword(s):  
Behavioral Problems ◽  
De Novo ◽  
Fetal Brain ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Childbearing Age ◽  
Antibody Positivity ◽  
Maternal Igg

Background Antiphospholipid antibody syndrome (APS) is an autoimmune disease that affects women in childbearing age. In recent years, great improvements were achieved in the management of pregnancies in these women. Prematurity could be an issue in these pregnancies, mainly due to the direct pathogenic effect of antiphospholipid antibodies (aPL) on the placental surface. Maternal IgG aPL can cross the placenta and theoretically interact with the growing fetus; it could reach the fetal brain because of the incompleteness of the fetal blood-brain barrier: whether this can have an effect on brain development is still debated. Neonatal thrombosis episodes have been described in children positive for aPL, not always associated with maternal antibody positivity, suggesting the hypothesis of a possible aPL de novo synthesis in fetus and neonates. Methods A keyword-based literature search was conducted. We also described a case of neonatal catastrophic antiphospholipid syndrome (CAPS). Results Offspring of patients with APS are generally healthy but the occurrence of neonatal thrombosis or minor neurological disorders were reported. Conclusions The limited number of the available data on this sensitive issue supports the need for further studies. Clinical follow-up of children of mothers with APS seems to be important to exclude, in the neonatal period, the occurrence of aPL associated pathological events such as thrombosis, and in the long-term, impairment in learning skills or behavioral problems.

Viral-Associated Immune Thrombocytopenic Purpura

Hematology ◽  
2008 ◽  
Vol 2008 (1) ◽  
pp. 212-218 ◽  
Author(s):  
Howard A. Liebman
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Immune Thrombocytopenic Purpura ◽  
Highly Active Antiretroviral Therapy ◽  
Chronic Infection ◽  
Liver Enzymes ◽  
De Novo ◽  
Thrombocytopenic Purpura ◽  
Highly Active ◽  
Immunodeficiency Virus

Abstract Chronic immune thrombocytopenic purpura (CITP) is a diagnosis of exclusion that occurs either de novo or secondary to other underlying disorders. Chronic infection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) are now well-characterized causes of CITP. Between 6% and 15% of patients infected with HIV may develop thrombocytopenia. Patients with CITP with risk factors for HIV infection should be screened for the virus. Treatment of HIV-related CITP should be directed toward antiviral therapy with highly active antiretroviral therapy (HAART) regimens. Hepatitis C viral infection can also be associated with chronic thrombocytopenia, even in the absence of overt liver disease. While HCV-related thrombocytopenia is typically less severe than primary CITP, affected patients are at greater risk of major bleeding. Sustained suppression of HCV virus with interferon-ribavirin therapy can improve platelet counts. Screening for HCV infection should be considered in patients with ITP with risk factors for infection, from regions with high rates of infection or in patients with unexplained mild elevations of liver enzymes.

scholarly journals Secondary Erosive Arthritis in a Young Lady – A Rare Manifestation of Primary Antiphospholipid Antibody Syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sathish Muthu ◽  
Girinivasan Chellamuthu ◽  
Thiruvenkita Prasad Gopalsamy ◽  
Velmurugan Kandasamy
Keyword(s):  
Knee Replacement ◽  
Perioperative Management ◽  
Systemic Lupus Erythematosis ◽  
Team Approach ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Secondary Osteoarthritis ◽  
Erosive Arthritis ◽  
The Past ◽  
Rare Manifestation

Introduction: Arthritis in primary antiphospholipid antibody syndrome (PAPS) is a rare manifestation that is much more common in secondary antiphospholipid antibody syndrome (APS), particularly those associated with systemic lupus erythematosis (SLE), and has been reported to be non-erosive responding to conservative management. In this background, we describe a case of secondary erosive arthritis of knee (SEAK) in a female patient with PAPS. Case Report: Thirty-seven-year-old working women presented with chronic right knee pain for the past 2 years which was increasing in severity and interfering with her activities of daily living for the past 3 months. The patient was a known case of PAPS with a history of one early and one late abortion. On radiological examination, Grade IV secondary osteoarthritis knee was made out. The patient underwent total knee replacement. At 2 years follow-up, the patient had a good functional outcome. To the best of our knowledge, this is the first report of secondary osteoarthritis in PAPS requiring arthroplasty. Perioperative management is crucial in PAPS to prevent thromboembolic complications. Multimodality approach with strict patient compliance is a key to achieve good functional recovery. Conclusion: SEAK can be a rare presentation of PAPS. Secondary causes like SLE or rheumatoid arthritis must be ruled out before a diagnosis of PAPS is made. Perioperative management in APS is critical and challenging. Multidisciplinary team approach involving internal medicine, anesthesiology, orthopedics, and rehabilitative departments is essential. Key words: Antiphospholipid syndrome, arthritis, knee replacement arthroplasty.

scholarly journals Thrombotic Microangiopathy After Kidney Transplantation: An Underdiagnosed and Potentially Reversible Entity

2021 ◽  
Vol 8 ◽  
Author(s):  
Ana Ávila ◽  
Eva Gavela ◽  
Asunción Sancho
Keyword(s):  
Renal Failure ◽  
Thrombotic Microangiopathy ◽  
De Novo ◽  
Organ Procurement ◽  
Ischemia Reperfusion ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Post Transplant ◽  
Antibody Mediated Rejection

Thrombotic microangiopathy is a rare but serious complication that affects kidney transplant recipients. It appears in 0.8–14% of transplanted patients and negatively affects graft and patient survival. It can appear in a systemic form, with hemolytic microangiopathic anemia, thrombocytopenia, and renal failure, or in a localized form, with progressive renal failure, proteinuria, or arterial hypertension. Post-transplant thrombotic microangiopathy is classified as recurrent atypical hemolytic uremic syndrome or de novo thrombotic microangiopathy. De novo thrombotic microangiopathy accounts for the majority of cases. Distinguishing between the 2 conditions can be difficult, given there is an overlap between them. Complement overactivation is the cornerstone of all post-transplant thrombotic microangiopathies, and has been demonstrated in the context of organ procurement, ischemia-reperfusion phenomena, immunosuppressive drugs, antibody-mediated rejection, viral infections, and post-transplant relapse of antiphospholipid antibody syndrome. Although treatment of the causative agents is usually the first line of treatment, this approach might not be sufficient. Plasma exchange typically resolves hematologic abnormalities but does not improve renal function. Complement blockade with eculizumab has been shown to be an effective therapy in post-transplant thrombotic microangiopathy, but it is necessary to define which patients can benefit from this therapy and when and how eculizumab should be used.

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