scholarly journals ITP revealing a SMM: A case report and review of the literature

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Rim Rakez ◽  
◽  
Areej Chefaii ◽  
Rym Hadhri ◽  
Mouna Bahrini Sassi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Immune Thrombocytopenic Purpura ◽  
Autoimmune Disorder ◽  
Causal Link ◽  
Lymphoproliferative Disorders ◽  
Review Of The Literature ◽  
Platelet Response ◽  
Thrombocytopenic Purpura ◽  
Smoldering Multiple Myeloma ◽  
Plasma Cell Neoplasms

Immune thrombocytopenic purpura is an autoimmune disorder retained after elimination of other causes of low platelets’ rate. It is mostly seen with B cell lymphoproliferative disorders. Immune thrombocytopenic purpura’s association with plasma cell neoplasms is possible but extremely rare. Although several pathophysiological mechanisms have been proposed, the causal link between these two conditions is not yet clearly understood. Therapeutic management is not standardized and depends mainly on the type of gammopathy and the chronology of onset of immune thrombocytopenic purpura compared to multiple myeloma. Our case is about an 81-year-old male diagnosed with concurrent smoldering multiple myeloma and immune thrombocytopenic purpura who was started on steroids without anti-neoplastic therapy for multiple myeloma with partial platelet response. We also review the few reported cases of simultanious immune thrombocytopenic purpura and smoldering multiple myelom or multiple myeloma. Keywords: ITP; thrombocytopenia; smoldering multiple myeloma; corticosteroids.

Helicobacter pylori infection and chronic immune thrombocytopenic purpura: long-term results of bacterium eradication and association with bacterium virulence profiles

Blood ◽  
2007 ◽  
Vol 110 (12) ◽  
pp. 3833-3841 ◽  
Author(s):  
Giovanni Emilia ◽  
Mario Luppi ◽  
Patrizia Zucchini ◽  
Monica Morselli ◽  
Leonardo Potenza ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Chronic Gastritis ◽  
Immune Thrombocytopenic Purpura ◽  
Long Term Results ◽  
Platelet Response ◽  
Related Factors ◽  
Thrombocytopenic Purpura ◽  
Platelet Recovery ◽  
Chronic Immune Thrombocytopenic Purpura ◽  
H Pylori

AbstractEradication of Helicobacter pylori may lead to improvement of chronic immune thrombocytopenic purpura (ITP), although its efficacy over time is uncertain. We report the results of H pylori screening and eradication in 75 consecutive adult patients with ITP. We also used molecular methods to investigate lymphocyte clonality and H pylori genotypes in the gastric biopsies from 10 H pylori–positive patients with ITP and 19 H pylori–positive patients without ITP with chronic gastritis. Active H pylori infection was documented in 38 (51%) patients and successfully eradicated in 34 (89%) patients. After a median follow-up of 60 months, a persistent platelet response in 23 (68%) of patients with eradicated infection was observed; 1 relapse occurred. No differences in mucosal B- or T-cell clonalities were observed between patients with ITP and control participants. Of note, the frequency of the H pylori cagA gene (P = .02) and the frequency of concomitant H pylori cagA, vacAs1, and iceA genes (triple-positive strains; P = .015) resulted statistically higher in patients with ITP than in control participants. All asymptomatic H pylori–positive patients with ITP were suffering from chronic gastritis. Our data suggest a sustained platelet recovery in a proportion of patients with ITP by H pylori eradication alone. Overrepresentation of specific H pylori genotypes in ITP suggests a possible role for bacterium-related factors in the disease pathogenesis.

scholarly journals Efficacy of Helicobacter pylori Eradication Therapy on Platelet Recovery in Pediatric Immune Thrombocytopenic Purpura-Case Series and a Systematic Review

2020 ◽  
Vol 8 (10) ◽  
pp. 1457
Author(s):  
Tamaki Ikuse ◽  
Masanori Toda ◽  
Kosuke Kashiwagi ◽  
Kimiko Maruyama ◽  
Masumi Nagata ◽  
...  
Keyword(s):  
Systematic Review ◽  
Helicobacter Pylori ◽  
Immune Thrombocytopenic Purpura ◽  
Pediatric Patients ◽  
Eradication Therapy ◽  
Platelet Response ◽  
Thrombocytopenic Purpura ◽  
Helicobacter Pylori Eradication ◽  
H Pylori ◽  
Helicobacter Pylori Eradication Therapy

Evidence relating to the efficacy of Helicobacter pylori eradication therapy for chronic immune thrombocytopenic purpura (cITP) in childhood is inadequate. The aim of this retrospective study was to determine the efficacy of H. pylori eradication therapy for platelet response in pediatric patients with cITP in our hospital, and to perform a systematic review of previous reports about pediatric patients with cITP who were positive for H. pylori infection and were treated with H. pylori eradication therapy. Analysis of the data of pediatric patients with cITP in our hospital and a systematic review of digital literature databases of studies in pediatric patients with cITP were performed. Data of 33 pediatric patients with cITP from our hospital records showed that the prevalence of H. pylori infection and the rate of response to platelet therapy were 15% and 33.3%, respectively. Data of 706 pediatric patients from 18 previous reports showed that the prevalence of H. pylori infection and rate of platelet response were 23% and 43.8%, respectively. Eradication therapy for H. pylori infection in pediatric cITP patients can be expected to result in a response equivalent to that in the adult population, with fewer adverse effects than other treatments for cITP.

scholarly journals Two Cases and Review of the Literature: Primary Percutaneous Angiography and Antiplatelet Management in Patients with Immune Thrombocytopenic Purpura

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Estelle Torbey ◽  
Harout Yacoub ◽  
Donald McCord ◽  
James Lafferty
Keyword(s):  
Antiplatelet Therapy ◽  
Immune Thrombocytopenic Purpura ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Review Of The Literature ◽  
Thrombocytopenic Purpura ◽  
Coronary Syndrome ◽  
First Case ◽  
St Elevation

We report two cases of immune thrombocytopenic purpura (ITP) associated with acute coronary artery syndrome highlighting the interventions done in every case along with the medications used during intervention and as outpatient. The first case is that of a woman with ITP exacerbation while on dual antiplatelet therapy and the second case is that of a male presenting with non-ST elevation myocardial infarction (NSTEMI) while in a thrombocytopenic crisis. In both cases antiplatelet therapy was held and thrombopoietic therapy was initiated before resuming full anticoagulation and coronary intervention. Given the paucity of data on ITP and antiplatelets treatment in the setting of acute coronary syndrome, no strict recommendations can be proposed, but antiplatelets appear to be safe acutely and in the long term in this category of patients as long as few measures are undertaken to minimize the risks of bleeding and thrombosis.

scholarly journals Severe Reversible Pulmonary Hypertension in Smoldering Multiple Myeloma: Two Cases and Review of the Literature

2015 ◽  
Vol 5 (1) ◽  
pp. 211-216 ◽  
Author(s):  
Wayne L. Feyereisn ◽  
Eric R. Fenstad ◽  
Robert B. McCully ◽  
Martha Q. Lacy
Keyword(s):  
Multiple Myeloma ◽  
Pulmonary Hypertension ◽  
Review Of The Literature ◽  
Smoldering Multiple Myeloma

scholarly journals Multiple myeloma associated with immune thrombocytopenic purpura

Cancer ◽  
1985 ◽  
Vol 56 (5) ◽  
pp. 1199-1200 ◽  
Author(s):  
Joseph D. Verdirame ◽  
John R. Feagler ◽  
James R. Commers
Keyword(s):  
Multiple Myeloma ◽  
Immune Thrombocytopenic Purpura ◽  
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.

Alteration of Circulating Regulatory T Cells in Japanese Adult Patients with Immune Thrombocytopenic Purpura after Eradication of Helicobacter Pylori.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3410-3410
Author(s):  
Koji Miyazaki ◽  
Mikio Danbara ◽  
Manabu Ohsaka ◽  
Yuhko Suzuki ◽  
Ryouichi Horie ◽  
...  
Keyword(s):  
T Cells ◽  
Helicobacter Pylori ◽  
Regulatory T Cells ◽  
Immune Thrombocytopenic Purpura ◽  
Mononuclear Cells ◽  
Eradication Therapy ◽  
Autoimmune Disorder ◽  
Japanese Adult ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts

Abstract Immune thrombocytopenic purpura (ITP) is an autoimmune disorder, and eradication of Helicobacter pylori (HP) has been demonstrated to be an effective and tolerable firstline treatment for the patients infected with HP in Japan. However the mechanism has still remained to be uncovered. Recently CD4+CD25high+Foxp3+ regulatory T cells (Tregs), which regulate autoreactive T cells, have been identified, and suggested to play an important role in pathogenesis of ITP, as well as other autoimmune disorders. It has been shown that Tregs are reduced and suppressed in the ITP patients. And a recent report has demonstrated that the defective Tregs are restored upon the rituximab treatment. However, the effects of HP eradication therapy on Tregs have not been determined. The aim of this study is to investigate the circulating Tregs in ITP patients treated with HP eradication. And we also attempted to elucidate the mechanisms of the treatment. The peripheral blood CD4+CD25high+ Tregs were measured by flow cytometry before and after the treatment in 21 Japanese adults with HP-positive chronic ITP. We also confirmed the expression of Foxp3 in this cellular population with the permeabilized mononuclear cells. Among 21 patients, the platelet counts increased in 13 cases (responders), but not in 9 cases (non-responders). In responders the numbers of Tregs have been restored, but not in non-responders after the treatment. It is interesting here that the amounts of Tregs were still transiently elevated in an early phase (2–3weeks) after the treatment in some non-responders without recovery of the platelet counts. Furthermore, in three cases, who failed in pylorus elimination, Tregs were also transiently increased in number associated with brief recovery of the platelet counts, and reduced to the initial level in about two months. After the successful re-eradication, the numbers of Tregs and platelets have been restored. From these results it is shown that HP eradication can modulate Tregs to increase the platelet counts for ITP patients. We also demonstrate that the increase of Tregs by HP eradication was more rapid than that by rituximab, which required about three months. Further, it might be suggested that there are two phases of the therapy with HP eradication for ITP. In an initial stage, the therapy itself could have an effect modulating the immune systems to potentiate Tregs. Some drugs, such as macrolide antibiotics including clarithromycin have been demonstrated to be a potent immunomodulator. However, this phase is not sufficient for the successful treatment, as shown in the cases of failure in HP elimination. In a retentive stage, extermination of HP is also necessary for sustainment of restored Tregs.

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