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Hamostaseologie Aug 2019Immune thrombocytopenia (ITP) occurs with an incidence rate of 1.6 to 3.9 per 100,000 patient-years, which increases with age and has a slight female preponderance. ITP... (Comparative Study)
Comparative Study Review
Immune thrombocytopenia (ITP) occurs with an incidence rate of 1.6 to 3.9 per 100,000 patient-years, which increases with age and has a slight female preponderance. ITP is termed acute, persistent or chronic when its duration is <3 months, 3 to 12 months and >12 months, respectively. In this narrative review, we discuss the clinical manifestations of ITP in children and adults. ITP is asymptomatic in some patients; however, when present, bleeding is the most common symptom and can be mild as in petechiae, purpura and epistaxis, or severe and even life threatening in cases of intracranial haemorrhage, and massive gastrointestinal or urinary tract bleeding. A platelet count <10-20 × 10/L, advanced age and prior minor bleeding are risk factors for major bleeding, which is also more common in the months following a new diagnosis of acute ITP. Fatigue and impaired health-related quality of life are also manifestations of ITP that often improve with treatment and improvement in platelet counts. Over long-term follow-up, ITP is also associated with an increased risk of venous and arterial thromboembolism, haematologic malignancy and overall mortality than the general population.
Topics: Adolescent; Adult; Aged; Autoimmune Diseases; Child; Child, Preschool; Fatigue; Female; Follow-Up Studies; Hematologic Neoplasms; Hemorrhage; Humans; Incidence; Male; Middle Aged; Platelet Count; Purpura, Thrombocytopenic, Idiopathic; Quality of Life; Receptors, Thrombopoietin; Risk Factors; Splenectomy; Venous Thromboembolism
PubMed: 30868551
DOI: 10.1055/s-0039-1683416 -
Journal of the American Academy of... Apr 2020Retiform purpura is a specific morphology within the spectrum of reticulate eruptions of vascular origin. It develops when blood vessels serving the skin are compromised... (Review)
Review
Retiform purpura is a specific morphology within the spectrum of reticulate eruptions of vascular origin. It develops when blood vessels serving the skin are compromised resulting in downstream cutaneous ischemia, purpura, and necrosis. Identifying retiform purpura is important particularly in the acutely ill patient. It may elucidate the underlying diagnosis, provide prognostic information, and suggest a treatment approach. The differential diagnosis of retiform purpura is vast, reflecting the myriad conditions that can lead to cutaneous vessel wall damage or lumen occlusion. In this article, we give an overview of the differential diagnosis of this cutaneous morphology, provide an approach to workup, and highlight updates in treatment of some of the more common conditions that manifest as retiform purpura.
Topics: Biopsy; Clinical Laboratory Techniques; Diagnosis, Differential; Humans; Medical History Taking; Physical Examination; Purpura; Skin Diseases, Vascular
PubMed: 31479689
DOI: 10.1016/j.jaad.2019.07.112 -
Romanian Journal of Internal Medicine =... Dec 2019Immune thrombocytopenia is an autoimmune hematological disorder characterized by severely decreased platelet count of peripheral cause: platelet destruction via... (Review)
Review
Immune thrombocytopenia is an autoimmune hematological disorder characterized by severely decreased platelet count of peripheral cause: platelet destruction via antiplatelet antibodies which may also affect marrow megakaryocytes. Patients may present in critical situations, with cutaneous and/or mucous bleeding and possibly life-threatening organ hemorrhages (cerebral, digestive, etc.) Therefore, rapid diagnosis and therapeutic intervention are mandatory. Corticotherapy represents the first treatment option, but as in any autoimmune disorder, there is a high risk of relapse. Second line therapy options include: intravenous immunoglobulins, thrombopoietin receptor agonists, rituximab or immunosuppression, but their benefit is usually temporary. Moreover, the disease generally affects young people who need repeated and prolonged treatment and hospitalization and therefore, it is preferred to choose a long term effect therapy. Splenectomy - removal of the site of platelet destruction - represents an effective and stable treatment, with 70-80% response rate and low complications incidence. A challenging situation is the association of ITP with pregnancy, which further increases the risk due to the immunodeficiency of pregnancy, major dangers of bleeding, vital risks for mother and fetus, potential risks of medication, necessity of prompt intervention in the setting of specific obstetrical situations - delivery, pregnancy loss, obstetrical complications, etc. We present an updated review of the current clinical and laboratory data, as well as a detailed analysis of the available therapeutic options with their benefits and risks, and also particular associations (pregnancy, relapsed and refractory disease, emergency treatment).
Topics: Diagnosis, Differential; Emergency Treatment; Female; Humans; Pregnancy; Pregnancy Complications; Purpura, Thrombocytopenic, Idiopathic
PubMed: 31199777
DOI: 10.2478/rjim-2019-0014 -
Postgraduate Medical Journal Feb 2022
Topics: Humans; Purpura Fulminans; Purpura
PubMed: 37066566
DOI: 10.1136/postgradmedj-2021-140510 -
British Journal of Hospital Medicine... Oct 2017
Review
Topics: Diagnosis, Differential; Drug Hypersensitivity; Hematologic Diseases; Humans; Purpura; Skin; Vascular Diseases
PubMed: 29019739
DOI: 10.12968/hmed.2017.78.10.C147 -
American Family Physician Mar 2024
Topics: Humans; Purpura; IgA Vasculitis; Skin Neoplasms
PubMed: 38574218
DOI: No ID Found -
Cutis Jan 2024
Topics: Humans; Factitious Disorders; Psychotic Disorders; Autoimmune Diseases; Purpura; Skin Diseases, Vascular
PubMed: 38478944
DOI: 10.12788/cutis.0957 -
Tidsskrift For Den Norske Laegeforening... May 2024
Topics: Humans; Purpura; Golf
PubMed: 38738575
DOI: 10.4045/tidsskr.24.0262 -
Annales de Dermatologie Et de... Mar 2018
Review
Topics: Adult; Child; Hematologic Diseases; Hemorrhage; Humans; Meningococcal Infections; Purpura; Thromboembolism; Vasculitis
PubMed: 29428444
DOI: 10.1016/j.annder.2018.01.027 -
Ugeskrift For Laeger May 2020In this review, we discuss pigmented purpuric dermatoses (PPD), which are a group of benign, chronic diseases characterised by purpuric eruption. PPD comprise mb.... (Review)
Review
In this review, we discuss pigmented purpuric dermatoses (PPD), which are a group of benign, chronic diseases characterised by purpuric eruption. PPD comprise mb. Schamberg, mb. Majocchi, Gougerot-Blum, lichen aureus, and Doucas and Kapetanakis eczematoid purpura. PPD can be seen in both genders and may affect all age groups. Purpura is often localised to the lower extremities, and it may be asymptomatic or pruritic. PPD is usually diagnosed upon recognition of classical clinical features, but the diagnosis can also be confirmed by a skin biopsy.
Topics: Female; Humans; Keratosis; Male; Pigmentation Disorders; Pruritus; Purpura; Skin
PubMed: 32515323
DOI: No ID Found