scholarly journals Thrombocytopenia in the Course of COVID-19 Infection

2020 ◽  
Author(s):  
Noel Lorenzo-Villalba ◽  
Abrar-Ahmad Zulfiqar ◽  
Marc Auburtin ◽  
Marie Helene Schuhmacher ◽  
Alain Meyer ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Biological Response ◽  
Intravenous Immunoglobulins ◽  
Severe Thrombocytopenia ◽  
The Third ◽  
Mucosal Bleeding

We report three cases of severe thrombocytopenia during COVID-19 infection associated with either cutaneous purpura or mucosal bleeding. The initial investigations ruled out other causes of thrombocytopenia. Two of the patients were treated with intravenous immunoglobulins and eltrombopag, while the third recovered spontaneously. A good clinical and biological response was achieved in all patients leading to hospital discharge.

scholarly journals Late onset of severe thrombocytopenia during interferon treatment for chronic hepatitis C infection: Case report

2010 ◽  
Vol 138 (3-4) ◽  
pp. 240-243 ◽  
Author(s):  
Jelena Hajder ◽  
Natasa Stanisavljevic ◽  
Olivera Markovic ◽  
Dragomir Marisavljevic
Keyword(s):  
Hepatitis C ◽  
Late Onset ◽  
Intravenous Immunoglobulins ◽  
Hcv Infection ◽  
Common Finding ◽  
Severe Thrombocytopenia ◽  
Hepatitis C Infection ◽  
Infection Treatment ◽  
Indium 111 ◽  
Therapy Completion

Introduction. Thrombocytopenia is a common finding in chronic liver diseases and it is caused by different pathophysiological mechanisms. Immunologic thrombocytopenic purpura (ITP) in hepatitis C infection is a distinct clinical entity. Possible reasons for ITP in this case could be capabillity of HCV to induce autoimmune phenomena but also immunomodulatory effects of interferon that is used for HCV infection treatment. The specific laboratory parameters for ITP diagnosis during HCV infection have not been defined yet. Case Outline. A 37-year-old patient diagnosed with HCV infection was treated with PEG-interferon and Ribavirin during 24 weeks. The partial response was achieved after the therapy with reduction of viral replications. One month after therapy completion, the patient was hospitalized due to skin haemorrhagic syndrome and a serious degree of thrombocytopenia (2?109/l). The number and megakaryocyte morphology in bone marrow aspirate were normal. An assay of thrombocyte kinetics by radioactive marker (Indium 111) showed rapid thrombocyte destruction and their early seljuestration in the spleen. Conclusion. Results of assays about thrombocyte kinetics during HCV infection show enchanced thrombocyte destruction in the liver. Accordingly, the most important parameter for ITP diagnosis in HCV infection, in this case, was rapid thrombocyte destruction and their early sequestration in the spleen approved by Indium kinetics. Also, in support of ITP is the increment of thrombocyte number during therapy with intravenous immunoglobulins. Thrombocytopenia was developing during antiviral therapy and on indirect conclusion is that viral replication is not the reason for it.

scholarly journals Successful Treatment of Vaccine-Induced Immune Thrombotic Thrombocytopenia in a 26-Year-Old Female Patient

2021 ◽  
pp. 1-4
Author(s):  
Marcel Kemper ◽  
Georg Lenz ◽  
Rolf Michael Mesters
Keyword(s):  
Female Patient ◽  
Treatment Options ◽  
Anticoagulation Therapy ◽  
Intravenous Immunoglobulins ◽  
High Dose ◽  
Severe Thrombocytopenia ◽  
Vein Thrombosis ◽  
Medical Facilities ◽  
Deep Vein ◽  
Improve Patient

Vaccine-induced immune thrombotic thrombocytopenia (VITT) has already been described after vaccination with ChAdOx2 nCov-19 (AstraZeneca) and Ad26.COV2.S (Johnson & Johnson/Janssen). However, less knowledge so far has been gained about optimal therapeutic regimens in VITT-suspected patients. Here, we report the case of a 26-year-old female patient, who developed bilateral deep vein thrombosis in the lower legs and severe thrombocytopenia after ChAdOx2 nCov-19 vaccination. After initial anticoagulation therapy regimens including fondaparinux, apixaban, and danaparoid failed, the patient was successfully treated with high-dose intravenous immunoglobulins in combination with parental anticoagulation therapy with argatroban. As vaccination against severe acute respiratory syndrome coronavirus 2 affects billions of people worldwide, medical facilities and hospitals have to be prepared and provide effective treatment options in VITT-suspected patients, including rapid application of high-dose intravenous immunoglobulins, to improve patient outcomes.

scholarly journals Management of immune thrombocytopenia during COVID-19 pandemic

2021 ◽  
Vol 66 (1) ◽  
pp. 20-36
Author(s):  
S. V. Semochkin ◽  
T. A. Mitina ◽  
T. N. Tolstykh
Keyword(s):  
Immune Thrombocytopenia ◽  
Remission Rate ◽  
Biological Response ◽  
Medical Community ◽  
Platelet Response ◽  
Social Distancing ◽  
The Third ◽  
Prednisolone Treatment ◽  
Thrombopoietin Receptor ◽  
Early Transfer

Introduction. The COVID-19 pandemic has challenged health professionals and patients suffering from haematological diseases with embarrassed diagnosis, treatment, surveillance, social distancing and other constraints.Aim — addressing therapy for immune thrombocytopenia (ITP) during the COVID-19 pandemic in the light of own experience, as well as national and international professional medical community guidelines.Main findings. A standard choice in COVID-19-negative ITP patients are conventional, e.g., glucocorticosteroid (GCS) and intravenous immunoglobulin therapies. An early transfer to thrombopoietin receptor agonists (rTPO) appears optimal as reducing the infection risk in GCS withdrawal and significantly improving the stable remission rate without supportive treatment. Combined ITP–COVID-19 patients should consider a prednisolone treatment of 20 mg/day, provided an absent active bleeding. The dose may increase to 1 mg/kg/day in no response after 3–5 days. ITP patients admitted for COVID-19 should start weight‐based LMWH thromboprophylaxis upon attaining a platelet count of ≥ 30 × 109 /L. Chronic ITP patients should carry on usual treatment with standard SARS-CoV-2 preventive and social distancing measures. We exemplify three contrasting clinical cases of COVID-19-comorbid thrombocytopenia and discuss the ITP differential diagnosis and therapy. Two patients received GCSs and rTPO agonists (romiplostim, eltrombopag), while GCSs alone provided for platelet response in the third case. All patients showed a good clinical and biological response. Issues in SARS-CoV-2 vaccination are discussed.

Zastosowanie eltrombopagu w leczeniu przewlekłej małopłytkowości immunologicznej u dziecka – doświadczenia własne

2018 ◽  
Vol 22 (3) ◽  
Author(s):  
Anna Adamowicz-Salach ◽  
Michał Matysiak
Keyword(s):  
Immune Thrombocytopenia ◽  
Autoimmune Disorder ◽  
Intravenous Immunoglobulins ◽  
Severe Form ◽  
Small Subset ◽  
Severe Thrombocytopenia ◽  
Permanent Improvement ◽  
Acute Form ◽  
Clinically Significant ◽  
Immune Thrombocytopenia Purpura

Immune thrombocytopenia purpura (ITP) is a rare autoimmune disorder but it is one of the most common bleeding disorder in childhood. Most children with this disease have acute form of ITP with self-limiting thrombocytopenia. A small subset of children with ITP has clinically significant disease with severe thrombocytopenia. We presented the case of a boy with a severe form of chronic immune thrombocytopenia who was treated for the first time six years before presented. At first autoimmunohemolytic anaemia was recognized. Next in therapeutic procedure, multi-drug treatment, including intravenous corticosteroids, intravenous immunoglobulins, and cyclosporine were used to achieve permanent improvement. Due to a chronic ITP and significant decrease platelets counts and severe symptoms of nose bleeding and anaemia, eltrombopag, thrombopoiesis stimulating factor, was used. After 16 weeks of treatment, as a result of triple therapy consisting of eltrombopag, prednisone and azathioprine, the platelets counts were normalized and the symptoms of bleeding resolved.

scholarly journals Treatment of Severe Thrombocytopenia with Intravenous Immunoglobulins and Corticosteroids in a Patient Receiving Continuous Ambulatory Peritoneal Dialysis

Nephron ◽  
1997 ◽  
Vol 77 (3) ◽  
pp. 371-372 ◽  
Author(s):  
Hitoshi Sugiyama ◽  
Minoru Satoh ◽  
Masahiro Odawara ◽  
Haruo Ichikawa ◽  
Keisuke Maruyama ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Intravenous Immunoglobulins ◽  
Severe Thrombocytopenia

scholarly journals Varying Biological Activity and Wind Stress Affect the DMS Response during the SAGE Iron Enrichment Experiment

2020 ◽  
Vol 8 (4) ◽  
pp. 268
Author(s):  
Graham Jones ◽  
Mike Harvey ◽  
Stacey King ◽  
Anke Schneider ◽  
Simon Wright ◽  
...  
Keyword(s):  
Surface Waters ◽  
Biological Response ◽  
Phytoplankton Production ◽  
Storm Activity ◽  
Chl A ◽  
Iron Enrichment ◽  
The Third ◽  
Enrichment Experiments ◽  
High Winds ◽  
Microzooplankton Grazing

Surface dissolved dimethylsulfide (DMS) and depth-integrated dimethylsulfoniopropionate (DMSP) measurements were made from March to April 2004 during the SOLAS Air–Sea Gas Exchange Experiment (SAGE), a multiple iron enrichment experiment in subantarctic waters SE of New Zealand. During the first two iron enrichments, chl a and DMS production were constrained, but during the third enrichment, large pulses of DMS occurred in the fertilised IN patch, compared with the unfertilised OUT patch. During the third and fourth iron infusions, total chl a concentrations doubled from 0.52 to 1.02 µg/L. Hapto8s and prasinophytes accounted for 50%, and 20%, respectively, of total chl a. The large pulses of DMS during the third iron enrichment occurred during high dissolved DMSP concentrations and wind strength; changes in dinoflagellate, haptophyte, and cyanobacteria biomass; and increased microzooplankton grazing that exerted a top down control on phytoplankton production. A further fourth iron enrichment did cause surface waters to increase in DMS, but the effect was not as great as that recorded in the third enrichment. Differences in the biological response between SAGE and several other iron enrichment experiments were concluded to reflect microzooplankton grazing activities and the microbial loop dominance, resulting from mixing of the MLD during storm activity and high winds during iron enrichment.

scholarly journals Successful Long-Term Use of Eltrombopag in a Patient with Refractory Severe Thrombocytopenia Associated with Chronic Lymphocytic Leukemia That Allowed Oral Anticoagulant Treatment for Severe Cardiomyopathy

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Juárez Salcedo Luis Miguel ◽  
Gil-Fernández Juan José
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Oral Treatment ◽  
Intravenous Immunoglobulins ◽  
Lymphocytic Leukemia ◽  
Severe Thrombocytopenia ◽  
Arrhythmogenic Cardiomyopathy ◽  
Oral Anticoagulant Treatment ◽  
Anticoagulation Treatment ◽  
Autoimmune Cytopenias

Autoimmune cytopenias (AICs) are frequently associated with chronic lymphocytic leukemia (CLL). The most common of these AICs is autoimmune hemolytic anemia (AIHA); the second most is immune thrombocytopenia (ITP). Here, we report on a patient with CLL-associated ITP, with thrombocytopenia refractory to corticosteroids and intravenous immunoglobulins, in which continuous oral treatment with Eltrombopag allowed initiation and maintenance of an oral anticoagulation treatment with Acenocoumarol that was indicated because of a severe arrhythmogenic cardiomyopathy.

DEPARTMENT OF CORRECTIONS

1989 ◽  
Vol 10 (10) ◽  
pp. 312-312
Keyword(s):  
Preterm Infant ◽  
Hospital Discharge ◽  
The Third ◽  
Department Of Corrections ◽  
Worse Prognosis

In the article by Bernbaum et al (Pediatr Rev 1989;10:195-206), "Caring for the Preterm Infant After Hospital Discharge," the sentence at the beginning of the first full paragraph in the third column on 204 should read: "The presence of hypotonicity carries with it a somewhat worse prognosis developmentally than transient hypertonicity."

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