Association Of Immune Thrombocytopenic Purpura Research Articles

Idiopathic thrombocytopenic purpura in tuberculosis (Case Report)

Tuberculosis (TB) is a contagious disease in both developing and developed countries. The incidence is increasing due to bacilli resistant to many drugs and the human immunodeficiency virus (HIV). Since 2012, India has the highest incidence of the disease at around 2.2 million cases, accounting for 26% of the global incidence according to World Health Organization statistics. A wide range of hematological manifestations is observed in TB, where thrombocytopenia is common in miliary TB and thrombocytosis in pulmonary TB. Immune thrombocytopenic purpura (ITP) is characterized by a low platelet count accompanied by the presence of autoantibodies. The association of immune thrombocytopenic purpura and tuberculosis is a rare condition. In the case presented, anti-tuberculosis therapy was effective for both tuberculosis and thrombocytopenia, suggesting a causal link between tuberculosis and immune thrombocytopenic purpura. Purpose: Reporting a case of association of PTI and TBC Method: Clinical case study and correlation with literature Discussion: The pathophysiology of thrombocytopenia in tuberculosis remains unanswered. This is a rare condition, estimated to occur in less than 1% of tuberculosis cases. Mycobacterium tuberculosis can break down the antigen with platelets leading to the formation of antiplatelet antibodies. HLA-specific presentation of tuberculosis may also lead to an antiplatelet immune response in some patients.

Idiopathic Thrombocytopenic Purpura in Tuberculosis

Tuberculosis (TB) is a contagious disease in both developing and developed countries. The incidence is increasing due to bacilli resistant to many drugs and the human immunodeficiency virus (HIV). Since 2012, India has the highest incidence of the disease at around 2.2 million cases, accounting for 26% of the global incidence according to World Health Organization statistics. A wide range of hematological manifestations is observed in TB, where thrombocytopenia is common in miliary TB and thrombocytosis in pulmonary TB. Immune thrombocytopenic purpura (ITP) is characterized by a low platelet count accompanied by the presence of autoantibodies. The association of immune thrombocytopenic purpura and tuberculosis is a rare condition. In the case presented, anti-tuberculosis therapy was effective for both tuberculosis and thrombocytopenia, suggesting a causal link between tuberculosis and immune thrombocytopenic purpura. Purpose: Reporting a case of association of PTI and TBC Method: Clinical case study and correlation with literature Discussion: The pathophysiology of thrombocytopenia in tuberculosis remains unanswered. This is a rare condition, estimated to occur in less than 1% of tuberculosis cases. Mycobacterium tuberculosis can break down the antigen with platelets leading to the formation of antiplatelet antibodies. HLA-specific presentation of tuberculosis may also lead to antiplatelet immune response in some patients.

Relationship of primary immune thrombocytopenic purpura and atopia among children: a case control study

Atopic dermatitis (AD) is a chronic disease affecting 10–30% of children and 2–10% of adults worldwide. It is manifested by the pruritus eczema lesions on the skin. Immune thrombocytopenic purpura (ITP) is the most common cause of acute onset of thrombocytopenia in childhood. The aim of this study was association of primary immune thrombocytopenic purpura and atopia among children. This case control study was performed on patients with acute and chronic ITP who were confirmed by a hematologist. The control group was also selected from the siblings of the patients who were healthy and almost matched by age and sex with the patient group. Data were entered into a questionnaire under the SPSS-20 program, and demographic data were analyzed descriptively. In the present study, 120 patients were enrolled, 60 of whom were in the patient group and 60 in the control group. Mean age was 95 and 98 months for patients and control. This study showed a significant association of ITP with allergic rhinitis (P = 0.02), atopic dermatitis (P = 0.004), itching (P = 0.042), and dry skin (P = 0.015). However, no significant relationship was found between ITP and asthma (P-value = 0.18). This study does not reveal the causality between atopy and ITP but clearly shows the association between atopy and ITP disease, so the prevalence of atopy in ITP patients is higher than the normal population. According to the results of this study, it is necessary to investigate the cause of atopy and ITP and to find other immunological and possibly genetic commonalities.

Tuberculous lymphadenitis associated thrombocytopenic purpura, effectiveness of anti-tuberculous therapy

The association of immune thrombocytopenic purpura and tuberculosis is extremely rare. We presented a case with tuberculous lymphadenopathy and immune-mediated thrombocytopenia, the complete remission with anti-tuberculous therapy, and partial response to immunoglobulin and steroid suggested a causal relationship between the two conditions.

The Risk of Immune Thrombocytopenic Purpura After Vaccination in Children and Adolescents

The risk of immune thrombocytopenic purpura (ITP) after childhood vaccines other than measles-mumps-rubella vaccine (MMR) is unknown. Using data from 5 managed care organizations for 2000 to 2009, we identified a cohort of 1.8 million children ages 6 weeks to 17 years. Potential ITP cases were identified by using diagnostic codes and platelet counts. All cases were verified by chart review. Incidence rate ratios were calculated comparing the risk of ITP in risk (1 to 42 days after vaccination) and control periods. There were 197 chart-confirmed ITP cases out of 1.8 million children in the cohort. There was no elevated risk of ITP after any vaccine in early childhood other than MMR in the 12- to 19-month age group. There was a significantly elevated risk of ITP after hepatitis A vaccine at 7 to 17 years of age, and for varicella vaccine and tetanus-diphtheria-acellular pertussis vaccine at 11 to 17 years of age. For hepatitis A, varicella, and tetanus-diphtheria-acellular pertussis vaccines, elevated risks were based on one to two vaccine-exposed cases. Most cases were acute and mild with no long-term sequelae. ITP is unlikely after early childhood vaccines other than MMR. Because of the small number of exposed cases and potential confounding, the possible association of ITP with hepatitis A, varicella, and tetanus-diphtheria-acellular pertussis vaccines in older children requires further investigation.

Fisher Syndrome Associated with Immune Thrombocytopenic Purpura

We describe a 51-year-old man with Fisher syndrome (FS) and immune thrombocytopenic purpura (ITP) that developed after upper respiratory infection (URI). Laboratory investigations demonstrated immunoglobulin (Ig) G class of anti-GQ1b autoantibody and reduced platelet count with platelet-associated IgG, which spontaneously improved in parallel with neurologic symptoms. Thus the possible association of ITP should be considered when encountering a patient with FS. This patient suggests that there may be a certain infectious agent causing URI, leading to the co-occurrence of FS and ITP.

Association of Immune Thrombocytopenic Purpura with Non-Bleeding Symptoms

AbstractAbstract 4674Immune thrombocytopenic purpura (ITP) is an autoimmune disorder defined by isolated thrombocytopenia in the absence of a clinically apparent cause. The patients most commonly report mild to moderate bleeding symptoms; severe bleeding is rare even with very low platelet counts. Patients with ITP have been shown to have a reduced quality of life compared to the general population, as shown by McMillan et al using the SF-36 questionnaire. Also, patients receiving treatment for ITP have been shown by Mathias et al, using the ITP-PAQ (patient assessment questionnaire), to have significantly lower scores for health-related scales including symptoms, fatigue/sleep, bother, activity, psychological health, and overall quality of life in comparison with patients with ITP not on treatment.Blatt et al reported that thrombocytopenia per se can manifest with constitutional symptoms which resolve with improvement of thrombocytopenia. They conducted a retrospective data review of 27 patients (between ages 6 months to 15 years) and showed that 6 (22%) patients, including 4 patients with chronic ITP, reported fatigue related to their low platelet counts. Their symptoms improved with an increase in the platelet counts. There is no data in the adult population regarding the presence of any symptoms other than bleeding as a manifestation of thrombocytopenia.We conducted a retrospective chart review involving patients diagnosed with ITP between January 2002 and August 2010. All these patients were followed by a single physician hence reducing reporting bias. A total of 30 patients with a median age of 49 years (range 30 yrs to 84 yrs) were included in the study. The male to female ratio was 3:7. Based on the experience with one patient who complained of fatigue associated with thrombocytopenia which improved with an increase in platelet counts, the physician decided to collect data on all constitutional symptoms associated with thrombocytopenia. All of the comorbidities and any coexistent abnormalities which could explain these symptoms were recorded. A total of 8 (26.7%) patients with a median age of 44 years (range 31 yrs to 75 yrs) reported fatigue associated with lower platelet counts; of these patients, one patient also complained of headaches and one patient also complained of bone pain (Table 1). The median platelet count at presentation was 13,000/μ L (range 3000/μ L – 75,000/μ L). All of these symptoms resolved with an increase in their platelet counts. Nine patients out of the total population were on chronic danazol treatment; only one of these patients complained of fatigue. None of the patients received chronic steroid therapy.Table 1:Characteristics of patients complaining of constitutional symptoms related to a decrease in platelet counts from their baseline.SubjectAge (yrs)Sex (M: male, F: female)SymptomPlatelet count at presentation (/μ L)131FFatigue22,000269FFatigue13,000375FFatigue9,000449FFatigue75,000537FFatigue10,000644MFatigue3,000744FFatigue, Bone pains38,000840FFatigue, Headache28,000This is the first study in an adult population to assess the relationship of thrombocytopenia to constitutional symptoms. Our results are comparable to those reported in the pediatric population by Blatt et al. The mechanism of fatigue in relation to low platelet counts is not clear. Currently, treatment guidelines for ITP are based upon platelet counts and the risk of bleeding. However, further studies will be needed to evaluate if fatigue or any other symptoms which can impair the quality of life of patients can also become an important factor in deciding treatment initiation. Disclosures:No relevant conflicts of interest to declare.

Tuberculosis associated thrombocytopenic purpura: effectiveness of antituberculous therapy

Association of immune thrombocytopenic purpura and tuberculosis is a rare condition. In 5 patients presenting with this association, anti-tuberculous therapy was effective on both tuberculosis and thrombocytopenia suggesting a causal relationship between tuberculosis and immune thrombocytopenic purpura

Tuberculosis associated thrombocytopenic purpura: effectiveness of antituberculous therapy

Association of immune thrombocytopenic purpura and tuberculosis is a rare condition. In 5 patients presenting with this association, anti-tuberculous therapy was effective on both tuberculosis and thrombocytopenia suggesting a causal relationship between tuberculosis and immune thrombocytopenic purpura