Navegando por Palavras-chave "immune thrombocytopenic purpura"
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- ItemAcesso aberto (Open Access)Anemia hemolítica auto-imune e outras manifestações imunes da leucemia linfocítica crônica(Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular, 2005-12-01) Bordin, Jose Orlando [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Chronic lymphocytic leukemia (CLL) is frequently associated with autoimmune diseases directed against hematopoietic cells, including autoimmune hemolytic anemia (AIHA), immune thrombocytopenic purpura (ITP), pure red cell aplasia (PRCA), and immune neutropenia. CLL represents the diagnosis in up to 15% of the patients with AIHA, and in 50% of the patients with AIHA secondary to malignancy. ITP occurs in 2% and PRCA in about 1% of all CLL patients. Prednisone is the first-line treatment for immune cytopenia related to CLL. About 60% of patients relapse when treatment is stopped therefore splenectomy, intravenous immunoglobulin, or cyclosporine are reasonable second-line treatments. Although the data on pathophysiology are very limited, it appears that the autoimmune mechanisms are related to the activity of the leukemic B lymphocytes that act as aberrant antigen-presenting cells, and are effective in processing and presenting proteins derived from red cells or platelets to auto-reactive TH cells. TH cells specific for certain auto-antigens escape from control mechanisms and when activated may initiate auto-immune disease. Patients with AIHA secondary to CLL should not receive fludarabine because there is an increased frequency of severe and fatal AIHA in patients treated with purine nucleoside analogues. Patients who are more immunosuppressed due to several previous treatments are at higher risk for developing this auto-immune complication.
- ItemAcesso aberto (Open Access)Cerebellar degeneration and immune thrombocytopenic purpura associated with human immunodeficiency virus infection (HIV)(Assoc Arquivos Neuro- Psiquiatria, 2007-12-01) Godeiro Junior, Clecio de Oliveira [UNIFESP]; Felício, Andre Carvalho [UNIFESP]; Barsottini, Orlando Graziani Povoas [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Cerebellar disorders associated with HIV infection are usually caused by opportunistic infections, central nervous system lymphoma, and toxic effects of medicines, nutritional and metabolic disorders, and cerebrovascular disease. We present an unusual association of cerebellar degeneration and immune thrombocytopenic purpura in a 28-years-old woman HIV infected. An autoimmune aetiology is likely.
- ItemSomente MetadadadosHelicobacter pylori infection & immune thrombocytopenic purpura in children and adolescents: A randomized controlled trial(Informa Healthcare, 2015-01-01) Hanai Brito, Helena Shino [UNIFESP]; Pellegrini Braga, Josefina Aparecida [UNIFESP]; Loggetto, Sandra Regina; Machado, Rodrigo Strehl [UNIFESP]; Hernandes Granato, Celso Francisco [UNIFESP]; Kawakami, Elisabete [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hematol Ctr São PauloHelicobacter pylori and immune thrombocytopenic purpura (ITP) association is not well established in chronic ITP (cITP) in children, although the cure of thrombocytopenia in approximately half of H. pylori eradicated adult patients has been described. the aim of this study was to investigate the effect of H. pylori eradication on platelet (PLT) recovery in cITP children and adolescents through a randomized, controlled trial. A total of 85 children (mean age 11.4 years) with cITP were prospectively enrolled. Diagnosis of H. pylori was established by two locally validated tests, C-13-urea breath test and monoclonal stool antigen test. Twenty-two infected patients were identified, and randomly allocated into two groups: H. pylori treatment group (n = 11) and the non-intervention control group (n = 11). the control group was offered treatment if the thrombocytopenia persisted after the follow-up. At baseline, there were no differences regarding age, sex, duration of disease, and PLT count between groups. Sixty three of 85 patients were uninfected. PLT response was classified as complete response: PLT > 150 x 10(9) l(-1); partial response: PLT 50-150 x 10(9) l(-1), or an increase of 20-30 x 10(9) l(-1); no response: PLT < 50 x 10(9) l(-1) or an increase of <20 x 10(9) l(-1) after at least 6 months of follow-up. Complete response was observed in 60.0% (6/10, one excluded) H. pylori eradicated patients vs. 18.2% (2/11) in non-eradicated patients (p = 0.08; OR = 6.75) after 6-9 months of follow-up. Among uninfected patients, only 13.8% (8/58) presented complete response. Two non-treated controls were treated after 6-12 months of follow-up, and PLT response was observed in 61.5% (8/13) of H. pylori eradicated patients, and in 19.0% (11/58) of uninfected patients (p = 0.004). Cytotoxin associated gene A and vacuolating cytotoxin gene A IgG antibodies were present in almost all infected patients. Therefore, the study suggests that H. pylori eradication plays a role in the management of H. pylori infected cITP children and adolescents.