Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019087 (hemorrhagic diathesis)
 678 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Childhood ITP is an acquired hemorrhagic disorder with a heterogeneous clinical course. We measured PAIgG levels in 20 children with ITP (7 acute, 13 chronic). Both groups had significantly greater PAIgG values than age-matched normal subjects and thrombocytopenic controls (P less than 0.001). In addition, PAIgG values in chronic ITP were significantly lower than those in acute ITP (P less than 0.003). Serial PAIgG values were obtained in some patients; most returned to normal in association with clinical recovery. The measurement of PAIgG is useful in the diagnosis and follow-up of childhood ITP. PAIgG values may assist in differentiating acute and chronic disease in children.
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PMID:Platelet-associated immunoglobulin G in childhood idiopathic thrombocytopenic purpura. 57 Feb 18

A ruptured cerebral aneurysm in a 50-year-old female with idiopathic thrombocytopenic purpura was successfully clipped after preoperative high-dose gamma-globulin therapy to control the hemorrhagic diathesis. High-dose gamma-globulin therapy with or without steroid and/or platelet transfusion is recommended for such cases if the blood pressure can be controlled and the neurological condition permits delayed surgery.
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PMID:Ruptured cerebral aneurysm successfully clipped in idiopathic thrombocytopenic purpura after high-dose gamma-globulin therapy--case report. 172 30

The authors present the case of a 21-year old woman patient who was admitted to hospital because of typical symptoms of chronic idiopathic thrombopenic purpura. Prednisolone therapy alone and subsequently combined with Immuran as well as later applied large dose of Methylprednisolone failed to be effective. Owing to the ineffective therapies and increasing hemorrhagic diathesis splenectomy was performed under perioperative Venagamma protection without success. Intraglobin-F therapy brought perfect recovery. The authors review the expectable results of immunoglobulin therapy, the strategy of ITP therapy changed as a consequence of the new therapeutic possibility as well as the indications of immunoglobulin treatment.
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PMID:[Successful therapeutic use of intraglobin-F in idiopathic immuno-thrombopenia, refractory to corticosteroid and immunosuppressive therapy as well as to splenectomy]. 249 3

Idiopathic thrombocytopenic purpura (ITP), an acquired hemorrhagic disorder, is characterized by the abrupt onset of thrombocytopenia despite normal megakaryocytic productivity. An accumulating body of evidence, including the recent demonstration of elevated levels of platelet-associated IgG, points to an immune etiology of acute childhood ITP. Although spontaneous recovery occurs in 80-90% of patients within 4 months of diagnosis, hemorrhagic complications may occur. Considerable evidence exists which suggests the efficacy of corticosteroid use in this disorder. Several clinical studies have shown that steroids may shorten the time to platelet count recovery, thus reducing the time at risk for hemorrhagic complications. The authors conclude with treatment recommendations for childhood ITP which include a brief course of prednisone.
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PMID:Prednisone treatment of acute idiopathic thrombocytopenic purpura of childhood. Advantages. 654 May 31

ITP is a hemorrhagic disorder in which thrombocytopenia is associated with increased peripheral destruction of platelets. It is a syndrome of different diseases, all of which have in common shortened platelet survival owing to the presence of an antiplatelet antibody. Most cases are secondary to an identifiable etiologic agent.
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PMID:Immune thrombocytopenic purpura. 699 33

350 patients with idiopathic thrombocytopenic purpura (ITP) aged 2/12-15 years (mean 6.3 +/- 2.7) were followed up during the period January 1st, 1975 to March 31, 1992. They constituted 40% of cases with hemorrhagic diathesis attending the Hematology/Oncology Clinic, Children's Hospital, Ain Shams University (relative frequency of 37.4/100.000 of the general Out-Patient Clinic in the same hospital). These patients presented with acute (71.4%), chronic (22.9%) and recurrent (5.7%) forms. The age of presentation was younger in acute ITP. In the recurrent form there was significant female predominance. Most cases of acute ITP (66%) presented in winter and spring, with a positive history of preceding viral illness in 50% in contrast to 10% in chronic form. Four chronic ITP cases developed lupus erythematosus; all were females > 9 years. As regards therapy, acute ITP cases with initial platelet count (PC) < 10 x 10(9)/l were randomized to receive either high-dose methyl prednisolone (HDMP) 10 mg/kg/day for 5 days i.v. (n = 10) or intravenous immunoglobulin (IVIG) 0.4 g/kg/day for 5 days (n = 10) or conventional-dose prednisone (CDP) 2 mg/kg/day 4 weeks p.o. (n = 10). A dramatic response was noticed in the first two groups. In chronic ITP, (n = 80) CDP induced complete response (CR) in 30% and partial response (PR) in 20%; 50% were nonresponders. Twenty-four refractory ITP with persistent PC < or = 20 x 10(9)/l received second-line therapy: vincristine 1.5 mg/m2/week i.v. 4 doses (n = 4) with no clinical or hematological improvement. IVIG 0.4 g/kg/day for 5 days (n = 8) with sustained CR only in 2 patients (25%) and PR in 2 patients (25%). Splenectomy was performed (n = 12) with CR in 50%; out of them, 2 patients had shown no improvement on prior IVIG therapy. In conclusion, ITP is a benign condition with no fatality reported, but it could run a chronic refractory course.
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PMID:Idiopathic thrombocytopenic purpura in Egyptian children. 829 70

A 68-year-old man who had abdominal aortic aneurysm (AAA) associated with idiopathic thrombocytopenic purpura (ITP) and consumption coagulopathy was successfully operated upon. The count of platelet was improved from 1.4 x 10(4)/microL to 8.0 x 10(4)/microL by the preoperative treatment with gamma-globulin (400mg/kg/day for 5 days) and heparin sodium (10000-15000 unit/day). Abdominal aortic aneurysm was replaced with a Y-shaped knitted Dacron graft, and splenectomy was performed for ITP. No severe hemorrhagic diathesis was encountered during and after the operation. This is the first report of surgical treatment of AAA associated with ITP and consumption coagulopathy.
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PMID:[Surgical treatment of abdominal aortic aneurysm associated with idiopathic thrombocytopenic purpura and consumption coagulopathy: a case report]. 830 72

An eighty-four-year-old man was admitted to the hospital because of pain at rest in the lower extremities. On physical examination, trophic changes of the skin and petechiae in the limbs were observed. Computed tomographic scan of the abdomen showed focal renal infarctions and calcification of the descending aorta. Moreover, radionuclide imaging of the arterial system revealed complete obstructions of the two right iliac arteries and the left external iliac artery, where collateral flows were observed. Laboratory examination showed a severe thrombocytopenia caused by immunoglobulin G (IgG)-type autoantibody against platelets. He was diagnosed as having arteriosclerosis obliterans complicated by idiopathic thrombocytopenic purpura, although no known risk factors promoting atherosclerosis other than age were evident. In such a case with hemorrhagic diathesis, a hemorheologic agent and the vasodilator prostaglandin could confer advantages in relieving and controlling the ischemic leg pain without hemorrhagic complications. Moreover, small doses of the initial prednisolone therapy for ITP might also be recommended to avoid thrombus formations in the atherosclerotic lesions.
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PMID:A rare case of arteriosclerosis obliterans without prominent risk factors complicated by idiopathic thrombocytopenic purpura. A case report. 861 16

A 47-year-old woman was admitted to our hospital complaining of subcutaneous hemorrhages. She had taken medicine because of a common cold one month before admission, and two weeks after that, she noticed the hemorrhagic diathesis. Laboratory data on admission were as follows; 1,000/microliters of platelet count (PLT), normal myelogram, normal coagulation tests, positive PAIgG and anti-platelet antibody. She was diagnosed as idiopathic thrombocytopenic purpura and a standard dose of prednisolone was started immediately. However, on the 3rd hospital day (HD), frequent hematemesis from submucosal hematomas developed. Pulse therapy of methylprednisolone and immunoglobulin therapy were ineffective. From the 15th HD slow drip infusion of vincristine and continuous drip infusion of 1, 500 mg/day of gabexate mesilate (GM) were started. Because PLT increased to 85,000/microliters and hematemesis disappeared on the 22nd HD, GM was discontinued. However on the 25th HD, PLT decreased to 1,000/microliters again. After re-starting GM, PLT was maintained at over 100,000/microliters. Subsequent examinations ruled out collagen diseases but revealed that she had Hashimoto's thyroiditis. We concluded that the complement inhibitory action of gabexate mesilate might have contributed to PLT increase in this case, as has been previously reported in three other cases.
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PMID:[Gabexate mesilate induced recovery from thrombocytopenia in a patient with acute ITP]. 877 83

Hemorrhagic diathesis represents a high risk for oral surgery. In clinical practice various kinds of diathetic diseases are seen that are of plasmatic, vascular, thrombocytic and hypertensive origin. Usually these patients will be primarily referred to the hospital as high-risk cases. Therefore, a broad spectrum of diagnostic and therapeutic interdisciplinary methods are available, so that as a rule it is possible to obtain a clear picture of the severity of the bleeding tendency. We represent a case of a 58-year-old woman who had decayed teeth with chronic periodontal and periapical lesions, who could not be treated by oral surgery because of refractory idiopathic thrombocytopenic purpura (ITP) with 1000 platelets/microliters. The patient's history showed that various hematologic concepts had been tried, including splenectomy, but all had failed entirely. After therapy with steroids, immunosuppressive and cytostatic agents, and even after administering immunoglobulins and substitution with platelets, the count did not increase; thus, an absolute contraindication for all kinds of surgery was declared. This rare example indicates that unmanagable bleeding diseases still exist that should be known by dentists and oral surgeons to prevent making deleterious therapeutic decisions.
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PMID:[Therapy refractory idiopathic thrombocytopenia. Contraindication for dental surgery interventions]. 1007 68


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