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Medicina
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Immune Thrombocytopenia
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Immune Thrombocytopenia

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Hematology and Immunology".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 16231

Special Issue Editors

Dr. Tomas Jose Gonzalez-Lopez

E-Mail Website
Guest Editor
Hematology Department, Hospital Universitario de Burgos, 09006 Burgos, Spain
Interests: wAIHA; immune thrombocytopenia; ITP; multiple myeloma; chemotherapy; acute myeloid leukaemia; leukaemia
Special Issues, Collections and Topics in MDPI journals
Dr. Drew Provan

E-Mail Website
Co-Guest Editor
Barts and The London School of Medicine and Dentistry, London, UK

Special Issue Information

Dear Colleagues,

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by low platelet counts (<100x109/L), whose diagnosis is based on first discarding other conditions that could be associated with thrombocytopenia.
In recent years, new discoveries regarding ITP diagnosis and treatment have been made. Thus, although ITP is still recognized on the basis of an exclusion diagnosis, new lab tools such as those proposed by molecular biology studies have acquired an increasing importance. Furthermore, new drugs such as thrombopoietin (TPO) analogues and spleen tyrosine kinase (Syk) inhibitors have been developed and extensively used in the last years.
Given the growing interest in ITP beyond routine daily clinical practice management, the journal Medicina is launching this Special Issue.

We encourage you and your co-workers to submit articles reporting on ITP. Reviews or original articles dealing with aspects associated with diagnosis, differential diagnosis, management of primary ITP, and therapeutic possibilities, as well as case reports of special interest are welcome. In addition, we warmly invite you to submit articles reporting on less frequent types of ITP, e.g., ITP secondary to autoimmune or infectious diseases and lymphoproliferative disorders, drug-induced ITP, etc.
We look forward to receiving your contributions and realizing an interesting and complete Special Issue!

Dr. Tomás José González-López
Dr. Drew Provan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Immune thrombocytopenia, diagnosis, treatment
  • thrombopoietin
  • thrombopoietin analogs
  • immunosuppression
  • eltrombopag
  • romiplostim
  • rituximab

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Published Papers (3 papers)

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Research

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9 pages, 329 KiB  
Article
Impact of COVID-19 Pandemic on Patients with Immune Thrombocytopaenia
by María-Teresa Álvarez Román, Víctor Jiménez Yuste, Sara García Barcenilla, Andrés Ramírez López, Elena Monzón Manzano, Beatriz de la Cruz Benito, Paula Acuña Butta, María Isabel Rivas Pollmar, Roberto Trelles Martínez, Elena González Zorrilla, Mónica Martín Salces, Tamara Cebanu and Nora V. Butta
Medicina 2021, 57(3), 219; https://doi.org/10.3390/medicina57030219 - 1 Mar 2021
Cited by 1 | Viewed by 2420
Abstract
Background and Objectives: The aim of this study was to determine the impact of the COVID-19 pandemic on the lives of patients with immune thrombocytopaenia (ITP) treated at our hospital. Materials and Methods: The study was conducted in the Community of [...] Read more.
Background and Objectives: The aim of this study was to determine the impact of the COVID-19 pandemic on the lives of patients with immune thrombocytopaenia (ITP) treated at our hospital. Materials and Methods: The study was conducted in the Community of Madrid, which has the highest number of COVID-19 cases in Spain. We included 143 adult patients with ITP (130 with chronic ITP, 8 with persistent ITP, and 5 with newly diagnosed ITP). We conducted a telephone survey to collect the data and created a registry. Materials and Methods: Overall, 24 patients presented symptoms suggestive of COVID-19, which was confirmed by RT-PCR in 8 cases. The cumulative incidence of confirmed SARS-CoV-2 infection was higher in the patients with ITP than in the Madrid population. There were no differences in the disease incidence or clinical course of infection in the patients treated with immunosuppressants. Almost all of the patients reported adherence to the prescribed treatment, although 49.2% of the hospital visits were either cancelled or postponed, 17.2% because of the patients’ fear of coming to the centre. Nearly half of the cohort was considered vulnerable, and 17% had been granted a dependency or disability benefit. Conclusions: COVID-19 had a major impact on the psychosocial, occupational, and quality of care of patients with ITP. Full article
(This article belongs to the Special Issue Immune Thrombocytopenia)

Review

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19 pages, 1284 KiB  
Review
Immune Thrombocytopenic Purpura as a Hemorrhagic Versus Thrombotic Disease: An Updated Insight into Pathophysiological Mechanisms
by Claudia Cristina Tărniceriu, Loredana Liliana Hurjui, Irina Daniela Florea, Ion Hurjui, Irina Gradinaru, Daniela Maria Tanase, Carmen Delianu, Anca Haisan and Ludmila Lozneanu
Medicina 2022, 58(2), 211; https://doi.org/10.3390/medicina58020211 - 1 Feb 2022
Cited by 14 | Viewed by 6219
Abstract
Immune thrombocytopenic purpura (ITP) is a blood disorder characterized by a low platelet count of (less than 100 × 109/L). ITP is an organ-specific autoimmune disease in which the platelets and their precursors become targets of a dysfunctional immune system. This [...] Read more.
Immune thrombocytopenic purpura (ITP) is a blood disorder characterized by a low platelet count of (less than 100 × 109/L). ITP is an organ-specific autoimmune disease in which the platelets and their precursors become targets of a dysfunctional immune system. This interaction leads to a decrease in platelet number and, subsequently, to a bleeding disorder that can become clinically significant with hemorrhages in skin, on the mucous membrane, or even intracranial hemorrhagic events. If ITP was initially considered a hemorrhagic disease, more recent studies suggest that ITP has an increased risk of thrombosis. In this review, we provide current insights into the primary ITP physiopathology and their consequences, with special consideration on hemorrhagic and thrombotic events. The autoimmune response in ITP involves both the innate and adaptive immune systems, comprising both humoral and cell-mediated immune responses. Thrombosis in ITP is related to the pathophysiology of the disease (young hyperactive platelets, platelets microparticles, rebalanced hemostasis, complement activation, endothelial activation, antiphospholipid antibodies, and inhibition of natural anticoagulants), ITP treatment, and other comorbidities that altogether contribute to the occurrence of thrombosis. Physicians need to be vigilant in the early diagnosis of thrombotic events and then institute proper treatment (antiaggregant, anticoagulant) along with ITP-targeted therapy. In this review, we provide current insights into the primary ITP physiopathology and their consequences, with special consideration on hemorrhagic and thrombotic events. The accumulated evidence has identified multiple pathophysiological mechanisms with specific genetic predispositions, particularly associated with environmental conditions. Full article
(This article belongs to the Special Issue Immune Thrombocytopenia)
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10 pages, 320 KiB  
Review
Immune Thrombocytopenia (ITP): Current Limitations in Patient Management
by Deirdra R. Terrell, Cindy E. Neunert, Nichola Cooper, Katja M. Heitink-Pollé, Caroline Kruse, Paul Imbach, Thomas Kühne and Waleed Ghanima
Medicina 2020, 56(12), 667; https://doi.org/10.3390/medicina56120667 - 30 Nov 2020
Cited by 32 | Viewed by 6789
Abstract
Primary immune thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by isolated thrombocytopenia caused by increased platelet destruction and impaired platelet production. First-line therapies include corticosteroids, intravenous immunoglobulin, and anti-D immunoglobulin. For patients who are refractory to these therapies, those who become corticosteroid [...] Read more.
Primary immune thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by isolated thrombocytopenia caused by increased platelet destruction and impaired platelet production. First-line therapies include corticosteroids, intravenous immunoglobulin, and anti-D immunoglobulin. For patients who are refractory to these therapies, those who become corticosteroid dependent, or relapse following treatment with corticosteroid, options include splenectomy, rituximab, and thrombopoietin-receptor agonists, alongside a variety of additional immunosuppressive and experimental therapies. Despite recent advances in the management of ITP, many areas need further research. Although it is recognized that an assessment of patient-reported outcomes in ITP is valuable to understand and guide treatment, these measures are not routinely measured in the clinical setting. Consequently, although corticosteroids are first-line therapies for both children and adults, there are no data to suggest that corticosteroids improve health-related quality of life or other patient-related outcomes in either children or adults. In fact, long courses of corticosteroids, in either children or adults, may have a negative impact on a patient’s health-related quality of life, secondary to the impact on sleep disturbance, weight gain, and mental health. In adults, additional therapies may be needed to treat overt hemorrhage, but unfortunately the results are transient for the majority of patients. Therefore, there is a need to recognize the limitations of current existing therapies and evaluate new approaches, such as individualized treatment based on the probability of response and the size of effect on the patient’s most bothersome symptoms and risk of adverse effects or complications. Finally, a validated screening tool that identifies clinically significant patient-reported outcomes in routine clinical practice would help both patients and physicians to effectively follow a patient’s health beyond simply treating the laboratory findings and physical symptoms of ITP. The goal of this narrative review is to discuss management of newly diagnosed and refractory patients with ITP, with a focus on the limitations of current therapies from the patient’s perspective. Full article
(This article belongs to the Special Issue Immune Thrombocytopenia)
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