1/14. Neutrophil antigen 5b is carried by a protein, migrating from 70 to 95 kDa, and may be involved in neonatal alloimmune neutropenia.BACKGROUND: Neutrophil antigen 5b has been described as involved in transfusion reactions and not in neonatal alloimmune neutropenia. CASE REPORT: Anti-5b was found in the serum of a mother of a persistently neutropenic newborn, who had several bacterial infections. The neutropenia responded to treatment with recombinant human granulocyte-colony-stimulating factor. immunoprecipitation experiments performed with this and three other 5b antisera identified a protein, migrating from 70 to 95 kDa, as carrier of 5b. The observed pattern of migration may point to heavy glycosylation of this protein. RESULTS: Six 5b-negative donors were identified among 54 screened white donors, for a 5b gene frequency of 0.66. CONCLUSION: Alloimmunization to 5b in pregnancy is rare. In the patients with neonatal neutropenia analyzed in the last decade, this was the first case discovered.- - - - - - - - - - ranking = 1keywords = neonatal alloimmune, alloimmune (Clic here for more details about this article) |
2/14. Immune thrombocytopenic purpura associated with brucella and toxoplasma infections.Bacterial and protozoal infections can cause thrombocytopenia and may mimic idiopathic thrombocytopenic purpura (ITP). brucella species and toxoplasma are among the infectious agents with protean clinical manifestations which may induce immune thrombocytopenia. In rare cases, thrombocytopenia can be severe and may result bleeding into the skin and from mucosal sites. Prompt recognition of this complication and aggressive therapy are essential, since the mortality associated with bleeding into the central nervous system is high. We report two patients with complaints of severe epistaxis and thrombocytopenia associated with brucellosis and toxoplasmosis. Thrombocytopenic purpura in these cases responded well to the high-dose corticosteroid treatment with platelet recovery within 2-3 days. For cases with infection-induced immune thrombocytopenic purpura, short-term high-dose corticosteroids may be applied as an urgent therapy without worsening of the clinical condition.- - - - - - - - - - ranking = 0.013566015012066keywords = thrombocytopenia (Clic here for more details about this article) |
3/14. diclofenac induced immune thrombocytopenia.We describe a patient with scleroderma who developed immune thrombocytopenia secondary to diclofenac on 2 occasions. platelet count returned to normal with cessation of diclofenac and institution of prednisone.- - - - - - - - - - ranking = 0.016957518765083keywords = thrombocytopenia (Clic here for more details about this article) |
4/14. Emergency surgery and refractory immune thrombocytopenic purpura. A case report.A 35-year-old woman with post-splenectomy refractory immune thrombocytopenia presented with an acute abdominal emergency requiring laparotomy. Her platelet count was raised from 10 to 96 X 10(9)/l using a combination of high-dose methylprednisolone, plasma exchange against fresh-frozen plasma, infusion of gammaglobulin and a single mega-unit of platelets. The surgical procedure was uneventful, and with no further therapy the platelet count rose to a peak of 244 X 10(9)/l, but over the following 7 days fell back slowly to 10 X 10(9)/l, at which time the patient was discharged well.- - - - - - - - - - ranking = 0.0033915037530166keywords = thrombocytopenia (Clic here for more details about this article) |
5/14. Emergency caesarean section and symptomatic immune thrombocytopenic purpura.A 24-year-old woman presented in labour with profound purpuric bleeding due to idiopathic immune thrombocytopenia. She was assessed as requiring immediate caesarean section for cephalopelvic disproportion and foetal distress. In view of her platelet count of 21 x 10(9)/L she was prepared with intravenous methylprednisolone, isovolaemic plasma exchange, and infusion of 400 mg/kg of gammaglobulin and 5 x 10(11) allogeneic platelets. Six hours after commencing the procedure, at a time when her platelet count was 97 x 11(9)/L, she went uneventful operation and with no further therapy this level subsequently reached 175 x 10(9)/L, at which time an uneventful operation was performed. The mother and her normal, full-term infant have been discharged; both are well and at follow-up have normal platelet counts. This experience illustrates that major surgery can safely be undertaken in severely thrombocytopenic patients, even as an emergency procedure, using this regimen.- - - - - - - - - - ranking = 0.0033915037530166keywords = thrombocytopenia (Clic here for more details about this article) |
6/14. Immune thrombocytopenia more than a year after allogeneic marrow transplantation due to antibodies against donor platelets with anti-PlA1 specificity: evidence for a host-derived immune reaction.We report on a male patient transplanted from his HLA-matched sister for Ph1-chromosome positive chronic myelogenous leukaemia who developed immune thrombocytopenia more than 1 year after transplantation. The platelet antibody reacted with the platelet specific antigen PlA1 on donor platelets, and also on recipient platelets after engraftment. A presumed host-versus-donor induced thrombocytopenia was supported by Southern blot analysis using a Y-chromosome specific probe demonstrating residual host-origin cells in the patient's excised spleen.- - - - - - - - - - ranking = 0.0203490225181keywords = thrombocytopenia (Clic here for more details about this article) |
7/14. Treatment of immune thrombocytopenic purpura in homosexual men.Over the past 3 yr we have treated 6 homosexual men (age 22-55 yr) with immune thrombocytopenic purpura. 4 of the 6 have antibody to HTLV-III in their serum, 1 of these patients has the acquired immune deficiency syndrome (AIDS), 1 has AIDS-related-complex (ARC), and a 3rd has persistent generalised lymphadenopathy (PGL). The platelet count at presentation was between 2 and 35 X 10(9)/l and in each case a bone marrow confirmed active platelet production. Antiplatelet antibodies were demonstrated in 3 of 4 patients tested. 3 of the 6 patients showed a partial response to prednisolone, 2 showed little or no response and the 6th showed a good response. 2 patients received high dose i.v. immunoglobulin - 1 had an excellent response prior to splenectomy, the other showed no response. 5 of the 6 patients had a splenectomy. 3 had a lasting remission (12-27 months after splenectomy), 1 of these has HTLV-III antibodies; 1 had a remission lasting 1 yr, followed by fluctuating thrombocytopenia (21-130 X 10(9)/l) and 1 showed no response.- - - - - - - - - - ranking = 0.0033915037530166keywords = thrombocytopenia (Clic here for more details about this article) |
8/14. cefotetan-induced immunologic thrombocytopenia.Profound thrombocytopenia accompanied by a severe coagulopathy developed in an elderly female patient being treated with cefotetan while undergoing surgery for closure of a perforated gastric ulcer. During the acute phase of the bleeding diathesis, the patient had a platelet count of 12 x 10(9)/l, a prothrombin time of 88 s (normal 10.0-11.8 s) and a PTT of 105 s (normal 23.0-37.0 s). Potent IgG cefotetan-dependent anti-platelet antibodies, which also were weakly reactive with ampicillin, were detected in the patient's serum using immunofluorescence and a recently developed protein A-agarose rosette forming assay. Unlike typical cephalosporin- and penicillin-induced antibodies that react with cells pretreated with drug, this antibody only reacted with platelets in the presence of exogenous drug. Failure of the antibody to react with drug-coated platelets suggests the possibility that, in this patient, sensitization to cefotetan involved mechanisms other than formation of typical hapten-carrier complexes normally described for members of the cephalosporin family of antibiotics. This appears to be the first definitive report that cefotetan, or any other cephalosporin derivative, can induce immunologic thrombocytopenia.- - - - - - - - - - ranking = 0.0203490225181keywords = thrombocytopenia (Clic here for more details about this article) |
9/14. Neonatal alloimmune thrombocytopenia: spontaneous in utero intracranial hemorrhage.Neonatal alloimmune thrombocytopenia is an uncommon but important cause of thrombocytopenia in infants. Because of the severity of the thrombocytopenia, some of these infants will have intracranial hemorrhage with resultant long-term disability. Obstetricians and neonatologists have recommended delivery by caesarean section and the rapid institution of appropriate treatment for the infant; however, it is theoretically possible that a hemorrhagic event could precede the delivery and consequently not be prevented by these perinatal interventions. In this report we describe a neonate in whom the diagnosis of alloimmune neonatal thrombocytopenia was suspected because of antenatal ultrasound evidence of intracerebral hemorrhage. This case demonstrates the importance of antenatal fetal assessment and indicates the need for the development of therapeutic strategies to maintain fetal hemostasis.- - - - - - - - - - ranking = 0.5813737130778keywords = alloimmune, alloimmune thrombocytopenia, thrombocytopenia (Clic here for more details about this article) |
10/14. Intrauterine intracranial hemorrhage in an infant with isoimmune thrombocytopenia.An infant with isoimmune thrombocytopenia and presumed intrauterine intracranial hemorrhage is presented. This infant developed focal seizures on day 6 of life which were controlled with phenobarbital. Presently, the infant is growing and developing normally. Previous cases have been described and are summarized in this paper. There is no known method for predicting or preventing this particular complication.- - - - - - - - - - ranking = 0.016957518765083keywords = thrombocytopenia (Clic here for more details about this article) |
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