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1/229. Simultaneous onset of alopecia areata and idiopathic thrombocytopenic purpura: A potential association?

    alopecia areata (AA) has been associated with a variety of autoimmune diseases. Immune thrombocytopenic purpura (ITP) is an autoimmune disease marked by isolated thrombocytopenia. We present a young girl with the simultaneous onset of AA and ITP. To the best of our knowledge, this association has not previously been reported. We hypothesize that ITP may be one of many autoimmune diseases associated with AA via antibodies that cross-react between platelet membrane glycoproteins and follicular glycoproteins.
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ranking = 1
keywords = idiopathic
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2/229. Remission of idiopathic thrombocytopenic purpura after femoral lengthening. Clinical case followed for 5 years.

    We report on a patient with chronic idiopathic thrombocytopenic purpura (ITP) who went into remission after femoral lengthening. Although it is possible that spontaneous remission (frequency 5%-10%) of chronic ITP coincided with the femoral lengthening, limb lengthening could also have caused the thrombocytosis. This case suggests a close relationship between osteogenesis and hematopoiesis during regenerate bone formation. Limb lengthening can therefore be defined as the formation not only of bone and soft tissue but also of hematopoietic tissue.
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ranking = 5.8154321062346
keywords = chronic idiopathic, idiopathic
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3/229. Primary percutaneous transluminal coronary angioplasty performed for acute myocardial infarction in a patient with idiopathic thrombocytopenic purpura.

    A 72-year-old female with idiopathic thrombocytopenic purpura (ITP) complained of severe chest pain. electrocardiography showed ST-segment depression and negative T wave in I, aVL and V4-6. Following a diagnosis of acute myocardial infarction (AMI), urgent coronary angiography revealed 99% organic stenosis with delayed flow in the proximal segment and 50% in the middle segment of the left anterior descending artery (LAD). Subsequently, percutaneous transluminal coronary angioplasty (PTCA) for the stenosis in the proximal LAD was performed. In the coronary care unit, her blood pressure dropped. Hematomas around the puncture sites were observed and the platelet count was 28,000/mm3. After transfusion, electrocardiography revealed ST-segment elevation in I, aVL and V1-6. Urgent recatheterization disclosed total occlusion in the middle segment of the LAD. Subsequently, PTCA was performed successfully. Then, intravenous immunoglobulin increased the platelet count and the bleeding tendency disappeared. A case of AMI with ITP is rare. The present case suggests that primary PTCA can be a useful therapeutic strategy, but careful attention must be paid to hemostasis and to managing the platelet count.
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ranking = 1.25
keywords = idiopathic
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4/229. Perioperative management of a patient with Werlhof disease undergoing myocardial revascularization.

    We herein report the case of a patient with idiopathic thrombocytopenic purpura (Werlhof disease) and coronary artery disease undergoing myocardial revascularization. The use of monomeric immunoglobulins, corticosteroids, platelets transfusion, use of a cell saver, normothermic cardiopulmonary bypass, aprotinine and homologous blood transfusion were combined in order to minimize the risk of bleeding complications in the postoperative period.
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ranking = 0.25
keywords = idiopathic
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5/229. Idiopathic thrombocytopenia after cytomegalovirus infection in a renal transplant recipient.

    infection with cytomegalovirus (CMV) is a frequent complication of organ transplantation and presents a spectrum of disease ranging from asymptomatic viremia to life-threatening tissue-invasive disease. CMV is also lymphotrophic, with the potential to induce autoimmune disease, although immunosuppressive therapy may prevent or attenuate the clinical course in transplant patients. We report a case of idiopathic thrombocytopenic purpura occurring in a renal transplant recipient after primary CMV infection and discuss the possible mechanisms involved.
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ranking = 0.25
keywords = idiopathic
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6/229. aortic valve replacement in a patient with idiopathic thrombocytopenic purpura.

    A patient with aortic regurgitation and idiopathic thrombocytopenic purpura underwent a successful valve replacement. Cardiac surgery requiring a cardiopulmonary bypass in idiopathic thrombocytopenic purpura can be safely carried out with the preoperative intravenous administration of high-dose gammaglobulin, which may thereby reduce the need for either perioperative transfusion or prophylactic splenectomy.
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ranking = 1.5
keywords = idiopathic
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7/229. Giant platelet disorders in African-American children misdiagnosed as idiopathic thrombocytopenic purpura.

    A retrospective chart review of six African-American children with a diagnosis of macrothrombocytopenias (MTCP) was performed to evaluate the accuracy of their diagnosis. The following was diagnosed in the six children with MTCP: Fechtner syndrome (two children), Sebastian syndrome (one child), and unnamed MTCP (three children). In five families, chronic idiopathic thrombocytopenic purpura (ITP) was diagnosed in the propositus, which resulted in therapy using steroids, intravenous immunoglobulin (IVIG), and in one case splenectomy. Bleeding symptoms were generally mild. All six patients had thrombocytopenia ranging from 10 to 125 x 10(9)/L with mean platelet volume of 8 to 20 fL. Bleeding times were abnormal in two of three patients, and platelet aggregation was abnormal in three of four patients tested. bone marrow aspirates were reported as increased megakaryocytes in the three patients on whom the procedure was performed. Ultrastructural morphology of platelets and leukocytes was performed in all six patients demonstrating giant platelets in all six patients and leukocyte inclusions in three patients. Differentiating MTCP from the more common ITP can be difficult but important in avoiding unnecessary diagnostic studies and potentially harmful therapy associated with ITP.
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ranking = 5.8154321062346
keywords = chronic idiopathic, idiopathic
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8/229. Idiopathic thrombocytopenic purpura associated with breast cancer: a case report and review of the current literature.

    The association of solid tumors with idiopathic thrombocytopenic purpura (ITP) is rare. Before this study, there have been three case reports indicating an association between breast cancer and ITP. We present a 69-year-old man with metastatic breast cancer and progressive thrombocytopenia without any evidence of a leukoerythroblastic picture or etiologies for the thrombocytopenia. serum platelet antibodies were identified. A bone marrow biopsy showed small foci of metastatic breast cancer, thrombocytopenia, and normal number of megakaryocytes. A subsequent trial of steroids resulted in a marked improvement of the patient's thrombocytopenia. This is the fourth case report indicating an association of breast cancer and ITP.
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ranking = 0.25
keywords = idiopathic
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9/229. Redo cardiac surgery for atrial septal defect in a patient with idiopathic thrombocytopenic purpura. Preoperative management with high-dose intravenous gamma-globulin.

    A 58-year-old woman with idiopathic thrombocytopenic purpura required redo cardiac surgery of atrial septal defect closure, mitral annuloplasty, and tricuspid annuloplasty. Preoperative high-dose intravenous gamma-globulin and platelet transfusion after termination of cardiopulmonary bypass allowed successful redo cardiac surgery. Management of a patient with idiopathic thrombocytopenic purpura undergoing open heart surgery are discussed.
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ranking = 1.5
keywords = idiopathic
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10/229. Leukocytoclastic vasculitis following staphylococcal protein a column immunoadsorption therapy for idiopathic thrombocytopenic purpura.

    A patient with refractory idiopathic thrombocytopenic purpura developed widespread palpable purpura, fever, diarrhea, and arthralgias forty-eight hours following a third protein A immunoadsorption treatment. A skin biopsy revealed leukocytoclastic vasculitis. His skin lesions and constitutional symptoms resolved with administration of antibiotics and bed rest.
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ranking = 1.25
keywords = idiopathic
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