1/48. Complete resolution of refractory immune thrombocytopenic purpura after colectomy for ulcerative colitis.Immune thrombocytopenia (ITP) is a destructive thrombocytopenia caused by an autoantibody directed to platelet membrane antigens. Various immunological diseases have been associated with ITP, but an association between inflammatory bowel disease (IBD) and ITP is not well recognised. We report a case of refractory immune thrombocytopenia associated with ulcerative colitis that resolved after colectomy. Although the medical treatment of inflammatory bowel disease or splenectomy are usually enough to treat ITP, it may be necessary to do a colectomy in refractory patients.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/48. Relapse of idiopathic thrombocytopenic purpura caused by influenza a virus infection: a case report.We report a patient with idiopathic thrombocytopenic purpura (ITP) in remission, who relapsed as a result of an influenza a virus infection. A 41-year-old woman presented with fever elevation, coughing, and generalized petechiae. Her platelet count had decreased to 1 x 10(9)/l. She had been diagnosed with ITP at age 23, and continuous complete remission had followed steroid therapy and splenectomy. Influenza A antigen was positive in her pharyngeal aspirate, and oseltamivir was effective for her symptoms. Findings of a bone marrow smear were typical for ITP. Steroid therapy resulted in a second complete remission. Although the development of ITP caused by influenza infection and a relapse caused by an influenza vaccination have been previously described, a relapse caused by a sporadic infection has never been documented to our knowledge. physicians should carefully monitor the hematological data of influenza patients, especially those with ITP, even in remission.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/48. A case report of neonatal alloimmune thrombocytopenic purpura: the importance of correct diagnosis for future pregnancies.CONTEXT: Neonatal alloimmune thrombocytopenic purpura (NAITP) is a neonatal disorder characterized by maternal alloimmunization against fetal platelet antigens inherited from the father. Intracranial hemorrhage leading to death or permanent neurological disability may occur in the fetus. CASE REPORT: A healthy 30-year-old woman gave birth to her first baby by cesarean after an uneventful 36-week pregnancy. Ten hours after birth, the infant presented severe petechiae, with platelet count of 8 x 10(3)/microl. The mother's platelet count was normal (180 x 10(3)/microl). The infant re ceived intravenous immunoglobulin and was discharged 18 days later, with platelet count of 100 x 10(3)/microl. The cause of thrombocytopenia was not elucidated at that time. One year later, the infant died of neuroblastoma. Since the parents wanted another child, they were referred for investigation of this thrombocytopenia. Platelet genotyping and platelet antibody screening were performed, showing total HPA-1 system mismatch between mother (HPA-1b1b) and father (HPA-1a1a), with anti-HPA-1a antibodies in the mother's serum. We concluded that the first baby was born with NAITP. Thus, in the second pregnancy, the mother was treated with several infusions of intravenous immunoglobulin. Careful ultrasound monitoring was performed, with normal results for mother and fetus throughout the pregnancy. The second baby was born by cesarean at 39 weeks, presenting 92 x 10(3) platelets/microl six hours after birth. The baby's platelets were genotyped as HPA-1a1b and the mother's serum again showed anti-HPA-1a antibodies. No clinical bleeding was observed. Intravenous immunoglobulin therapy was an effective treatment for preventing NAITP in the second baby.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/48. Neonatal alloimmune thrombocytopenia caused by human leucocyte antigen-B27 antibody.Neonatal alloimmune thrombocytopenia (NAIT) occurs when maternal alloantibodies to antigens presented on foetal platelets cause their immune destruction. Whether human leucocyte antigen (HLA) antibodies can cause NAIT is controversial. Here, a patient was described who suffered from a NAIT caused by an HLA-B27 antibody. Sera from the mother and the newborn were tested for human platelet antigen antibodies and HLA antibodies by monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay, solid phase-linked immunosorbent assay (ELISA), lymphocytotoxicity assay (LCT) and flow cytometric analysis. No antibodies against cluster designation (CD)109 and platelet glycoproteins of the father were found in patient's and mother's serum. However, HLA ELISA was used to identify HLA antibody in both sera. The antibody was specified as HLA-B27 antibody. Typing results showed that the father descended hla-b27 antigen on patient and his brother. The mother was HLA-B27 negative. It is most conceivable that the previous pregnancy of the mother induced the production of anti-HLA-B27 antibody, which crossed the placenta and subsequently caused an NAIT in the case presented.- - - - - - - - - - ranking = 9keywords = antigen (Clic here for more details about this article) |
5/48. Elevated common acute lymphoblastic leukemia antigen expression in pediatric immune thrombocytopenic purpura.bone marrow examination is often performed in thrombocytopenic children to distinguish immune thrombocytopenic purpura (ITP) from acute leukemia. We describe a patient with thrombocytopenia and 50% common acute lymphoblastic leukemia antigen (CALLA) positivity in his marrow who was subsequently shown to have ITP. CALLA (CD10) is a surface antigen found in early b-lymphocytes and is elevated in most cases of childhood acute lymphoblastic leukemia (ALL). This case prompted us to prospectively study the frequency of immature lymphocyte populations in children with ITP. Fourteen patients with acute ITP and five with other conditions were studied. The two groups were comparable with respect to age: ITP mean, 4.3 (range 0.3-15.5) years; control mean, 5.8 (0.6-13.8) years. The ITP group had a significantly higher percentage of CD10 positive bone marrow lymphocytes (p = 0.007). Five of the 10 patients younger than 4 years of age in the ITP group had CD10 levels of greater than 30%, which is in the leukemic range, whereas none of the control patients had a CD10 levels of greater than 17% (p = 0.003). There was good correlation between CD10 positivity and B4 positivity indicating that both of these markers arise from the same population of immature b-lymphocytes. None of the ITP patients who were older than 4 years had a CD10 level of greater than 30%. We conclude that it is common to have an increase in the proportion of immature lymphocytes in the marrow of young children with ITP. The cause of this increase in CD10 positive cells is unknown.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 6keywords = antigen (Clic here for more details about this article) |
6/48. Congenital parvovirus infection.A case of congenital parvovirus (B19) viraemia with associated thrombocytopenic purpura and platelet antigen incompatibility in an infant is reported. Results of laboratory investigations indicated that the baby was infected in utero.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/48. Discrepancy between antiplatelet antibody activities detected by immunoblot procedure and platelet counts in idiopathic thrombocytopenic purpura.By immunoblot procedure it is possible to identify the pathogenic autoantibody responsible for platelet destruction in idiopathic thrombocytopenic purpura (ITP). We assessed the relationship between antiplatelet antibody activities detected by this technique and clinical thrombocytopenia in a patient with ITP whose antiplatelet autoantibody was directed toward an 85-kDa antigen. In this patient, over a 2-year-period, the platelet counts were not correlated with the levels of antiplatelet autoantibody detected by immunoblotting. The present observations suggest that IgG autoantibody directed toward a specific antigen is not necessarily a critical determinant of the degree of thrombocytopenia, and that factors other than IgG-Fc-receptor-mediated platelet destruction are also important in the determination of the disease activity in ITP.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
8/48. Chronic active hepatitis following splenectomy for autoimmune thrombocytopenia.Two patients with immune thrombocytopenic purpura underwent splenectomy following the failure of steroid therapy. In neither patient was there evidence of liver disease prior to the splenectomy. Both had autoimmune parameters before the operation. They both received blood compounds; one patient remained negative for hepatitis b surface antigen (HBsAg) and antibodies, and the other had anti-HBs and anti-HBc. antibodies for hepatitis c virus were found in both patients. In the two patients hepatitis developed 4 and 6 weeks, respectively, following splenectomy, and liver biopsies performed 6 months and 2 years post splenectomy revealed chronic active hepatitis. The relationship between the two disorders is discussed and a possible role of the splenectomy in the development of chronic active hepatitis in these two cases is suggested.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/48. Elution of anti-Zwa (-PIA1) from autologous platelets after normalization of platelet count in post-transfusion purpura.In two patients suffering from post-transfusion purpura, anti-Zwa was demonstrated in either eluates from autologous platelets harvested during the remission phase and after normalization of the platelet count. In both patients, platelet-associated immunoglobulin (PAIg) was demonstrated during the acute phase. PAIg disappeared concomitantly with recovery and, thus, seems to be associated with the thrombocytopenia. These data support the assumption that immunocomplexes are adsorbed nonspecifically to the platelets and cause destruction of autologous platelets lacking the corresponding antigen. An association between the IgG3 subclass of anti-Zwa antibodies and the destruction of autologous platelets was also seen.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/48. Neonatal alloimmune thrombocytopenic purpura associated with sensitization against the platelet-specific antigen Yuk(a).We report a Japanese newborn who developed alloimmune thrombocytopenia by the antibodies to the newly discovered platelet antigen Yuk(a). The infant recovered uneventfully in 10 days without specific treatment. Antiplatelet alloantibodies in the patient were IgG class detected by mixed passive hemagglutination (MPHA). family study showed that Yuk(a) antigen was inherited as an autosomal dominant trait. Cases with Yuk(a)-associated alloimmune thrombocytopenia are reviewed.- - - - - - - - - - ranking = 6keywords = antigen (Clic here for more details about this article) |
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