Journal of Yeungnam Medical Science

Review article

Advances in management of pediatric chronic immune thrombocytopenia: a narrative review: Jae Min Lee; J Yeungnam Med Sci. 2023;40(3):241-246. Published online January 9, 2023; DOI: https://doi.org/10.12701/jyms.2022.00745

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Immune thrombocytopenia (ITP) is a disease in which thrombocytopenia occurs because of immune-mediated platelet destruction and decreased platelet production. Although many pediatric patients with ITP experience spontaneous remission or reach remission within 12 months of first-line therapy, approximately 20% progress to chronic ITP. Patients who do not respond to first-line treatment or experience frequent relapses are of great concern to physicians. This review summarizes recent treatments for second-line treatment of pediatric chronic ITP.

Citations

Citations to this article as recorded by

Beta-Thalassemia with Initial Presentation as Immune Thrombocytopenia: A Case Report
Hyun Sik Kang
Clinical Pediatric Hematology-Oncology.2023; 30(1): 42. CrossRef

Case report

Delayed treatment-free response after romiplostim discontinuation in pediatric chronic immune thrombocytopenia: Hyun Ji Lim, Young Tae Lim, Jeong Ok Hah, Jae Min Lee; Yeungnam Univ J Med. 2021;38(2):165-168. Published online August 7, 2020; DOI: https://doi.org/10.12701/yujm.2020.00493

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Abstract PDF

We report the case of a 16-month-old patient with chronic immune thrombocytopenia (ITP) patient who experienced delayed treatment-free response (TFR) after romiplostim treatment. He received intravenous immunoglobulin every month to maintain a platelet count above 20,000/μL for 2 years. Thereafter, he received rituximab and cyclosporine as second-line therapy, with no response, followed by romiplostim. After 4 weeks of treatment, the platelet count was maintained above 50,000/μL. Following 7 months of treatment, he discontinued romiplostim, and the platelet count decreased. His platelet counts remained above 50,000/μL, without any bleeding symptoms, 2 years after romiplostim discontinuation. This is the first report of TFR after romiplostim treatment in pediatric chronic ITP.

Citations

Citations to this article as recorded by

A cost–utility analysis of thrombopoietin receptor agonists for treating pediatric immune thrombocytopenia purpura after failure of first‐line therapies
Huimin Du, Jiamin Wang, Joel Livingston, Ziyad Alrajhi, Melanie Kirby‐Allen, Brian Chan, Rebecca Hancock‐Howard, Peter C. Coyte
Pediatric Blood & Cancer.2023;[Epub] CrossRef
Generic romiplostim for children with persistent or chronic immune thrombocytopenia: Experience from a tertiary care centre in North India
Chandana Mareddy, Manas Kalra, Anupam Sachdeva
British Journal of Haematology.2022; 197(5): 618. CrossRef
Tapering of the thrombopoietin receptor agonist in paediatric patients with chronic immune thrombocytopenia: Is it possible?
María Solsona, Rubén Berrueco, Elena Sebastián, Áurea Cervera, Ana Sastre, Itziar Astigarraga, Bienvenida Argilés, María Ángeles Dasí, José Luís Dapena, Emilio Monteagudo
British Journal of Clinical Pharmacology.2022; 88(9): 4220. CrossRef

Case Report

Immune thrombocytopenia associated with sarcoidosis.: Da Eun Jeong, Min Kyoung Kim, Sung Ae Koh, Kyoung Hee Lee, Joon Hyuk Choi, Young Hoon Hong, Jae Ho Cho, Eun Ju Goo, Myung Soo Hyun; Yeungnam Univ J Med. 2015;32(1):26-30. Published online June 30, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.1.26

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Abstract PDF: Sarcoidosis is a systemic disease of unknown cause involving multiple organs and is characterized by noncaseating granuloma. Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased peripheral platelet destruction due to the presence of an antibody to the platelet and abnormal platelet production. There is no known pathogenesis that occurs concurrently with ITP and sarcoidosis. However, considering together of 2 known pathogenesis, abnormal immune response triggers either ITP or sarcoidosis. The disease that develops first stimulates secondary disease. After development of secondary disease, they stimulate each other. A few cases of ITP associated with sarcoidosis are well documented in English; however, the disease has rarely been reported in Korea. Here, we report on a case of ITP with sarcoidosis in a 29-year-old man. He suffered from easy bruising. The chest X-ray and the contrast-enhanced computed tomography scan showed bihilar lymphadenopathy and reticulonodular infiltrates. Bone marrow study and fluoroscopy-guided percutaneous needle biopsy were performed and the patient was diagnosed with sarcoidosis and ITP. He was put on 400 mg/kg of intravenous immunoglobulin for 5 days and administered oral steroids and further follow-up will be carried out. He has shown a good response without significant bleeding event. However, administration of more oral steroid and additional follow-up is required than for single disease, whether sarcoidosis or ITP.

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