Immune Thrombocytopenia (ITP) in Emergency Medicine Questions & Answers

1. Cooper N, Ghanima W. Immune Thrombocytopenia. N Engl J Med. 2019 Sep 5. 381 (10):945-955. [QxMD MEDLINE Link].

2. Frederiksen H, Schmidt K. The incidence of idiopathic thrombocytopenic purpura in adults increases with age. Blood. 1999 Aug 1. 94(3):909-13. [QxMD MEDLINE Link].

3. Zeller B, Helgestad J, Hellebostad M. Immune thrombocytopenic purpura in childhood in Norway: a prospective, population-based registration. Pediatr Hematol Oncol. 2000 Oct-Nov. 17(7):551-8. [QxMD MEDLINE Link].

4. Reese JA, Li X, Hauben M, Aster RH, Bougie DW, Curtis BR, et al. Identifying drugs that cause acute thrombocytopenia: an analysis using 3 distinct methods. Blood. 2010 Sep 23. 116(12):2127-33. [QxMD MEDLINE Link]. [Full Text].

5. Warkentin TE, Anderson JA. DITP causation: 3 methods better than 1?. Blood. 2010 Sep 23. 116(12):2002-3. [QxMD MEDLINE Link].

6. David P, Shoenfeld Y. ITP following vaccination. Int J Infect Dis. 2020 Oct. 99:243-244. [QxMD MEDLINE Link]. [Full Text].

7. Mahévas M, Moulis G, Andres E, Riviere E, Garzaro M, Crickx E, et al. Clinical characteristics, management and outcome of COVID-19-associated immune thrombocytopenia: a French multicentre series. Br J Haematol. 2020 Aug. 190 (4):e224-e229. [QxMD MEDLINE Link]. [Full Text].

8. Bomhof G, Mutsaers PGNJ, Leebeek FWG, Te Boekhorst PAW, Hofland J, Croles FN, et al. COVID-19-associated immune thrombocytopenia. Br J Haematol. 2020 Jul. 190 (2):e61-e64. [QxMD MEDLINE Link]. [Full Text].

9. Pavord S, Thachil J, Hunt BJ, Murphy M, Lowe G, Laffan M, et al. Practical guidance for the management of adults with immune thrombocytopenia during the COVID-19 pandemic. Br J Haematol. 2020 Jun. 189 (6):1038-1043. [QxMD MEDLINE Link]. [Full Text].

10. Tarawneh O, Tarawneh H. Immune thrombocytopenia in a 22-year-old post Covid-19 vaccine. Am J Hematol. 2021 May 1. 96 (5):E133-E134. [QxMD MEDLINE Link]. [Full Text].

11. Lee EJ, Cines DB, Gernsheimer T, Kessler C, Michel M, Tarantino MD, et al. Thrombocytopenia following Pfizer and Moderna SARS-CoV-2 vaccination. Am J Hematol. 2021 May 1. 96 (5):534-537. [QxMD MEDLINE Link]. [Full Text].

12. Arepally GM, Ortel TL. Vaccine-induced immune thrombotic thrombocytopenia: what we know and do not know. Blood. 2021 Jul 29. 138 (4):293-298. [QxMD MEDLINE Link]. [Full Text].

13. Aleem A, Nadeem AJ. Coronavirus (COVID-19) Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT). 2021 Jan. [QxMD MEDLINE Link]. [Full Text].

14. Tiede A, Sachs UJ, Czwalinna A, Werwitzke S, Bikker R, Krauss JK, et al. Prothrombotic immune thrombocytopenia after COVID-19 vaccination. Blood. 2021 Jul 29. 138 (4):350-353. [QxMD MEDLINE Link]. [Full Text].

15. [Guideline] Neunert C, Lim W, Crowther M, Cohen A, Solberg L Jr, Crowther MA. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood. 2011 Apr 21. 117(16):4190-207. [QxMD MEDLINE Link]. [Full Text].

16. Lambert MP, Gernsheimer TB. Clinical updates in adult immune thrombocytopenia. Blood. 2017 May 25. 129 (21):2829-2835. [QxMD MEDLINE Link].

17. [Guideline] Neunert C, Terrell DR, Arnold DM, Buchanan G, Cines DB, Cooper N, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019 Dec 10. 3 (23):3829-3866. [QxMD MEDLINE Link]. [Full Text].

18. Provan D, Stasi R, Newland AC, Blanchette VS, Bolton-Maggs P, Bussel JB, et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. 2010 Jan 14. 115 (2):168-86. [QxMD MEDLINE Link]. [Full Text].

19. Provan D, Newland AC. Current Management of Primary Immune Thrombocytopenia. Adv Ther. 2015 Oct. 32 (10):875-87. [QxMD MEDLINE Link]. [Full Text].

20. Schultz CL, Mitra N, Schapira MM, Lambert MP. Influence of the American Society of Hematology guidelines on the management of newly diagnosed childhood immune thrombocytopenia. JAMA Pediatr. 2014 Oct. 168(10):e142214. [QxMD MEDLINE Link].

21. Khellaf M, Charles-Nelson A, Fain O, Terriou L, Viallard JF, Cheze S, et al. Safety and efficacy of rituximab in adult immune thrombocytopenia: results from a prospective registry including 248 patients. Blood. 2014 Nov 20. 124(22):3228-36. [QxMD MEDLINE Link].

22. Deshayes S, Khellaf M, Zarour A, et al. Long-term safety and efficacy of rituximab in 248 adults with immune thrombocytopenia: Results at 5 years from the French prospective registry ITP-ritux. Am J Hematol. 2019 Sep 5. [QxMD MEDLINE Link].

23. Wang J, Li Y, Wang C, Zhang Y, Gao C, Lang H, et al. Efficacy and Safety of the Combination Treatment of Rituximab and Dexamethasone for Adults with Primary Immune Thrombocytopenia (ITP): A Meta-Analysis. Biomed Res Int. 2018. 2018:1316096. [QxMD MEDLINE Link]. [Full Text].

24. Thabet AF, Moeen SM. More about the combination of rituximab, cyclosporine and dexamethasone in the treatment of chronic ITP. A useful option on an environment with limited resources. Platelets. 2019 Oct 11. 1-4. [QxMD MEDLINE Link].

25. Wong RSM, Saleh MN, Khelif A, Salama A, Portella MSO, Burgess P, et al. Safety and efficacy of long-term treatment of chronic/persistent ITP with eltrombopag: final results of the EXTEND study. Blood. 2017 Dec 7. 130 (23):2527-2536. [QxMD MEDLINE Link].

26. Kuter DJ, Newland A, Chong BH, Rodeghiero F, Romero MT, Pabinger I, et al. Romiplostim in adult patients with newly diagnosed or persistent immune thrombocytopenia (ITP) for up to 1 year and in those with chronic ITP for more than 1 year: a subgroup analysis of integrated data from completed romiplostim studies. Br J Haematol. 2019 May. 185 (3):503-513. [QxMD MEDLINE Link]. [Full Text].

27. Kuter DJ, Bussel JB, Lyons RM, Pullarkat V, Gernsheimer TB, Senecal FM, et al. Efficacy of romiplostim in patients with chronic immune thrombocytopenic purpura: a double-blind randomised controlled trial. Lancet. 2008 Feb 2. 371(9610):395-403. [QxMD MEDLINE Link].

28. Williams JA, Boxer LA. Combination therapy for refractory idiopathic thrombocytopenic purpura in adolescents. J Pediatr Hematol Oncol. 2003 Mar. 25(3):232-5. [QxMD MEDLINE Link].

29. Pasa S, Altintas A, Cil T, Danis R, Ayyildiz O. The efficacy of rituximab in patients with splenectomized refractory chronic idiopathic thrombocythopenic purpura. J Thromb Thrombolysis. 2008 Mar 3. [QxMD MEDLINE Link].

Michael A Silverman, MD, FACEP Chairman, Department of Emergency Medicine, Virginia Hospital Center; Instructor of Emergency Medicine, Johns Hopkins University School of Medicine; Chief of Emergency Medicine, Harbor Hospital; Attending Emergency Physician, Harbor Hospital, St Agnes Healthcare, and Johns Hopkins Bayview Medical Center

Michael A Silverman, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jeffrey L Arnold, MD, FACEP Chairman, Department of Emergency Medicine, Santa Clara Valley Medical Center

Jeffrey L Arnold, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Physicians

Disclosure: Nothing to disclose.

Gil Z Shlamovitz, MD, FACEP Professor of Clinical Emergency Medicine, Keck School of Medicine of the University of Southern California; Chief Medical Information Officer, Keck Medicine of USC

Gil Z Shlamovitz, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Edward A Michelson, MD Associate Professor, Program Director, Department of Emergency Medicine, University Hospital Health Systems of Cleveland

Edward A Michelson, MD is a member of the following medical societies: American College of Emergency Physicians, National Association of EMS Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

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