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Treatment of patients with immune thrombocytopenia admitted to the emergency room

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Abstract

Immune thrombocytopenia (ITP) is the most frequent cause of acquired thrombocytopenia. In adult ITP patients, corticosteroids and intravenous immunoglobulin (IVIg) are used as first-line treatment. The aim of the present study was to investigate retrospectively the demographic and etiologic characteristics of patients with ITP admitted to the emergency room at our hospital. Seventy-five adult patients with ITP were included, and demographic data, bleeding characteristics, etiologic features and responses to treatments were evaluated retrospectively. Fifty-six patients (75 %) were female, and the median age was 43 years. Eighteen patients had a history of ITP, whereas in 57, thrombocytopenia was identified for the first time. During admission, the median platelet count was 5 × 109/L. Cutaneous and/or mucosal bleeding was the most common clinical feature. High-dose dexamethasone was administered in 60 episodes, whereas IVIg and conventional-dose methylprednisolone were used in nine and six episodes, respectively. The overall response rate of the entire cohort following first-line treatments was 67 %, and complete remission was achieved in 31 patients, 19 patients achieved partial remission, and 25 patients were non-responders. In cases with life-threatening bleeding, concomitant infection, post-traumatic bleeding and need for emergency surgery, IVIg can be used as the first line of treatment option in addition to platelet transfusions.

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Authors and Affiliations

  1. Division of General Internal Medicine, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey

    Işıl Bavunoğlu, Mahir Cengiz, Serap Yavuzer & Aydın Tunçkale

  2. Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey

    Ahmet Emre Eşkazan, Muhlis Cem Ar, Ayşe Salihoğlu, Şeniz Öngören & Teoman Soysal

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  1. Işıl Bavunoğlu
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  2. Ahmet Emre Eşkazan
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  3. Muhlis Cem Ar
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  4. Mahir Cengiz
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  8. Aydın Tunçkale
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Correspondence to Muhlis Cem Ar.

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Bavunoğlu, I., Eşkazan, A.E., Ar, M.C. et al. Treatment of patients with immune thrombocytopenia admitted to the emergency room. Int J Hematol 104, 216–222 (2016). https://doi.org/10.1007/s12185-016-2003-5

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  • DOI: https://doi.org/10.1007/s12185-016-2003-5

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