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[Treatment of chronic immune thrombocytopenic purpura. Looking for something better. Review].
- Source :
-
Investigacion clinica [Invest Clin] 2009 Mar; Vol. 50 (1), pp. 95-108. - Publication Year :
- 2009
-
Abstract
- Chronic Immune Thrombocytopenic Purpura (cITP) has become a field of multiple therapeutic assays. More than 20 types of treatment have been developed to obtain a favorable and prolonged platelet response. The treatment of cITP is oriented to inhibit the antiplatelet antibodies production by interference with the macrophage of the reticulum endothelial system and a blockade of the antigenic response with a decrease in the amplification of the immunological response. Steroids of the glucocorticoids type and splenectomy constitute the first line of treatment. Failure of these treatments leads to the use of second line drugs such as non steroid immuno-supressors and the immunoglobulins type IgG and anti-D. Therapeutic assays with others immunomodulators have been reported. The introduction of new drugs destined to increase the megakaryocytic bone marrow platelet production, has opened a new way to treat the cITP. However, the splenectomy remains as the simplest, safest and most effective treatment in cITP. The principal criteria does not have to be focused on obtaining a normal platelet count, but to reach safe hemostatic levels in absence of hemorrhage, for a prolonged time. On the other hand, despite the persistence of thrombocytopenia, the hematologist can choose to maintain the patient with no treatment and with only a strict clinical observation. It is obvious that the cost-benefit from the different treatments is inclined towards those of lower cost and minimal secondary effects.
- Subjects :
- Adrenal Cortex Hormones therapeutic use
Antigens, Human Platelet immunology
Autoantibodies immunology
Benzoates pharmacology
Benzoates therapeutic use
Blood Platelets immunology
Clinical Trials as Topic
Combined Modality Therapy
Cost-Benefit Analysis
Dapsone therapeutic use
Helicobacter Infections complications
Helicobacter Infections drug therapy
Helicobacter Infections immunology
Helicobacter pylori immunology
Humans
Hydrazines pharmacology
Hydrazines therapeutic use
Immunoglobulins, Intravenous therapeutic use
Immunologic Factors therapeutic use
Immunosuppressive Agents therapeutic use
Models, Immunological
Molecular Mimicry
Purpura, Thrombocytopenic, Idiopathic drug therapy
Purpura, Thrombocytopenic, Idiopathic immunology
Purpura, Thrombocytopenic, Idiopathic physiopathology
Purpura, Thrombocytopenic, Idiopathic surgery
Pyrazoles pharmacology
Pyrazoles therapeutic use
Splenectomy
Thrombopoiesis drug effects
Purpura, Thrombocytopenic, Idiopathic therapy
Subjects
Details
- Language :
- Spanish; Castilian
- ISSN :
- 0535-5133
- Volume :
- 50
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Investigacion clinica
- Publication Type :
- Academic Journal
- Accession number :
- 19418731