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X Feng - One of the best experts on this subject based on the ideXlab platform.
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efficacy and safety of tacrolimus in systemic lupus erythematosus patients with Refractory Thrombocytopenia a retrospective study
Lupus, 2018Co-Authors: X FengAbstract:Objective We evaluated the efficacy and safety of tacrolimus in systemic lupus erythematosus patients with Refractory Thrombocytopenia. Methods We retrospectively reviewed the data for 20 systemic lupus erythematosus patients with Refractory Thrombocytopenia and treated with tacrolimus during the period January 2013 to January 2015. In addition to glucocorticoids, all patients were treated with tacrolimus, 1 mg taken twice daily. The clinical effect of tacrolimus treatment in patients was evaluated by analysis of platelet counts at baseline and after one, three and six months of tacrolimus treatment. Levels of anti-double-stranded DNA antibodies and complement C3, C4 were determined individually. Results After one month of tacrolimus treatment, three patients (15%) did not respond, three patients (15%) achieved a complete response and the other 14 patients (75%) achieved a partial response. After three months of tacrolimus treatment, the platelet counts of all patients were significantly improved. A partial response was seen in 14 patients (75%) and the complete response rate increased to 25% (five patients). After six months, all patients attained partial response or complete response without relapse, and the rate of complete response increased to 75%. Compared to pretreatment, anti-double-stranded DNA antibody levels and the disease activity index score were markedly decreased after tacrolimus treatment. The levels of serum C3 and C4 were increased significantly ( P < 0.05). Conclusions Our survey revealed that a six-month course of tacrolimus is a safe and effective treatment for systemic lupus erythematosus patients with Refractory Thrombocytopenia.
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Efficacy and safety of tacrolimus in systemic lupus erythematosus patients with Refractory Thrombocytopenia: a retrospective study.
Lupus, 2017Co-Authors: X FengAbstract:Objective We evaluated the efficacy and safety of tacrolimus in systemic lupus erythematosus patients with Refractory Thrombocytopenia. Methods We retrospectively reviewed the data for 20 systemic lupus erythematosus patients with Refractory Thrombocytopenia and treated with tacrolimus during the period January 2013 to January 2015. In addition to glucocorticoids, all patients were treated with tacrolimus, 1 mg taken twice daily. The clinical effect of tacrolimus treatment in patients was evaluated by analysis of platelet counts at baseline and after one, three and six months of tacrolimus treatment. Levels of anti-double-stranded DNA antibodies and complement C3, C4 were determined individually. Results After one month of tacrolimus treatment, three patients (15%) did not respond, three patients (15%) achieved a complete response and the other 14 patients (75%) achieved a partial response. After three months of tacrolimus treatment, the platelet counts of all patients were significantly improved. A partial response was seen in 14 patients (75%) and the complete response rate increased to 25% (five patients). After six months, all patients attained partial response or complete response without relapse, and the rate of complete response increased to 75%. Compared to pretreatment, anti-double-stranded DNA antibody levels and the disease activity index score were markedly decreased after tacrolimus treatment. The levels of serum C3 and C4 were increased significantly ( P
Anne L. Angiolillo - One of the best experts on this subject based on the ideXlab platform.
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Long-term treatment of Refractory Thrombocytopenia in a patient with Wiskott-Aldrich syndrome with vincristine, immunoglobulin, and methylprednisolone.
American journal of hematology, 1999Co-Authors: Guy Young, Anne L. AngiolilloAbstract:We report a child with Wiskott-Aldrich syndrome with severe, Refractory, symptomatic Thrombocytopenia who achieved an excellent response to combination therapy with vincristine 1.5 mg/m2 × 1 day, intravenous immunoglobulin 1 g/kg × 3 days, and methylprednisolone 25 mg/kg × 3 days (VIM) for 7 years after failing multiple treatments. He did not have a histocompatible donor for bone marrow transplantation. When the patient ceased to respond to this regimen, he was rescued with pulse dexamethasone. Vincristine, immunoglobulin, and methylprednisolone might serve as a novel treatment option for the patient with Refractory Thrombocytopenia. Our patient had a sustained remission of symptomatic Thrombocytopenia without toxicity. Furthermore, pulse dexamethasone might be an alternative treatment option to which patients with Wiskott-Aldrich syndrome may respond. Am. J. Hematol. 62:183–185, 1999. © 1999 Wiley-Liss, Inc.
Guy Young - One of the best experts on this subject based on the ideXlab platform.
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Long-term treatment of Refractory Thrombocytopenia in a patient with Wiskott-Aldrich syndrome with vincristine, immunoglobulin, and methylprednisolone.
American journal of hematology, 1999Co-Authors: Guy Young, Anne L. AngiolilloAbstract:We report a child with Wiskott-Aldrich syndrome with severe, Refractory, symptomatic Thrombocytopenia who achieved an excellent response to combination therapy with vincristine 1.5 mg/m2 × 1 day, intravenous immunoglobulin 1 g/kg × 3 days, and methylprednisolone 25 mg/kg × 3 days (VIM) for 7 years after failing multiple treatments. He did not have a histocompatible donor for bone marrow transplantation. When the patient ceased to respond to this regimen, he was rescued with pulse dexamethasone. Vincristine, immunoglobulin, and methylprednisolone might serve as a novel treatment option for the patient with Refractory Thrombocytopenia. Our patient had a sustained remission of symptomatic Thrombocytopenia without toxicity. Furthermore, pulse dexamethasone might be an alternative treatment option to which patients with Wiskott-Aldrich syndrome may respond. Am. J. Hematol. 62:183–185, 1999. © 1999 Wiley-Liss, Inc.
Madhu S. Bajaj - One of the best experts on this subject based on the ideXlab platform.
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Fatal tumor thrombosis due to an inferior vena cava leiomyosarcoma in a patient with antiphospholipid antibody syndrome.
Mayo Clinic proceedings, 2002Co-Authors: Joseph Espiritu, Michael H. Creer, Andrew Z. Miklos, Madhu S. BajajAbstract:We describe a patient with antiphospholipid antibody syndrome (APS) who died because of relentless inferior vena cava (IVC) tumor thrombosis due to an unsuspected leiomyosarcoma. Laboratory confirmation for APS was provided by functional identification of a lupus anticoagulant and anticardiolipin IgG and anti-β 2 -glycoprotein I IgM antibodies. Although sensitive for detecting vascular obstruction, radiocontrast venography and magnetic resonance imaging and angiography detected the IVC thrombosis but failed to distinguish its malignant nature. Concomitant Refractory Thrombocytopenia prevented further invasive diagnostic and therapeutic maneuvers for progressive, severe IVC thrombosis unresponsive to aggressive treatment of APS. Deep venous thrombosis Refractory to anticoagulant and immunomodulatory therapies in a patient with APS may be due to a concomitant underlying malignancy, such as a leiomyosarcoma, causing vascular obstruction.
Marcos Roberto De Menezes - One of the best experts on this subject based on the ideXlab platform.
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radiofrequency ablation for treatment of hypersplenism a feasible therapeutic option
World Journal of Gastroenterology, 2015Co-Authors: Guilherme Martins, Joao Paulo G Bernardes, Marcello S Rovella, Raphael G Andrade, Publio Cesar Cavalcante Viana, Paulo Herman, Giovanni Guido Cerri, Marcos Roberto De MenezesAbstract:We present a case of a patient with hypersplenism secondary to portal hypertension due to hepato-splenic schistosomiasis, which was accompanied by severe and Refractory Thrombocytopenia. We performed spleen ablation and measured the total spleen and ablated volumes with contrast-enhanced computed tomography and volumetry. No major complications occurred, Thrombocytopenia was resolved, and platelet levels remained stable, which allowed for early treatment of the patient’s underlying disease. Previous work has shown that splenic radiofrequency ablation is an attractive alternative treatment for hypersplenism induced by liver cirrhosis. We aimed to contribute to the currently sparse literature evaluating the role of radiofrequency ablation (RFA) in the management of hypersplenism. We conclude that splenic RFA appears to be a viable and promising option for the treatment of hypersplenism.