INTRODUCTION Chronic refractory immune thrombocytopenic purpura can be a challenging condition to treat. By definition, the standard first and second line treatments have failed in these patients and modalities such as thrombopoiesis-stimulating agents and more intensive immunosuppressive drugs are therefore used. However, there still remains a subset of patients who continue to be refractory t...

Treatment of autoimmune cytopenias remains unsatisfactory for patients refractory to first-line management. We evaluated the safety and efficacy of low-dose rituximab plus alemtuzumab in patients with steroid-refractory autoimmune hemolytic anemia and immune thrombocytopenic purpura. Nineteen of 21 included patients were assessable for response (11 with immune thrombocytopenic purpura, 8 with a...

The mechanisms of platelet destruction and their sites of sequestration in disease states are poorly understood. Although recent studies have emphasized the importance of platelet isoantibodies in certain clinical situations (1-3), little is known of the effects of antibodies on platelets in vivo. In conditions such as idiopathic thrombocytopenic purpura, there is debate as to whether immune me...

Laparoscopic splenectomy (LS) for immune thrombocytopenic purpura has a success rate of 70-90%. This invasive procedure is sometimes required for patients with refractory thrombocytopenia. However, no data on their outcome are available. If the hematologic response is inadequate, its value vis-à-vis the risk associated with major surgery is open to question. Twelve of 110 patients who underwent...

Although both leukopenia and thrombocytopenia are not uncommon hematological findings among patients with novel 2009 H1N1 influenza virus infection, immune thrombocytopenic purpura has rarely been shown to be associated with this novel influenza A infection. Here, we describe a previously healthy adolescent who presented with fever, influenza-like symptoms and acute onset of generalized petechi...

In this paper, we describe a patient with immune thrombocytopenic purpura (ITP) secondary to endometriosis. To our knowledge, this is the first reported case presenting such an association. Surgical eradication of the endometriosis was the only effective treatment for the thrombocytopenia. The pathogenic connection between both disorders seems to be an altered immune function.

Spontaneous intracranial haemorrhage (ICH) is a rare complication of chronic immune thrombocytopenic purpura (ITP) in children. We report four patients with cITP who developed ICH. The latency between onset of ITP and ICH varied from 1-8 years. All our patients were profoundly thrombocytopenic (platelet count of <10 x 109/l) at the time of their intracranial bleed. The presenting features and m...