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Refractory case of ulcerative colitis with idiopathic thrombocytopenic purpura successfully treated by Janus kinase inhibitor tofacitinib:A case report

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World Journal of Clinical Cases 2020年第24期8卷 6389-6395页

作者： Yoriaki Komeda Toshiharu Sakurai Arito Hashimoto Tomoyuki Nagai Satoru Hagiwara Masatoshi Kudo Kazuko Sakai Kazuto Nishio Yasuyoshi Morita Itaru Matsumura Department of Gastroenterology and Hepatology Kindai University Faculty of MedicineOsaka 589-8511Japan Department of Genome Biology Kindai University Faculty of MedicineOsaka 589-8511Japan Department of Hematology and Rheumatology Kindai University Faculty of MedicineOsaka 589-8511Japan

BACKGROUND Concomitant ulcerative colitis (UC) and idiopathic thrombocytopenic purpura(ITP) is a rare phenomenon. The management of UC with ITP can be challenging,since a decreased platelet count augments *** SUMMARY A 24-year-old man with UC and steroid-resistant ITP experienced UC *** continuous infusion of cyclosporine was initiated, UC did not *** administration of tofacitinib subsequently led to the induction of *** patient has maintained remission of UC and ITP for over one year ontofacitinib treatment. Whole transcriptomic sequencing was performed forinflamed rectal mucosae obtained before and after the initiation of Janus kinase(JAK) inhibitor, suggesting that distinct molecular signatures seemed to beregulated by JAK inhibitors and other conventional therapies including tumornecrosis factor *** Tofacitinib should be considered in refractory cases of UC with ITP.

关键词： Ulcerative colitis idiopathic thrombocytopenic purpura Tofacitinib Whole transcriptome analysis Case report Predictive biomarker

idiopathic thrombocytopenic purpura pluripara with twin gestation:case report and review of the literature

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Idiopathic thrombocytopenic purpura pluripara with twin gest...

Association of primary biliary cirrhosis with idiopathic thrombocytopenic purpura

2015年泛长三角围产医学学术年会暨浙江省围产医学学术年会

作者： Wei-Xiu Zhao Jian-Hua Lin Department of Obstetrics and Gynecology Ren Ji HospitalSchool of MedicineShanghai Jiao Tong University Department of Obstetrics and Gynecology Ren Ji HospitalSchool of Medicine

Purpose To present a pluripara with idiopathic thrombocytopenic purpura(ITP)who carried twin gestation and to review the pertinent *** We report a 33-year-old pluripara with previously diagnosed ITP giving birth to preterm *** had a twelve-year history of documented ITP with a platelet count of 60*109/L before *** first pregnancy was uneventful during which the platelet count was maitained at 60*109/*** twin pregnancy was complicated by recurrent very low platelets and ended in preterm *** case is reported in *** also review the *** A PubMed search with the key words idiopathic thrombocytopenic purpura,pluripara,twin gestation,showed no case on *** with the key words idiopathic thrombocytopenic purpura,twin gestation,4 cases were mentioned among which only one was described in detail in a case *** Particular attention should be paid to the ITP women with twin pregnancy,regardless of pluripara who have experienced uneventful pregnancy.

关键词： idiopathic thrombocytopenic purpura pluripara twin gestation

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World Journal of Gastroenterology 2008年第15期14卷 2451-2453页

作者： Nobuyuki Toshikuni Ryumei Yamato Haruhiko Kobashi Ken Nishino Nobu Inada Ritsuko Sakanoue Mitsuhiko Suehiro Yoshinori Fujimura Gotaro Yamada Department of Internal Medicine Center for Liver Diseases Kawasaki Hospital Kawasaki Medical School Okayama 7008505 Japan Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama 7008558 Japan

Although both primary biliary cirrhosis (PBC) and idiopathic thrombocytopenic purpura (ITP) are autoimmune diseases, the association of the 2 diseases is rare. Here, we report a case of ITP that developed during the follow-up of PBC in a 74-year- old man. The patient had been diagnosed with PBC 12 years previously, and had received treatment with ursodeoxycholic acid. The platelet count decreased from approximately 60 × 109/L to 8 × 109/L, and the association of decompensated liver cirrhosis (PBC) with ITP was diagnosed. Steroid and immune gamma globulin therapy were successful in increasing the platelet count. Interestingly, human leukocyte antigen genotyping detected the alleles DQB10601 and DRB10803, which are related to both PBC and ITP in Japanese patients. This case suggests common immunogenetic factors might be involved in the development of PBC and ITP.

关键词： Primary biliary cirrhosis idiopathic thrombocytopenic purpura Anti-platelet autoantibody Platelet surface glycoprotein complex Human leukocyteantigen

Mycophenolate mofetil as a treatment for refractory idiopathic thrombocytopenic purpura

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Acta Pharmacologica Sinica 2005年第5期26卷 598-602页

作者： Wang-gang ZHANG~2,Lei JI,Xing-mei CAO,Yin-xia CHEN,Ai-li HE,Jie LIU,Wan-hong ZHAO,San-peng ZOU~2Department of Hematology,the 2nd Hospital of Xi’an Jiaotong University Xi’an 710004,China DepartmentofHematology the2ndHospitalofXi'anJiaotongUniversityXi'an710004China

Aim:To determine whether mycophenolate mofetil(MMF)has beneficial effectson refractory idiopathic thrombocytopenic purpura(ITP)and the correspondingcellular ***:Twenty refractory ITP patients resistant to corti-costeroid and/or splenectomy and chemical therapy were given MMF 1.5-2.0g/dorally for a 2 to 4-month *** immunoglobulin was detected by ***-associated antibodies(PAIgG)were assayed by enzyme-linked immunosorbant *** immunophenotypic analysis was performed ona flow cytometer and cell apoptosis was detected with transferase mediated dUTPbiotin nick end labeling(TUNEL)***:Sixteen of the 20(80%)pa-tients had responses to MMF treatment;9(45%) achieved a complete response,4(20%)achieved a partial response,and 3(15%)achieved a minor *** effects were found to be better in male patients than female *** number of CD3~+ peripheral blood cells(PBCs)and CD4~+ PBCs increased andthe number of CD8~+ PBCs *** plasma level of IgG,IgM,IgA andplatelet associated IgG(PAIgG)decreased in 86% of the *** assayshowed that mycophenolate acid(MPA)0.1 mmol/L induced apoptosis of periph-eral blood mononuclear cells isolated from refractory ITP *** apoptosisrate was increased in male patients after treatment with MPA,but was unchangedin female ***:Therapy for a period of 8 to 16 weeks with median-dose of MMF was valuable for the treatment of refractory ITP.

关键词： mycophenolate acid idiopathic thrombocytopenic purpura male female apoptosis

Therapeutic Uses of Lycium barbarum Polysaccharides on idiopathic thrombocytopenic purpura Mice via Inhibition of Oxidative Stress

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Journal of Biosciences and Medicines 2016年第8期4卷 17-23页

作者： Chengqiang Jin Haixin Dong Jianwei Zhou Shuhua Lu Xiaxia Yang Zhenwen Qian Yanxia Jia Analytical Section of Attached Hospital of Jining Medical College Jining China Radiology Department of Jining No. 1 People’s Hospital Jining China

The aim of the present study was to investigate the effect of Lycium barbarum polysaccharides (LBP) on the treatment of ITP mice and to explore its mechanism. Forty idiopathic thrombocytopenic purpura (ITP) mice were divided randomly into a model control group and LBP groups I, II, III and IV. ITP mice in LBP groups I, II, III, and IV were administered LBP at four different doses (50, 100, 200 and 400 mg·kg-1·d-1, respectively) for 7 days by gavage. Blood samples were collected from the tail veins of the mice after treatment. Platelet counts were determined, and the total antioxidant status (TAS), total oxidant status (TOS) were measured with ELISA kits. The platelet count was (30.28 ± 13.42) × 109/L in the model control group, and the number of platelets in all LBP groups was higher than that in the model control group. The platelet count increased, and it reached (67.09 ± 10.81) × 109/L in LBP group I;the platelet counts in the other three groups increased significantly compared to LBP group I, and they did not differ significantly. TAS concentrations in the LBP groups were significantly increased compared to the model control group, whereas TOS concentrations were significantly decreased. Taken together, these results indicate that LBP is effective at increasing the number of platelet (PLT), and LBP may treat ITP mice via suppressing oxidative stress.

关键词： Lycium barbarum Polysaccharides idiopathic thrombocytopenic purpura Total Antioxidant Status Total Oxidant Status

Treatment of 37 Patients with Refractory idiopathic thrombocytopenic purpura by Shengxueling (升血灵)

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Chinese Journal of Integrative Medicine 2007年第1期13卷 33-36页

作者：邵科钉周郁鸿沈一平叶宝东高瑞兰张宇 Department of Hematology the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine

Objective： To explore the clinical effect and possible mechanism of Shengxueling （升血灵, SXL）, a Chinese medical preparation mainly consisting of ginseng saponins, in treating refractory idiopathic thrombocytopenic purpura （ITP）. Methods： The selected 69 patients with ITP were randomly assigned to two groups, the 37 patients in the treated group were treated orally by SXL with the dose for adult as 60 mg twice a day for two weeks. Then when no marked rise of platelet count after that, the dose would be doubled and administered for another two weeks. Then the dose could be gradually reduced to the initiative level in patients who responded to the treatment, and if they did not, the treatment was regarded as ineffective and be terminated. The 32 patients in the control group were treated with ampeptide elemente instead of SXL, 0.4 g each time three times a day in the first two weeks, and, if that was ineffective, 0.2 g would be added each time and 1.8 g would be administered a day for two more weeks. Four weeks＇ treatment was regarded as one therapeutic course for both groups and the observation lasted for two successive courses in patients showing positive reslbonse. Results： In the 37 patients in the treated group, markedly effective was obtained in 7 （19.0%）, favorably effective in 15 （40.5%）, improved in 5 （13.5%） and ineffective in 10 （27.0%）, the total effective rate being 59.5%. The corresponding number in the 32 patients in the control group was 4 （12.5%）, 6 （18.8%）, 3 （9.4%）, 19 （59.4%） and 31.3% respectively. Comparison showed the difference in therapeutic efficacy between the two groups was significant （P〈0.05）. Conclusion： SXL is a safe and effective preparation for treatment of ITP, showing an immediate effect which is obviously superior to that of ampeptide elemente with less adverse effect.

关键词： idiopathic thrombocytopenic purpura refractability ginseng saponins

Clinical Study on the Effect of Shengxueling (生血灵) on idiopathic thrombocytopenic purpura

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Chinese Journal of Integrated Traditional and Western Medicine 2005年第1期11卷 60-64页

作者：周永明黄振翘胡明辉周韶虹黄韬许毅陆嘉惠甘晓芳朱文伟 Yueyang Hospital of Integrated Traditional and Western Medicine Shanghai University of TCM Shanghai (200437)

Objective:To observe the clinical effect of Shengxueling (生血灵, SXL) on idiopathic thrombocytopenic purpura (ITP), and study the possible ***: Eighty-six cases of ITP were randomly divided into two groups. The SXL group, 56 patients treated with SXL, a traditinal Chinese medicine and 30 patients administered with prednisone were taken as control. Each group took drugs for 3 months and was under follow-up ***: In the SXL group, the total effective rate was 85.71%, similar to prednisone 83.33%( P >0.05) for 3 months, but the total effective rate of SXL (91.07%) were obviously better than that of the control group (53.33%) ( P <0.01) for 6 months and had no obvious adverse reaction. The patients bleeding was alleviated or stopped, the general condition was improved. At the same time, blood platelet count (PLT) was increased, platelet associated immunoglobulin (PAIg) and interleukin-4 (IL-4) were markedly dropped, the level of natural killers cells activity (NKa) increased, the rate of T lymphocyte subsets gradually returned to normal level. Megakaryocyte tended to maturation on bone marrow smear after treatment. All differences above were statistically ***: SXL is an effective and safe medicine for ITP. Its mechanism could regulate cytoimmune, inhibit platelet antibody to reduce the destruction of platelet, increase the number of platelet, promote the division and maturation of megakaryocyte, facilitate the production and release of platelet, lower the fragility of capillary, prevent and cure hemorrhagic tendency.

关键词： Shengxueling idiopathic thrombocytopenic purpura traditional Chinese medicine therapy

Helicobacter pylori infection in Mongolian gerbils does not initiate hematological diseases

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World Journal of Gastroenterology 2014年第34期20卷 12308-12312页

作者： Chuan Xie Li-Yao Xu Wei Li Zhen Yang Nong-Hua Lu Department of Gastroenterology the First Affiliated Hospital of Nanchang University

AIM: To investigate whether Helicobacter pylori (H. pylori) infection contributes to idiopathic thrombocytopenic purpura (ITP) or iron-deficiency anemia (IDA) onset in gerbils.

关键词： Helicobacter pylori Extragastric diseases idiopathic thrombocytopenic purpura Iron-deficiency anemia Chronic inflammation

DETERMINATION OF SERUM SOLUBLE MACROPHAGE COLONY-STIMULATING FACTOR RECEPTOR LEVELS IN PATIENTS WITH HEMATOLOGICAL DISEASES

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Chinese Journal of Cancer Research 2001年第3期13卷 185-189页

作者：饶青韩敬淑沙晓津杨仁池耿以琪郑国光吴克复 Institute of Hematology & Blood Diseases Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin

Objective: To investigate the serum levels of soluble macrophage colony-stimulating factor receptor (M-CSFsR) in normal subjects and patients with hematological diseases and its clinical implications in hematological diseases. Methods: The concentration of M-CSFsR was determined by ELISA. The serum M-CSFsR was identified and characterized by immunoprecipitation and Western blotting. Results: The mean serum level of M-CSFsR of 123 normal individuals was 0.48 ng/ml ± 0.41 ng/ml. Immunoprecipitation and Western blotting assay revealed a ～ 90kD band of serum M-CSFsR. The mean serum M-CSFsR level of 60 patients with acute lymphoblastic leukemia (ALL), 36 patients with acute myeloblastic leukemia (AML), 13 patients with myelodysplastic syndrome (MDS) and 42 patients with aplastic anemia (AA) .were 0.22 ng/ml±0.23 ng/ml, 0.17 ng/ml±0.16 ng/ml, 0.19 ng/ml±0.16 ng/ml and 0.23 ng/ml±0.21 ng/ml, respectively, which were significantly lower than that of normal subjects (P=0.002 ,Pidiopathic thrombocytopenic purpura (ITP) patients was significantly higher than that of normal subjects (2.05 ng/ml±2.75 ng/ml,P<0.0001). Conclusion: The serum M-CSFsR levels of patients with ALL, AML, MDS and AA were significantly lower, while the level of patients with ITP was significantly higher than that of normal individuals. Patients with severe ITP (platelet count<30×l09/L) had the highest M-CSFsR level. It suggested that the abnormal levels of serum M-CSFsR may associate with some hematological diseases and may contribute to the pathological process.

关键词： Macrophage colony-stimulating factor Receptor Enzyme linked immunosorbent assay Immunoprecipitation Western blotting Leukemia idiopathic thrombocytopenic purpura