Primær immun trombocytopeni: Forløp og prognose
Sykdommen er i all hovedsak godartet og kortvarig. Også ved den kroniske formen kan spontan bedring forekomme. Men dette gjelder bare en andel, og det tar ofte mange år. Dersom blodplatetallet stadig er under 30, kan det hos noen pasienter være nødvendig med langvarig behandling med medisiner.
Pasienter som får fjernet milten, må vaksineres mot pneumokokk-bakterien ca. hvert hvert 5. år, og de bør også vaksineres mot hemophilus influenza (Hib-vaksine) og mot meningokokker. Infeksjonsforsvaret mot denne typen bakterier er svekket når milten er fjernet. Ved feber er det viktig å raskt søke lege fordi det ofte vil være aktuelt å behandle febersykdommer med antibotika.
Dette dokumentet er basert på det profesjonelle dokumentet Primær immun trombocytopeni . Referanselisten for dette dokumentet vises nedenfor
- Gudbrandsdottir S, Frederiksen H, Birgens HS, et al. Nye behandlingsmuligheder ved primær immun trombocytopeni. Ugeskr Læger 2011; 173: 271. Ugeskrift for Læger
- Pruemer J. Epidemiology, pathophysiology, and initial management of chronic immune thrombocytopenic purpura. Am J Health Syst Pharm 2009; 66 (2 Suppl 2): S4-S10.
- Christiansen CF, Bahmanyar S, Ghanima W et al. Chronic immune thrombocytopenia in Denmark, Sweden and Norway: The Nordic Country Patient Registry for Romiplostim. EClinicalMedicine 2019. epub. doi:https://doi.org/10.1016/j.eclinm.2019.07.015
- Provan D, Stasi R, Newland AC, et al. International concensus report on the investigation and management of primary immune thrombocytopenia. Blood 2010; 115: 168-86. Blood
- Neunert C, Terrel DR, Arnold DM, et al . American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv 2019; 3: 3829-66. doi:10.1182/bloodadvances.2019000966 DOI
- Schultz NH, Sørvoll IH, Michelsen AE, et al. Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination. N Engl J Med 2021. pmid:33835768 PubMed
- Rodeghiero F, Stasi R, Gernsheimer T, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood 2009; 113: 2386-93. Blood
- Bach Treppendahl M, Juul Nielsen O. Idiopatisk trombocytopenisk purpura. Ugeskr Læger 2004; 166: 3393-7. PubMed
- Tarantino MD, Bussel JB, Blanchette VS, et al. Romiplostim in children with immune thrombocytopenia: a phase 3, randomised, double-blind, placebo-controlled study. Lancet 2016; 388: 45-54. doi:10.1016/S0140-6736(16)00279-8 DOI
- Grainger JD, Locatelli F, Chgotsampancharoen T, et al. Eltrombopag for children with chronic immune thrombocytopenia (PETIT2): A randomised, multicentre, placebo-controlled trial. Lancet 2015. DOI: 10.1016/S0140-6736(15)61107-2 DOI
- Chugh S, Darvish-Kazem S, Lim W, et al. Rituximab plus standard of care for treatment of primary immune thrombocytopenia: a systematic review and meta-analysis. Lancet Hematology 2015; 2: e71-e85. doi:10.1016/S2352-3026(15)00003-4 DOI
- Iversen PO, Sandset PM. Norsk legemiddelhåndbok, sist endret 07.03.2016. legemiddelhandboka.no
- Buchanan GR, Adix L. Grading of hemorrhage in children with idiopathic thrombocytopenic purpura. J Pediatr 2002; 141: 683-8. pmid:12410198 PubMed
- Wei Y, Ji X, Wang Y, et al. High-dose dexamethasone vs prednisone for treatment of adult immune thrombocytopenia: a prospective multicenter randomized trial. Blood 2016. doi:10.1182/blood-2015-07-659656 DOI
- BlanchetteV, Freedman J, Garvey B. Management of chronic immune thrombocytopenic purpura in children and adults. Semin Hematol 1998; 35: 36-51. PubMed
- Vianelli N, Galli M, de VA, Intermesoli T et al. Efficacy and safety of splenectomy in immune thrombocytopenic purpura: long-term results of 402 cases. Haematologica 2005; 90: 72-7. PubMed
- Kojouri K, Vesely SK, Terrell DR, George JN. Splenectomy for adult patients with idiopathic thrombocytopenic purpura: a systematic review to assess long-term platelet count responses, prediction of response, and surgical complications.. Blood 2004; 104: 2623-34. pmid:15217831 PubMed
- Bussel JB, Cheng G, Saleh MN, et al. Eltrombopag for the treatment of chronic idiopathic thrombocytopenic purpura. N Engl J Med 2007; 357: 2237-47. New England Journal of Medicine
- Bussel JB, Provan D, Shamsi T, et al. Effect of eltrombopag on platelets count and bleeding during treatment of chronic idiopathic thrombocytopenic purpura: a randomised, double-blind, placebo-controlled trial. Lancet 2009; 373: 641-8. PubMed
- Wong RSM, Saleh MN, Khelif A et al. Safety and efficacy of long-term treatment of chronic/persistent ITP with eltrombopag: final results of the EXTEND study. Blood 2017; 130: 2527-36. pmid:29042367 PubMed
- Kuiter DJ, Rummel M, Boccia R. Romiplostin or standard of care in patients with immune thrombocytopenia. N Engl J Med 2010; 363: 1959-61. New England Journal of Medicine
- Arnold DM1, Dentali F, Crowther MA et al.. Systematic review: efficacy and safety of rituximab for adults with idiopathic thrombocytopenic purpura. Ann Intern Med 2007; 146: 25-33. pmid:17200219 PubMed
- Waleed Ghanima, Pål André Holme, Geir E. Tjønnfjord. Immune thrombocytopenia--pathophysiology and treatment. Tidsskr Nor Laegeforen 2010; 130: 2120-3. pmid:21052113 PubMed
- Bell WR Jr. Long-term outcome of splenectomy for idiopathic thrombocytopenic purpura. Semin Hematol 2000; 37: 22-5. PubMed
- Bach Treppendahl M, Juul Nielsen O . Kronisk idiopatisk trombocytopenisk purpura. Ugeskr Læger 2004; 166: 3389-93. PubMed
- Portielje JEA, Westendrop RGJ, Kluin-Nelemans HC et al. Morbidity and mortality in adults with idiopathic thrombocytopenic purpura. Blood 2001; 97: 2549-54. Blood