| Autor: |
Tărniceriu CC; Department of Morpho-Functional Sciences I, Discipline of Anatomy, 'Grigore T. Popa' University of Medicine and Pharmacy, Universității str 16, 700115 Iasi, Romania.; Hematology Clinic, 'Sf. Spiridon' County Clinical Emergency Hospital, 700111 Iasi, Romania., Hurjui LL; Department of Morpho-Functional Sciences II, Discipline of Physiology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.; Central Clinical Laboratory-Hematology Department, 'Sf. Spiridon' County Clinical Emergency Hospital, 700111 Iasi, Romania., Florea ID; Department of Morpho-Functional Sciences I, Discipline of Imunology, 'Grigore T. Popa' University of Medicine and Pharmacy, Universității str 16, 700115 Iasi, Romania., Hurjui I; Department of Morpho-Functional Sciences II, Discipline of Biophysics, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania., Gradinaru I; Department of Implantology Removable Dentures Technology, 'Grigore T. Popa' University of Medicine and Pharmacy, Universității str 16, 700115 Iasi, Romania., Tanase DM; Department of Internal Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700111 Iasi, Romania., Delianu C; Central Clinical Laboratory-Hematology Department, 'Sf. Spiridon' County Clinical Emergency Hospital, 700111 Iasi, Romania.; Department of Biochemistry, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania., Haisan A; Surgery Department, 'Grigore T. Popa' University of Medicine and Pharmacy, Universității str 16, 700115 Iasi, Romania.; Emergency Department, 'Sf. Spiridon' Emergency County Hospital, 700111 Iasi, Romania., Lozneanu L; Department of Morpho-Functional Sciences I, Discipline of Histology, 'Grigore T. Popa' University of Medicine and Pharmacy, Universității str 16, 700115 Iasi, Romania.; Department of Pathology, 'Sf. Spiridon' Emergency County Hospital, 700111 Iasi, Romania. |
| Abstrakt: |
Immune thrombocytopenic purpura (ITP) is a blood disorder characterized by a low platelet count of (less than 100 × 10 9 /L). ITP is an organ-specific autoimmune disease in which the platelets and their precursors become targets of a dysfunctional immune system. This interaction leads to a decrease in platelet number and, subsequently, to a bleeding disorder that can become clinically significant with hemorrhages in skin, on the mucous membrane, or even intracranial hemorrhagic events. If ITP was initially considered a hemorrhagic disease, more recent studies suggest that ITP has an increased risk of thrombosis. In this review, we provide current insights into the primary ITP physiopathology and their consequences, with special consideration on hemorrhagic and thrombotic events. The autoimmune response in ITP involves both the innate and adaptive immune systems, comprising both humoral and cell-mediated immune responses. Thrombosis in ITP is related to the pathophysiology of the disease (young hyperactive platelets, platelets microparticles, rebalanced hemostasis, complement activation, endothelial activation, antiphospholipid antibodies, and inhibition of natural anticoagulants), ITP treatment, and other comorbidities that altogether contribute to the occurrence of thrombosis. Physicians need to be vigilant in the early diagnosis of thrombotic events and then institute proper treatment (antiaggregant, anticoagulant) along with ITP-targeted therapy. In this review, we provide current insights into the primary ITP physiopathology and their consequences, with special consideration on hemorrhagic and thrombotic events. The accumulated evidence has identified multiple pathophysiological mechanisms with specific genetic predispositions, particularly associated with environmental conditions. |
