Homologous In-Radiolabeled Platelet Survival and Sequestration Exploration for Refractory Immunologic Thrombocytopenic purpura in Children: A Strategy to Avoid Unnecessary Splenectomy

Autor: Julien Dubois PharmD, Florentin Kucharczak PhD, Léa De Neef PharmD, Virginie Kouyoumdjian PharmD, Gilles Palenzuela MD, Virginie Tunez MD, Denis Mariano-Goulart MD, PhD, Aurélie Bourdon MD, Tom Paunet MD
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Molecular Imaging, Vol 23 (2024)
Druh dokumentu: article
ISSN: 1536-0121
15353508
DOI: 10.1177/15353508241293961
Popis: Immunologic thrombocytopenic purpura (ITP) is a condition that affects four to 18 per 100 000 children every year. In most cases, spontaneous remission occurs, but splenectomy may be proposed. Exploring the site of platelet sequestration can help to better predict potential poor responders to splenectomy, but 111 In-radiolabeled platelet scintigraphy (IPS) can be difficult to perform in children with very few platelets. A 12-year-old boy suffering from refractory ITP was referred for evaluation of platelet survival and sequestration and consideration of splenectomy. His platelet count consistently remained below 10 000/mm 3 . An exceptional procedure was set up to use homologous platelets to perform the IPS. Splenectomy was ruled out based on the results of 111 In-radiolabeled homologous platelet scintigraphy. The attending pediatrician intensified medical treatments, resulting in a significant improvement in platelet count. This increase in platelet levels allowed for 111 In-radiolabeled autologous platelet scintigraphy, which confirmed the absence of splenic sequestration. This allowed us to reject splenectomy in this child. Homologous IPS could help clinicians to choose splenectomy as a treatment option for ITP in children with a very low platelet count, and its use should be promoted after failed thrombopoietin receptor agonist (TPO-RA) treatment. More systematic studies are needed to confirm the predictive response to splenectomy of homologous IPS.
Databáze: Directory of Open Access Journals
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