Hopp til innhold
NHI.no
Annonse

Primær immun trombocytopeni: Forløp og prognose

Innhold i artikkelen

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 kan ta mange år. Dersom blodplatetallet stadig er under 30, kan det hos noen pasienter være nødvendig med langvarig behandling med medisiner.

Annonse

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.

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Primær immun trombocytopeni . Referanselisten for dette dokumentet vises nedenfor

  1. Gudbrandsdottir S, Frederiksen H, Birgens HS, et al. Nye behandlingsmuligheder ved primær immun trombocytopeni. Ugeskr Læger 2011; 173: 271. Ugeskrift for Læger
  2. Pruemer J. Epidemiology, pathophysiology, and initial management of chronic immune thrombocytopenic purpura. Am J Health Syst Pharm 2009; 66 (2 Suppl 2): S4-S10.
  3. 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
  4. Zeller B, Wormdal OM. Generell veileder i pediatri. Utredning og behandling av kronisk ITP (trombocytopeni). Sist oppdatert 01.01.2017. Siden lest 25.06.2024. www.helsebiblioteket.no
  5. Neunert C, Terrel DR, Arnold DM, et al . American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv 2019; 3: 3829-3866. PMID: 31794604 PubMed
  6. Scully M. Immune thrombocytopenia. BMJ Best Practice. Last reviewed 24.05.2024. Siden lest 24.06.2024. bestpractice.bmj.com
  7. McKenzie CGJ, Freedman LGJ, Semple JW. Cellular immune dysfunction in immune thrombocytopenia (ITP). Br J Haematol 2013; 163: 10-23. pmid:23937260 PubMed
  8. Schultz NH, Sørvoll IH, Michelsen AE, et al. Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination. N Engl J Med 2021. pmid:33835768 PubMed
  9. 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
  10. 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
  11. Xin-Guang Liu, Yu Hou, Ming Hou. How we treat primary immune thrombocytopenia in adults. J Hematol Oncol 2023; 16: 4. pmid:36658588 PubMed
  12. Stabell N, Bechensteen AG, Zeller B, et al. Akutt trombocytopeni. Akuttveileder i pediatri. Sist oppdatert 01.01.2021. Siden lest 21.06.2024 www.helsebiblioteket.no
  13. 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
  14. 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
  15. 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
  16. Iversen PO, Sandset PM. Norsk legemiddelhåndbok, sist endret 07.03.2016. legemiddelhandboka.no
  17. Buchanan GR, Adix L. Grading of hemorrhage in children with idiopathic thrombocytopenic purpura. J Pediatr 2002; 141: 683-8. pmid:12410198 PubMed
  18. BlanchetteV, Freedman J, Garvey B. Management of chronic immune thrombocytopenic purpura in children and adults. Semin Hematol 1998; 35: 36-51. PubMed
  19. 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
  20. 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
  21. 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
  22. 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
  23. Waleed Ghanima, Pål André Holme, Geir E. Tjønnfjord. Immune thrombocytopenia--pathophysiology and treatment. Tidsskr Nor Laegeforen 2010; 130: 2120-3. pmid:21052113 PubMed
  24. 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
  25. 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
Annonse
Annonse