Tatalaksana Purpura Trombostipenik Imun pada Anak

Authors

  • Nicodemus Rumah Sakit Mayapada Jakarta Selatan, Jakarta, Indonesia

DOI:

https://doi.org/10.55175/cdk.v46i9.449

Keywords:

Anak, ITP, Purpuran Trombositopenik Imun, trombositopenia

Abstract

Purpura trombositopenik imun adalah salah satu penyebab trombositopenia tanpa demam pada anak. Istilah immune thrombocytopenia (ITP) telah menggantikan istilah lama purpura trombostitopenik idiopatik. ITP dibagi menjadi tiga, akut (newly diagnosed), persisten, dan kronik. Onset ITP saat usia remaja lebih berisiko menjadi kronik (>12 bulan) dan sering refrakter terhadap pengobatan. Kortikosteroid tetap menjadi pilihan terapi lini pertama. Pada ITP kronik didapatkan defisiensi relatif trombopoietin. Atas dasar inilah, reseptor agonis trombopoietin seperti romipolstim dan eltrombopag dapat digunakan untuk tatalaksana ITP kronik.

Immune thrombocytopenia is one of the cause of thrombocytopenia without fever in children. Terminology immune thrombocytopenia replaces the old terminology idiopathic thrombocytopenic purpura. ITP is classified into three categories, acute (newly diagnosed), persistent, and chronic. Onset at adolescent have greater risk to become chronic (>12 months) and frequently refractory to therapy. Corticosteroid is the first line therapy for ITP. Relative thrombopoietin deficiency is found in chronic ITP; thrombopoietin receptor agonists such as romiplostim and eltrombopag can be used for treatment

Downloads

Download data is not yet available.

References

Frederiksen H, Lund Maegbaek M, Norgaard M. Twenty-year mortality of adult patients with primaryimmune thrombocytopenia: a Danish population-based cohort study. Br J Haematol 2014;166: 260–267.

Terrell DR, Beebe LA, Vesely SK, Neas BR, Segal JB, George JN. The incidence of immune thrombocytopenic purpura in children and adults: a critical review of published reports. Am J Hematol 2010; 85: 174–180.

Weide R, Feiten S, Friesenhahn V, Heymanns J, Kleboth K, Thomalla J, et al. Outpatient management of patients with immune thrombocytopenia (ITP) by hematologists 1995–2014. Oncol Res Treat 2016; 39: 41–44.

Silverman MA. Idiopathic Thrombocytopenic Purpura. Epidemiology 2015.

Kaushansky K. Lineage-specific hematopoietic growth factors. N Engl J Med 2006; 354: 2034-2045.

Kliegman RM, Santon BF, Behrman RE, eds. Nelson Textbook of Pediatrics, 20th ed. Philadelphia: Elsevier Inc; 2016.

Rodeghiero F, Stasi R, Gernsheimer T, Michel M, Provan D, Arnold DM, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura (ITP) of adults and children: report from an international working group. Blood 2009; 113: 2386–2393.

Cines DB, Bussel JB, Liebman HA, Prak ETL. The ITP syndrome: pathogenic and clinical diversity. Blood 2009; 113: 6511–6521

Moulis G, Germain J, Comont T, Brun N, Dingremont C, Castel B, et al. Newly diagnosed immune thrombocytopenia adults: clinical epidemiology, exposure to treatments, and evolution. Results of the CARMEN multicenter prospective cohort. Am J Hematol 2017;92: 493–500.

Matzdorff A, Meyer O, Ostermann H, Kiefel V, Eberl W, Kuhna T, et al. Immune thrombocytopenia-Cuurent diagnostic and therapy: Recommendations of a Joint Working Group of DGHO, OGHO, SGH, GPOH, and DGTI.Oncol Res Treat 2018;4(suppl 5):1-30.

Raj AB.Immune thrombocytopenia: pathogenesis and treatment approaches. J Hematol Transfus 2017;5(1):1056.

Grozovsky R, Begonja AJ, Liu K, Visner G, Hartwig JH, Falet H, et al. The Ashwell-Morell receptor regulates hepatic thrombopoietin production via JAK2-STAT3 signaling. Nat Med 2015; 21: 47–54.

Imbach P, Crowther M. Thrombopoietin-receptor agonists for primary immune thrombocytopenia. N Engl J Med. 2011; 365: 734-741.

Grainger JD, Harrison L, Bolton-Maggs PHB. United Kingdom experience of intracranial bleeds in childhood immune thrombocytopenia. Blood 2016; 128: 1380.

Cuker A, Neunert CE. How I treat refractory immune thrombocytopenia. Blood 2016; 128: 1547-1554.

Mazza P, Minoia C, Melpignano A, Polimeno G, Cascavilla N, Di Renzo N, et al. The use of thrombopoietin-receptor agonists (TPO-RAs) in immune thrombocytopenia (ITP): a “real life” retrospective multicenter experience of the Rete Ematologica Pugliese (REP). Ann Hematol 2016; 95: 239-244.

Yilmaz B, Tokuc AG, Koc A. Successful treatment of two children with refractory immune thrombocytopenic purpura with eltrombopag. Acad J Ped Neonatol 2018;7(1):555758.

Oved JH, Lee CSY, Bussel JB. Treatment of children with persistent and chronic idiopathic thrombocytopenic purpura: 4 infusions of Rituximab and three 4-day cycles of dexamethasone. J Pediatr 2017;191:225-231.

Neunert C, Lim W, Crowther M, Cohen A, Solberg L Jr, Crowther MA, et al. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood 2011; 117: 4190- 4207.

Moulis G, Sailler L, Lapeyre-Mestre M. Severe bleeding events in adults and children with primary immune thrombocytopenia: a systematic review: comment. J Thromb Haemost 2015;13:1521–1522.

Neunert C, Noroozi N, Norman G, Buchanan GR, Goy J, Nazi I, et al. Severe bleeding events in adults and children with primary immune thrombocytopenia: a systematic review. J Thromb Haemost 2015;13: 457–464.

Downloads

Published

02-09-2019

How to Cite

Nicodemus. (2019). Tatalaksana Purpura Trombostipenik Imun pada Anak. Cermin Dunia Kedokteran, 46(9), 592–598. https://doi.org/10.55175/cdk.v46i9.449

Issue

Section

Articles