Management of adult idiopathic thrombocytopenic purpura.

Abstract:

:Idiopathic thrombocytopenic purpura (ITP) is a common hematologic disorder manifested by immune-mediated thrombocytopenia. The diagnosis remains one of exclusion, after other thrombocytopenic disorders are ruled out based on history, physical examination, and laboratory evaluation. The goal of treatment is to raise the platelet count into a hemostatically safe range. The disorder is usually chronic, although there is considerable variation in the clinical course and most patients eventually attain safe platelet counts off treatment. However, a subset of patients has severe disease refractory to all treatment modalities, which is associated with considerable morbidity and mortality. This article focuses on the management of primary ITP in adults. We discuss criteria for treatment, the roles of splenectomy and other treatment options along with their side effects, and the management of ITP during pregnancy.

journal_name

Annu Rev Med

authors

Cines DB,McMillan R

doi

10.1146/annurev.med.56.082103.104644

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

425-42

eissn

0066-4219

issn

1545-326X

journal_volume

56

pub_type

杂志文章,评审
  • Management of Rectal Cancer Without Radical Resection.

    abstract::The basis of the current treatment of rectal cancer is a radical total mesorectal excision of the rectum, and although this provides excellent oncological control, it is associated with morbidity and functional problems in cancer survivors. Organ-preservation alternatives are local excision alone for very early tumors...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-062915-021419

    authors: Beets GL,Figueiredo NF,Beets-Tan RG

    更新日期:2017-01-14 00:00:00

  • Basket Studies: Redefining Clinical Trials in the Era of Genome-Driven Oncology.

    abstract::Understanding a tumor's detailed molecular profile has become increasingly necessary to deliver the standard of care for patients with advanced cancer. Innovations in both tumor genomic sequencing technology and the development of drugs that target molecular alterations have fueled recent gains in genome-driven oncolo...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-062016-050343

    authors: Tao JJ,Schram AM,Hyman DM

    更新日期:2018-01-29 00:00:00

  • Sweating and its disorders.

    abstract::Eccrine sweat is produced by millions of miniscule glands buried in the skin. Eccrine sweating from the general body surface is an extremely important function in human thermoregulation; disturbances either in the control of sweating activity or in the glands themselves can result in problems ranging from minor social...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.34.020183.002241

    authors: Quinton PM

    更新日期:1983-01-01 00:00:00

  • Endothelial dysfunction in coronary artery disease.

    abstract::The endothelium is a physical barrier between the blood and vascular smooth muscle, a source of enzymes activating and deactivating cardiovascular hormones and a site of production of relaxing and contracting factors. In addition, the endothelium is a source of growth inhibitors and promoters of vascular smooth muscle...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.44.020193.002143

    authors: Lüscher TF,Tanner FC,Tschudi MR,Noll G

    更新日期:1993-01-01 00:00:00

  • Ketamine and rapid-acting antidepressants: a window into a new neurobiology for mood disorder therapeutics.

    abstract::Ketamine is the prototype for a new generation of glutamate-based antidepressants that rapidly alleviate depression within hours of treatment. Over the past decade, there has been replicated evidence demonstrating the rapid and potent antidepressant effects of ketamine in treatment-resistant depression. Moreover, prec...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-053013-062946

    authors: Abdallah CG,Sanacora G,Duman RS,Krystal JH

    更新日期:2015-01-01 00:00:00

  • Diet and nephrolithiasis.

    abstract::Pharmacologic therapy of recurrent nephrolithiasis continues to be the mainstay of the strategy to prevent recurrence. This approach persists even in the face of increasing evidence of a marked benefit of mere entry into a nonpharmacologic diet and fluid modification protocol at a clinic specializing in the evaluation...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.45.1.235

    authors: Goldfarb S

    更新日期:1994-01-01 00:00:00

  • The challenge of viral reservoirs in HIV-1 infection.

    abstract::A viral reservoir is a cell type or anatomical site in association with which a replication-competent form of the virus accumulates and persists with more stable kinetic properties than the main pool of actively replicating virus. This article reviews several cell types and anatomical sites proposed as potential reser...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.53.082901.104024

    authors: Blankson JN,Persaud D,Siliciano RF

    更新日期:2002-01-01 00:00:00

  • Hepatocellular carcinoma: novel molecular approaches for diagnosis, prognosis, and therapy.

    abstract::The genomic era is changing the understanding of cancer, although translation of the vast amount of data available into decision-making algorithms is far from reality. Molecular profiling of hepatocellular carcinoma (HCC), the most common cause of death among cirrhotic patients and a fast-growing malignancy in Western...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.080608.100623

    authors: Villanueva A,Minguez B,Forner A,Reig M,Llovet JM

    更新日期:2010-01-01 00:00:00

  • Arrhythmogenic Right Ventricular Cardiomyopathy: Progress Toward Personalized Management.

    abstract::Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart disease characterized by fibrofatty replacement of the ventricular myocardium, a high risk of ventricular arrhythmias, and progressive ventricular dysfunction. The clinical course is highly variable, and optimal approaches to management remai...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,meta分析

    doi:10.1146/annurev-med-041217-010932

    authors: James CA,Calkins H

    更新日期:2019-01-27 00:00:00

  • Precision Medicine: Functional Advancements.

    abstract::Precision medicine was conceptualized on the strength of genomic sequence analysis. High-throughput functional metrics have enhanced sequence interpretation and clinical precision. These technologies include metabolomics, magnetic resonance imaging, and I rhythm (cardiac monitoring), among others. These technologies a...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-041316-090905

    authors: Caskey T

    更新日期:2018-01-29 00:00:00

  • Thrombopoietin: understanding and manipulating platelet production.

    abstract::Until recently, platelet production was the least understood aspect of blood cell development. This gap in our understanding resulted from the scarcity of megakaryocytes, the marrow precursor of blood platelets, and from confusion surrounding the cytokines and hormones that support their development. The recent clonin...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.48.1.1

    authors: Kaushansky K

    更新日期:1997-01-01 00:00:00

  • Differential diagnosis and treatment of panic attacks and phobic states.

    abstract::Recent advances in our understanding of and ability to treat panic disorders and various types of phobia have been reviewed. A case of agoraphobia was presented in detail to illustrate clinical issues and serve as a basis for discussing differential diagnosis. The presence or absence of spontaneous panic attacks has c...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.32.020181.003055

    authors: Liebowitz MR,Klein DF

    更新日期:1981-01-01 00:00:00

  • Molecular approaches to amyotrophic lateral sclerosis.

    abstract::New discoveries are expanding our knowledge of mechanisms involved in amyotrophic lateral sclerosis (ALS) pathogenesis. Some recent advances in our understanding of motoneuron death in familial ALS (fALS) and sporadic ALS (sALS) are reviewed, with emphasis on molecular similarities that may further unite these phenoty...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.46.1.133

    authors: Smith RG,Appel SH

    更新日期:1995-01-01 00:00:00

  • Targeting metabolic changes in cancer: novel therapeutic approaches.

    abstract::Therapeutic strategies designed to target cancer metabolism are an area of intense research. Antimetabolites, first used to treat patients in the early twentieth century, served as an early proof of concept for such therapies. We highlight strategies that attempt to improve on the anti-metabolite approach as well as n...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-092012-112344

    authors: Bobrovnikova-Marjon E,Hurov JB

    更新日期:2014-01-01 00:00:00

  • Hereditary distal renal tubular acidosis: new understandings.

    abstract::The primary or hereditary form of distal renal tubular acidosis (dRTA), although rare, has received increased attention recently because of dramatic advances in the understanding of its genetic basis. The final regulation of renal acid excretion is effected by various acid/base transporters localized in specialized ce...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.52.1.471

    authors: Batlle D,Ghanekar H,Jain S,Mitra A

    更新日期:2001-01-01 00:00:00

  • The biology of the eosinophilic leukocyte.

    abstract::The eosinophil is characterized by specific cytoplasmic granules that contain a series of cationic toxins able to kill many targets, including helminths, protozoa, bacteria, and other cells. In bronchial asthma, considerable evidence exists that the eosinophil releases granule proteins, especially the major basic prot...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.44.020193.000505

    authors: Gleich GJ,Adolphson CR,Leiferman KM

    更新日期:1993-01-01 00:00:00

  • Genetic testing in clinical practice.

    abstract::In the practice of internal medicine, the value of genetic testing in common (mono)genetic diseases such as familial hemochromatosis, hypercholesterolemia, Mediterranean fever, and thrombophilia is limited. The genotype insufficiently predicts the phenotype because of the powerful effects of other modifying genes, env...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.60.103007.132540

    authors: Lamberts SW,Uitterlinden AG

    更新日期:2009-01-01 00:00:00

  • Neurocysticercosis: updates on epidemiology, pathogenesis, diagnosis, and management.

    abstract::Neurocysticercosis is now recognized as a common cause of neurologic disease in developing countries and the United States. The pathogenesis and clinical manifestations vary with the site of infection and accompanying host response. Inactive infection should be treated symptomatically. Active parenchymal infection res...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.51.1.187

    authors: White AC Jr

    更新日期:2000-01-01 00:00:00

  • Imaging of atherosclerosis.

    abstract::It is now well recognized that the atherosclerotic plaques responsible for thrombus formation are not necessarily those that impinge most on the lumen of the vessel. Nevertheless, clinical investigations for atherosclerosis still focus on quantifying the degree of stenosis caused by plaques. Many of the features assoc...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-041709-133809

    authors: Owen DR,Lindsay AC,Choudhury RP,Fayad ZA

    更新日期:2011-01-01 00:00:00

  • Update on typical and atypical antipsychotic drugs.

    abstract::Antipsychotic drugs (APDs) are best classified as typical or atypical. The distinction is based solely on their ability to cause extrapyramidal side effects (EPS), including tardive dyskinesia (TD). The two classes differ in mechanism of action, with atypical APDs providing important modulation of serotonergic neurotr...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-050911-161504

    authors: Meltzer HY

    更新日期:2013-01-01 00:00:00

  • Nonsurgical treatment of gallstone disease.

    abstract::Gallstones can now be treated nonsurgically as well as surgically. The current view is that only symptomatic gallstones should be treated; of these, only cholesterol gallstones can be treated nonsurgically. Cholesterol gallstones in a functioning gallbladder will dissolve slowly when the secretion of unsaturated bile ...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.41.020190.002153

    authors: Hofmann AF

    更新日期:1990-01-01 00:00:00

  • Cyclosporine treatment of glomerular diseases.

    abstract::Cyclosporine-A is primary therapy for organ transplantation. Its immunosuppressive effect might suggest a therapeutic role in autoimmune diseases, including several idiopathic and secondary glomerular conditions. Various forms of idiopathic nephrotic syndrome, including focal segmental glomerulosclerosis (FSGS), minim...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.50.1.1

    authors: Klein M,Radhakrishnan J,Appel G

    更新日期:1999-01-01 00:00:00

  • Cardiac Pacing and Defibrillation Devices: Cost and Effectiveness.

    abstract::Implantable cardiac pacing and defibrillation devices are effective and commonly used therapies for patients with cardiac rhythm disorders. Because device implantation is not easily reversible, as well as the high healthcare costs inherent in device use, a clear understanding of the clinical benefits relative to costs...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-043015-123540

    authors: Groeneveld PW,Dixit S

    更新日期:2017-01-14 00:00:00

  • Genetic privacy.

    abstract::During the past 10 years, the number of genetic tests performed more than tripled, and public concern about genetic privacy emerged. The majority of states and the U.S. government have passed regulations protecting genetic information. However, research has shown that concerns about genetic privacy are disproportionat...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.med.54.101601.152131

    authors: Sankar P

    更新日期:2003-01-01 00:00:00

  • Lymphatic mapping and sentinel lymph node biopsy in patients with breast cancer.

    abstract::The standard of care for the evaluation of axillary nodal involvement remains complete lymph node dissection. Lymphatic mapping and sentinel lymph node (SLN) biopsy are changing this long-held paradigm; indeed, several leading institutions already reserve complete axillary dissection for patients with metastasis to th...

    journal_title:Annual review of medicine

    pub_type: 杂志文章

    doi:10.1146/annurev.med.51.1.525

    authors: Cox CE,Bass SS,McCann CR,Ku NN,Berman C,Durand K,Bolano M,Wang J,Peltz E,Cox S,Salud C,Reintgen DS,Lyman GH

    更新日期:2000-01-01 00:00:00

  • Significance of diastolic dysfunction of the heart.

    abstract::Diastolic dysfunction is an important cause of the clinical syndrome of congestive heart failure. Traditionally, the syndrome of pulmonary congestion due to the elevation of left heart filling pressure has been attributed to the depressed ability of the heart to eject blood during systole, with a secondary increase in...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.42.020191.002211

    authors: Lorell BH

    更新日期:1991-01-01 00:00:00

  • Thyroid cancer.

    abstract::Thyroid cancer is rapidly increasing in incidence, but the mortality rate remains flat. Debate has arisen over the need to detect or treat most thyroid cancers early, given their favorable natural history. The appropriate extent of surgery for thyroid cancer is also controversial: some researchers advocate partial and...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-061512-105739

    authors: Carling T,Udelsman R

    更新日期:2014-01-01 00:00:00

  • Abbreviated Magnetic Resonance Imaging (MRI) for Breast Cancer Screening: Rationale, Concept, and Transfer to Clinical Practice.

    abstract::Given the increasing understanding of cancer as a heterogeneous group of diseases, detection methods should offer a sensitivity profile that ensures perfect sensitivity for biologically important cancers while screening out self-limiting pseudocancers. However, mammographic screening is biased toward detection of duct...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev-med-121417-100403

    authors: Kuhl CK

    更新日期:2019-01-27 00:00:00

  • IgG subclass deficiencies.

    abstract::IgG subclasses represent distinct immunoglobulin types, each defined by unique primary structures of the constant region of the heavy-chain molecule, and each with characteristic biological and functional properties. New methods and reagents to measure serum concentrations have contributed to the study of the ontogeny...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.38.020187.001545

    authors: Ochs HD,Wedgwood RJ

    更新日期:1987-01-01 00:00:00

  • Cellular action of calcium channel blocking drugs.

    abstract::The calcium antagonists are an exciting "class" of drugs that are already making an important impact in the treatment of coronary artery disease. All three drugs in use in the US, verapamil, nifedipine, and diltiazem, are effective coronary vasodilators. In addition, verapamil and diltiazem have antiarrhythmic activit...

    journal_title:Annual review of medicine

    pub_type: 杂志文章,评审

    doi:10.1146/annurev.me.35.020184.001545

    authors: Schwartz A,Triggle DJ

    更新日期:1984-01-01 00:00:00