PDSA E-News: November 30, 2014


Research Finds Predictors of Chronic Childhood ITP

blood graphicA recent meta-analysis by researchers in the Netherlands found several predictive factors for development of chronic immune thrombocytopenia (ITP) in children. They reviewed data from 54 studies (1975 to 2013) of children (ages 3 months to 18 years) newly diagnosed with ITP. Clinical predictors of developing chronic ITP included: female gender, absence of previous infections or vaccinations, insidious (gradual without many symptoms) onset of ITP, and higher absence of bleeding. Children older than 11 were more likely to develop the chronic form of ITP. Researchers found platelet counts of 20,000 or higher at presentation and presence of antinuclear antibodies also increased risk for chronic ITP.

Research findings showed patients treated with a combination of methylprednisolone (steroids) and IV immunoglobulin (IVIg) were more likely to develop chronic ITP, while patients treated with just IVIg alone were found less likely to develop the chronic form. The researchers wrote, "The protective effect of IV immunoglobulin is remarkable and needs confirmation in prospective randomized trials, as well as future laboratory studies..."

Reference: Heitink-Pollé KM, Nijsten J, et al. "Meta-analysis identifies predictors of chronic childhood immune thrombocytopenia." Blood, 124 (22) November 20, 2014


Canada Maple Leaf Symbol Picture9Bridging ITP Study

Do you have ITP and need surgery?
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Medications Are Leading Cause of Allergic Deaths in the US

Medications were the leading cause of allergy-related sudden deaths in the US according to analysis of death certificates from 1999-2010 carried out by researchers at Montefiore Medical Center and Albert Einstein College of Medicine of Yeshiva University, in New York City. They found risk of fatal drug-induced allergic reactions was high among older patients and African American patients. A sudden, life-threatening allergic reaction is called anaphylaxis. It can occur rapidly after exposure to an allergen. Until recently data on anaphylactic deaths had not been well understood. One reason: unlike countries like the UK, the US does not maintain a national registry for anaphylaxis deaths.

Researchers analyzed death certificates from the US National Mortality Database. Medication-related anaphylaxis was the most common cause of death (58.8 %). In reports of 2,458 deaths between 1999-2010, of the culprit drugs mentioned, almost half were antibiotics, followed by radiocontrast agents (for diagnostic imaging studies) and chemotherapy drugs. They found a significant increase in fatal drug allergy deaths, from 0.27 per million in 1999-2001 to 0.51 per million in 2008-2010. They hope their findings bring increased awareness of the need for better understanding of allergy-related deaths.

Reference: Jerschow E, Lin, R, et al. "Fatal anaphylaxis in the United States, 1999-2010: Temporal patterns and demographic associations." Journal of Allergy and Clinical Immunology, September 2014.



Cranberries Help the Immune System Fight Colds and Flu

cranberriesHere's good news to help fight off colds and flu this winter season. A randomized, double-blind, placebo study gave cranberry juice or placebo to people during flu season. Researchers assessed the subjects' immune function over 10 weeks. Results showed cranberry juice didn't prevent the subjects from getting colds or flu; however, it did reduce seriousness of the symptoms of infections. Those receiving the cranberry juice reported fewer missed days of work/school. When researchers examined blood samples, they found gamma-delta-T cells developed faster in the cranberry group than in the placebo group. These are the immune cells that are most active in the bowels. Researchers believe the cranberries boost the activity of natural killer (NK) cells, helping the immune system fight colds and flu viruses.

Note: ITP patients with low (below 40,000) platelet counts should be careful of eating many foods with bright red, blue or purple skins (such as blueberries, red grapes, and cranberries) as they can affect the way platelets function, slowing the clotting process. See 'Warnings' on our Web site: http://www.pdsa.org/about-itp/warnings.html Discuss any concerns with your doctor.

Reference: Nantz MP, Rowe CA, Muller C. "Consumption of cranberry polyphenols enhances human γδ-T cell proliferation and reduces the number of symptoms associated with colds and influenza: a randomized, placebo-controlled intervention study." Nutrition Journal. December 13, 2013, 12:161. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3878739/


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