Immune thrombocytopenia and thrombosis. Hematological paradox or clinical reality?

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Abstract

One of the features of primary immune thrombocytopenia is the development of thrombosis in patients, the incidence of which exceeds that in the population. The review provides epidemiological data on thromboembolic events, pathogenetic mechanisms and risk factors for their development, therapeutic tactics in this category of patients. In patients with immune thrombocytopenia, the following factors are important for the development of thromboembolic events: the pathogenetic features of the disease itself (increased functional activity of young platelets, platelet microparticles, antiphospholipid antibodies, activation of complement, an increase in the level of procoagulants, a decrease in the activity of ADAMTS13), the presence of comorbid risk factors for thrombosis, thrombogenic adverse effects of drugs used to treat immune thrombocytopenia. Therapeutic tactics of managing patients with immune thrombocytopenia who develop thromboembolic events consists in correcting the number of platelets (glucocorticoids, intravenous immunoglobulin) and administration of antithrombotic agents, given the clinical situation and the number of platelets.

About the authors

Leonid I. Dvoretsky

Sechenov First Moscow State Medical University (Sechenov University)

Email: dvoretski@mail.ru
д-р мед. наук, проф. каф. Moscow, Russia

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