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Danazol: an effective option in acquired amegakaryocytic thrombocytopaenic purpura.

Mulroy E, Gleeson S, Chiruka S - Case Rep Hematol (2015)

Bottom Line: The optimal treatment of AATP is not clearly defined but revolves around immunosuppressive therapies.We report a case of successful treatment of AATP with danazol, an antioestrogenic medication.We also review the aetiologies and pathogenesis of the disorder and suggest that danazol should be considered as an effective alternative to potent immunosuppression in AATP.

View Article: PubMed Central - PubMed

Affiliation: Department of Haematology, Dunedin Hospital, Great King Street, Dunedin 9016, New Zealand.

ABSTRACT
Acquired amegakaryocytic thrombocytopaenic purpura (AATP) is a rare haematological condition characterised by isolated thrombocytopaenia with normal other cell lines. It is often initially misdiagnosed as immune thrombocytopaenic purpura but has characteristic bone marrow findings of reduced megakaryocyte numbers. The optimal treatment of AATP is not clearly defined but revolves around immunosuppressive therapies. We report a case of successful treatment of AATP with danazol, an antioestrogenic medication. We also review the aetiologies and pathogenesis of the disorder and suggest that danazol should be considered as an effective alternative to potent immunosuppression in AATP.

No MeSH data available.


Related in: MedlinePlus

Haematoxylin and eosin stain of bone marrow trephine showing absence of megakaryocytes (magnification: ×5).
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fig3: Haematoxylin and eosin stain of bone marrow trephine showing absence of megakaryocytes (magnification: ×5).

Mentions: He was initially treated for presumed immune thrombocytopaenic purpura (ITP) with oral prednisone at a dose of 1 mg/kg daily. Due to poor clinical response, intravenous methylprednisolone of 1 g/day for 3 days and intravenous immunoglobulin (0.4 g/kg/day) for 5 days were given. This led to a transient but nonsustained improvement in platelet counts (to a maximum of 132 × 109/L). Bone marrow aspirate and trephine were performed, showing overall bone marrow cellularity of approximately 50%, with reduced megakaryocyte numbers (see Figures 2 and 3). There was no increase in CD34, CD117 positive cells. CD3 and CD20 stains showed no evidence of abnormal lymphoid infiltration. A diagnosis of acquired amegakaryocytic thrombocytopaenic purpura (AATP) was made.


Danazol: an effective option in acquired amegakaryocytic thrombocytopaenic purpura.

Mulroy E, Gleeson S, Chiruka S - Case Rep Hematol (2015)

Haematoxylin and eosin stain of bone marrow trephine showing absence of megakaryocytes (magnification: ×5).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4402186&req=5

fig3: Haematoxylin and eosin stain of bone marrow trephine showing absence of megakaryocytes (magnification: ×5).
Mentions: He was initially treated for presumed immune thrombocytopaenic purpura (ITP) with oral prednisone at a dose of 1 mg/kg daily. Due to poor clinical response, intravenous methylprednisolone of 1 g/day for 3 days and intravenous immunoglobulin (0.4 g/kg/day) for 5 days were given. This led to a transient but nonsustained improvement in platelet counts (to a maximum of 132 × 109/L). Bone marrow aspirate and trephine were performed, showing overall bone marrow cellularity of approximately 50%, with reduced megakaryocyte numbers (see Figures 2 and 3). There was no increase in CD34, CD117 positive cells. CD3 and CD20 stains showed no evidence of abnormal lymphoid infiltration. A diagnosis of acquired amegakaryocytic thrombocytopaenic purpura (AATP) was made.

Bottom Line: The optimal treatment of AATP is not clearly defined but revolves around immunosuppressive therapies.We report a case of successful treatment of AATP with danazol, an antioestrogenic medication.We also review the aetiologies and pathogenesis of the disorder and suggest that danazol should be considered as an effective alternative to potent immunosuppression in AATP.

View Article: PubMed Central - PubMed

Affiliation: Department of Haematology, Dunedin Hospital, Great King Street, Dunedin 9016, New Zealand.

ABSTRACT
Acquired amegakaryocytic thrombocytopaenic purpura (AATP) is a rare haematological condition characterised by isolated thrombocytopaenia with normal other cell lines. It is often initially misdiagnosed as immune thrombocytopaenic purpura but has characteristic bone marrow findings of reduced megakaryocyte numbers. The optimal treatment of AATP is not clearly defined but revolves around immunosuppressive therapies. We report a case of successful treatment of AATP with danazol, an antioestrogenic medication. We also review the aetiologies and pathogenesis of the disorder and suggest that danazol should be considered as an effective alternative to potent immunosuppression in AATP.

No MeSH data available.


Related in: MedlinePlus