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Master Thesis

Thrombopénies immunologiques liées à des anticorps anti-plaquettes méthylprednisolone-dépendants

Abstract : Introduction: drug-induced immune thrombocytopenia is due to anti-platelet antibodies active only on presence of the suspected treatment. They are usually associated with a unique drug. Materiel and methods: between 2009 and 2017, six adult patients with a suspected methylprednisolone (MP)-induced immune thrombocytopenia for which sera where addressed to the Mondor hospital EFS unit were included. Their medical charts were retrospectively reviewed. Drug-induced anti-platelet antibodies were screened by the MAIPA test and identified by an adsorption-elution method. Results: the six patients presented with acute and profound thrombocytopenia occurring after a MP infusion and resolving in a week. MP-induced antiplatelet antibodies were found in the blood of all the six patients. All had been previously exposed to MP without adverse events. Five out of 6 patients had chemotherapy for neoplasia. Three out of the 5 patients had associated thrombocytopenia induced by oxaliplatin or folinic acid anti-platelets antibodies. Adsorption-elution analysis of 2 patients suggested the presence on 2 different drug-induced anti-platelets antibodies (MP and folinic acid or MP and oxaliplatin). Conclusion: we report 6 cases of MP-induced immune thrombocytopenia. Three of them had associated folinic acid or oxaliplatin-induced thrombocytopenia mediated by different drug-induced anti-platelets antibodies.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02279171
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Marie Dubert. Thrombopénies immunologiques liées à des anticorps anti-plaquettes méthylprednisolone-dépendants. Médecine humaine et pathologie. 2018. ⟨dumas-02279171⟩

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