4 research outputs found
Rheumatoid Arthritis-Associated Interstitial Lung Disease: Radiologic and Clinical Characteristics
Immunological parameters associated with the severity of COVID-19 pneumonia in kidney transplant recipients
Purpose An outbreak of a novel respiratory disease due to coronavirus species was emerged in 2019 and named as Coronavirus Disease-2019 (COVID-19). Clinical and immunological factors affecting the course of COVID-19 in kidney transplant recipients (KTR) are not well-known. Methods In this prospective observational study, we presented 20 KTR with COVID-19 pnemonia and examined the factors predicting the severity of COVID-19. A total of 10 KTR without COVID-19 was used as control group. Lymphocyte subsets were determined by flow cytometry. In 13/20 patients, immunophenotyping was repeated 1 week later. Results Mean age of the patients was 50 +/- 9 years. Patients were classified as mild-moderate (oxygen saturation: SO2 > 90%) and severe disease groups (SO2 <= 90%). Serum albumin and hemoglobin were lower and CRP, fibrinogen and peak d-dimer were higher in severe group. Peak CRP was inversely associated with nadir SO2 (r = - 0.68, p = 0.001). Neutrophil/lymphocyte ratio was higher in severe group (p = 0.01). CD3 + and CD4 + cells were lower and NK cell percentage (CD16 + 56 +) was higher in severe group. Percentage of spontaneously activated CD8 cells (CD8 + CD69 +) was higher in severe group. In comparison of KTR with and without COVID-19, CD8 + cells were lower but NK cell percentage was higher in KTR with COVID-19. Conclusion In this pilot study, increased NK cells, activated CD8 + cells and decreased CD3 + and CD4 + cells were associated with severity of COVID-19 in KTR. Peripheral immunophenotyping of lymphocyte subtypes may provide prognostic information about the clinical course of COVID-19 in KTR
A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia: A Real-Life Experience
Objective: The aim of the present study was to evaluate the efficacy and safety of eltrombopag, an oral thrombopoietin receptor agonist, in patients with chronic immune thrombocytopenia (ITP)
A Multi-Center Study on the Efficacy of Eltrombopag in Management of Refractory Chronic Immune Thrombocytopenia: A Real-Life Experience
Objective: The aim of the present study was to evaluate the efficacy and
safety of eltrombopag, an oral thrombopoietin receptor agonist, in
patients with chronic immune thrombocytopenia (ITP).
Materials and Methods: A total of 285 chronic ITP patients (187 women,
65.6 \%; 98 men, 34.4\%) followed in 55 centers were enrolled in this
retrospective cohort. Response to treatment was assessed according to
platelet count (/mm(3)) and defined as complete (platelet count of
>100,000/mm(3)), partial (30,000-100,000/mm(3) or doubling of platelet
count after treatment), or unresponsive (<30,000/mm(3)). Clinical
findings, descriptive features, response to treatment, and side effects
were recorded. Correlations between descriptive, clinical, and
hematological parameters were analyzed.
Results: The median age at diagnosis was 43.9 +/- 20.6 (range: 3-95)
years and the duration of follow-up was 18.0 +/- 6.4 (range: 6-28.2)
months. Overall response rate was 86.7\% (n=247). Complete and partial
responses were observed in 182 (63.8\%) and 65 (22.8\%) patients,
respectively. Thirty-eight patients (13.4\%) did not respond to
eltrombopag treatment. For patients above 60 years old (n=68), overall
response rate was 89.7\% (n=61), and for those above 80 years old
(n=12), overall response rate was 83\% (n=10). Considering thrombocyte
count before treatment, eltrombopag significantly increased platelet
count at the 1st, 2nd, 3rd, 4th, and 8th weeks of treatment. As the time
required for partial or complete response increased, response to
treatment was significantly reduced. The time to reach the maximum
platelet levels after treatment was quite variable (1-202 weeks).
Notably, the higher the maximum platelet count after eltrombopag
treatment, the more likely that side effects would occur. The most
common side effects were headache (21.6\%), weakness (13.7\%),
hepatotoxicity (11.8\%), and thrombosis (5.9\%).
Conclusion: Results of the current study imply that eltrombopag is an
effective therapeutic option even in elderly patients with chronic ITP.
However, patients must be closely monitored for response and side
effects during treatment. Since both response and side effects may be
variable throughout the follow-up period, patients should be evaluated
dynamically, especially in terms of thrombotic risk factors