Talk:Immune thrombocytopenic purpura

message: Wikipedia is not the place to look for help with idiopathic thrombocytopenic purpura or any other medical condition.  This article has been written only to be a source of information, and posting questions such as seen below regarding ITP is inappropriate.  Most of those who have edited this article are not medical professionals and therefore are not qualified to suggest anything related to treating ITP, other than to recommend you seek professional help.  If you or a loved one has been diagnosed with ITP, you need to see a hematologist or similarly qualified medical professional for answers and recommended courses of treatment.
Some of the editors of this article have been diagnosed with ITP, putting them in a position to contribute some knowledge to this article.  At least one of them is an elderly male patient who is chronic and refractory, and whose case, due to its rarity, has undergone extensive clinical analysis, as well as treatment.  Since being diagnosed, this individual has engaged in extensive research about ITP and the efforts underway to develop treatments, both for personal benefit and to contribute more knowledge about ITP.  He is, however, not a medical professional and will not answer questions regarding treatment courses or long-term prognosis.
A suggested resource on the Internet for ITP patients is the Platelet Disorder Support Association (http://www.pdsa.org).  Be aware, however, that some PDSA netizens advocate the use of herbs, Chinese medicine and other non-scientific methods of treatment to attempt to "cure" ITP.  There is currently no cure for chronic ITP, and no scientific evidence that any of these alternative methods will affect ITP in a positive way.  In some cases, the use of such methods may interact in unpredictable ways with drugs being administered to treat ITP, possibly posing a health risk over and above ITP itself.  Caveat emptor! — Preceding unsigned comment added by  (talk • contribs) 
:We can only rely on published high-quality sources, not original research. JFW | T@lk 07:29, 8 July 2013 (UTC)
thread_title: This is not a medical advice forum

message: Low platelet count is very common in people with aids, can we reference it ? http://www.thebody.com/Forums/AIDS/Cancer/Archive/chemo/Q16511.html
: HIV is now mentioned.  Andrew73 12:05, 16 October 2005 (UTC)
thread_title: AIDS

message: I believe that the page has incorrect units for platelet count. They are usually given in microliters (uL), not milliliters (mL). Your counts used in examples would be correct for uL and you use mm^3 in a comment which is equivalent to uL.
: So wait, is 10,000 per uL the same as 30,000 per cu/ml? --LycanFury09 16:51, 27 October 2006 (UTC)
replies: text: I'm not sure what you mean by "cu/ml", but a uL (microlitre) and mm^3 (cubic millimetre) are the same.  Thus 10,000 platelets/uL = 10,000 platelets/mm^3.  -- Coneslayer 17:29, 27 October 2006 (UTC)
thread_title: Units

message: I believe the statement that says antibodies are detected in a minority of pts may be incorrect.  In Robbin's Pathology, 7th ed. (p. 651) it states, "Antibodies reactive with these membrane glycoproteins can be demonstrated in the plasma as well as bound to the platelet surface (platelet-associated immunoglobulins) in approximately 80% of patients."--Jfurr1981 05:58, 13 October 2005 (UTC)
replies: text: Perhaps the distinction refers to clinical use of platelet antibody assays.  The performance of these tests needs some improvement before they can be routinely used.  See also the recent Blood review article .  Andrew73 12:05, 16 October 2005 (UTC)

text: You're correct. In the UK they are expressed as billion per litre (109/L). The normal range is usually 150-450. JFW | T@lk 21:24, 6 December 2005 (UTC)
thread_title: Antibodies

message: I had a severe, but acute, case of ITP.  It started with huge blood blisters inside my cheeks and on my tongue, immediately after starting a sulfa-based antibiotic prescribed for a urinary infection.  The hematologist dismissed that as a possible trigger, but I recently learned that sulfa-based drugs are known to trigger autoimmune responses, such as lupus.  I say dismiss it at your peril.  Nobody will ever put a sulfa drug in this body again.  --Bob K 21:26, 4 February 2006 (UTC)
thread_title:  Trigger mechanism 

message: Added a bit on Dapsone.  It's really helping my child!  Given the generally minor side effects, I'd encourage everyone with long-term ITP to consider it.  One pill a day from home.... Hobit (talk) 05:26, 16 December 2007 (UTC)
thread_title:  Dapsone 

message: describes an 11-point score to assess severity of bleeding in ITP. JFW | T@lk 22:50, 23 June 2007 (UTC)
thread_title:  Score 

message: I'm not sure what this page is but I'm hoping it's one where I may get some urgently needed answers. I have had ITP for 2 years and now have been diagnosed with a disease called Erythema Nodosum. My doctor is very upset that he can't find what has caused it and how to treat it it. So far I am just getting sent home after short hospital stays with a load of pain meds.  I may be the first known case of ITP with E N  and it's not going away. Help! Anyone? 71.61.253.91 (talk) 06:11, 8 May 2008 (UTC)
thread_title:  I.T.P with Erythema Nodosum 

message: I relocated the subsection on eltrombopag to the TRA section below romiplostim, since the two agents behave in similar fashion and because eltrombopag was FDA-approved in November, effectively removing it from the "novel agent" classification.
Bigdumbdinosaur (talk) 22:21, 18 December 2008 (UTC)
thread_title: Thrombopoietin Receptor Agonists

message: I modified the treatment subsection on platelet transfusions to remove the following:
 An exception to this rule is when a patient is bleeding profusely, when transfusion of platelets can quickly form a platelet plug to stop bleeding. 
I couldn't find anything in the medical literature to support the above, and a discussion with the hematologist who is treating me for chronic ITP, contradicted the claim that a platelet transfusion will "quickly form a platelet plug."
Bigdumbdinosaur (talk) 07:03, 23 December 2008 (UTC)
thread_title: Platelet Transfusions

message: Is she really notable?  I haven't found much about her on-line and in checking with those who would be inclined to listen to her sort of music, I couldn't find anyone that knew about her.
Bigdumbdinosaur (talk) 05:17, 10 September 2010 (UTC)
thread_title:  Stacy Clark 

message: doi: 10.1111/j.1365-2141.2010.08562.x is a historical review that has just appeared. JFW | T@lk 16:52, 11 April 2011 (UTC)
replies: text: Unfortunately, the article is not publicly accessible.
Bigdumbdinosaur (talk) 05:50, 15 April 2011 (UTC)
thread_title:  History 

message: I've just reverted two good-faith edits that changed the name in the lead from "Idiopathic thrombocytopenic purpura" to "Immune thrombocytopenic purpura". At a quick glance, it looks like there might be some support for the change, but "idiopathic" is used by most of the med sources in the infobox, and ICD-10 actually switched to "idiopatchic" from ICD-9's "immune", so I don't feel this should be done without some discussion. I'm just a WikiGnome here and have no medical knowledge of the condition whatsoever, so I lack any experience to say that either makes more sense in the context of the article. – RobinHood70 talk 16:35, 6 May 2011 (UTC)
replies: text: There are lots of references to both "immune thrombocytopenic purpura" and "idiopathic thrombocytopenic purpura" and the terms are used basically interchangeably.  UpToDate, a fantastic resource geared towards healthcare professionals with several articles written about ITP by hematologists, refers to the disease as  "immune (idiopathic) thrombocytopenic purpura".   Since the disease is caused by IgG autoantibodies, it is an "immune" disease, even though the underlying reason why these autoantibodies are produced is unknown (idiopathic).   "immune" is probably a more descriptive term at this point, and treatments are immunosuppresants.   Wawot1 (talk) 15:23, 7 May 2011 (UTC)
replies: text: In that case, we can probably put it back to "immune", but we should cite something (UpToDate?) that indicates that that's the case. – RobinHood70 talk 20:29, 7 May 2011 (UTC)

text: I wasn't as precise as I should have been;  I agree that not ALL cases of ITP are caused by IgG activity, but, to quote a 2010 review article by Cuker from the journal Hematology, (http://asheducationbook.hematologylibrary.org/cgi/content/full/2010/1/377), "Platelet life span is reduced as a consequence of antibody-mediated clearance by tissue macrophages in essentially all patients."  Most frequently, IgG antibodies are to blame.  Wawot1 (talk) 23:27, 15 May 2011 (UTC)

text: Again, I should have been more precise.  First line treatments are immunosuppressants and they are effective for many patients. You write that immunosuppressants predispose patients to infection;  that's true,  but that has nothing to do with the underlying etiology of the problem.  You're right that thrombopoetin receptor antagonists (TRAs) such as romipolostim and eltrombopag do not suppress the immune system, but, according to the Cuker review "TRAs appear capable of overriding antibody-mediated platelet clearance in most patients."  In other words, TRAs work in spite of antibody-mediated platelet destruction;  the fact that they do work for some patients does NOT mean that these patients do not have  antibody-mediated platelet destruction.  Wawot1 (talk) 23:27, 15 May 2011 (UTC)

text: This whole discussion is an argument about semantics, but I do think that in many (if not most) patients an immune process can be demonstrated.  In this sense it is an immune thrombocytopenia - the underlying reason WHY this immune process is directed against self is often idiopathic, however.  The Cuker review designates cases of ITP  (which he calls IMMUNE thrombocytopenia, by the way) in which there is an identifiable cause as "secondary ITP" and cases that have no identifiable cause as "primary ITP".  Wawot1 (talk) 23:27, 15 May 2011 (UTC)

text: The most up to date name for the disorder is 'Immune Thrombocytopenia'.  The 'purpura' part has been dropped and by definition, if the aetiology is not immune related then it isn't ITP, although the exact immune process cannot yet be demonstrated in all cases.  No drug works for everyone and many work less and less effectively in a patient each time it's used.  Take rituximab for example which this article says is effective, it is actually only effective in about 40% of patients. 87.194.81.2 (talk) 23:22, 26 May 2011 (UTC)

text: The off-label use of rituximab, a chimeric monoclonal antibody against the B cell surface antigen CD20, has been shown in preliminary studies to be an effective alternative to splenectomy in some patients (emphasis added).  However, many patients experience significant side-effects, there is a small risk of fatality due to progressive multifocal leukoencephalopathy caused by a reactivated JC virus, and randomized controlled trials have yet to be conducted.
Exactly where does the above statement say "...is effective..." without qualification?  You seem to have a problem with selective reading.  Note the additional information about side-effects and lack of controlled studies.  Also, exactly where did you get your 40 percent number?  I'll bet I've read ten times as much medical literature about ITP as you have, and I can't recall anything quoting a percentage figure for successful treatment with rituximab.
I believe you are trying to push your point of view into this article, which is exactly contrary to Wikipedia policy.  An encyclopedia is a compilation of facts, not uneducated opinions  You should spend a little less time asserting "facts" that you can't support.  Also, may I suggest you get a username and password instead of hiding behind an IP address?
Bigdumbdinosaur (talk) 04:57, 31 May 2011 (UTC)
thread_title:  Idiopathic or Immune 

message: In 2010 the following international consensus guideline appeared: doi:10.1182/blood-2009-06-225565. We should regard this as the standard of care. JFW | T@lk 13:57, 9 October 2011 (UTC)
thread_title:  Consensus guideline 

message: The following was added:
This is a summary of doi:10.1111/j.1600-0609.2011.01587.x, which is a primary research study. Newton's group is known for its fatigue-related research, but we cannot base content on primary studies and at any rate this discussion is rather too detailed for a general purpose article that might be read not just by patients but also by people just wanting a general overview. I would not be surprised if this study would eventually be covered in secondary sources (e.g. reviews). See WP:MEDRS. JFW | T@lk 23:31, 29 December 2012 (UTC)
replies: text: A review due to be published in BJH pulls together recent reseach on the subject. doi:10.1111/bjh.13385 JFW | T@lk 11:19, 31 March 2015 (UTC)
thread_title: Fatigue

message: This was added:
These are two primary sources. VIral infections (which is what live virus immunisation is, of course) is often linked with thrombocytopenia. I think we should only include this if a solid secondary source can be presented. JFW | T@lk 22:38, 22 June 2013 (UTC)
replies: text: Please follow my advice and supply a secondary source (e.g. review article, textbook chapter) that will make your edit stick. I don't dispute the facts, but we cannot build an encyclopedia on primary studies. JFW | T@lk 07:29, 8 July 2013 (UTC)
replies: text: Could I recommend  JFW | T@lk 07:32, 8 July 2013 (UTC)
thread_title:  MMR 

message: doi:10.1111/j.1538-7836.2012.04876.x is a review in JTH that I missed. JFW | T@lk 21:49, 21 January 2014 (UTC)
thread_title:  Review 

message: added that ITP is now called "primary immune thrombocytopenia", but didn't back this up with a reference. Almost every publication I have seen in recent time uses the current terminology, so I remain to be convinced. JFW | T@lk 21:49, 21 January 2014 (UTC)
thread_title: Name

message: :The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section. 
The result of the move request was: moved. Unopposed for over a week. Jenks24 (talk) 04:44, 10 January 2016 (UTC)
replies: text: Idiopathic thrombocytopenic purpura →  – Over time the name has been slowly changing.  At the moment reliable sources are split (for example Mayo clinic uses Idiopathic , NIH uses Immune ). A web search seems split.  However the journal Blood (journal) has moved to Immune , which I find convincing as I believe it's the most relevant research journal.  Obviously this move is going to involve a fair bit of editing as we change the primary name. Hobit (talk) 16:17, 31 December 2015 (UTC)

text: The above discussion is preserved as an archive of a requested move.  Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.
*The handful of changes needed were made to deal with the move.  I easily could have missed something, so please take a look.  Thanks, Hobit (talk) 18:45, 13 January 2016 (UTC)
thread_title:  Requested move 31 December 2015 

message: doi:10.1111/bjh.14515 JFW | T@lk 13:13, 14 March 2017 (UTC)
replies: text: NEJM today: doi:10.1056/NEJMcp1810479 JFW | T@lk 22:51, 4 September 2019 (UTC)
thread_title:  State of the art 

message: Hello fellow Wikipedians,
I have just modified one external link on Immune thrombocytopenic purpura. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:
*Added archive https://web.archive.org/web/20101227031913/http://www.gsk.com/media/pressreleases/2008/2008_pressrelease_10127.htm to http://www.gsk.com/media/pressreleases/2008/2008_pressrelease_10127.htm
When you have finished reviewing my changes, you may follow the instructions on the template below to fix any issues with the URLs.
Cheers.—InternetArchiveBot (Report bug) 09:01, 12 November 2017 (UTC)
thread_title:  External links modified