ArticleAnnals of hematology2023
Bleeding risk assessment in immune thrombocytopenia.
Article in Annals of hematology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 10 citations in OpenAlex.
- Design of a modified platelet immunofluorescence test to assess platelet-reactive antibody burden and its association with platelet functional exhaustion and clinical features in chronic immune thrombocytopenia.British journal of haematology · 2026Article
- Von Willebrand, factor VIII, and D-dimer levels as predictors of risk and clinical outcomes in acute myeloid leukemia.Clinical and experimental medicine · 2026Article
- Severe Thrombocytopenia With Wet Purpura in Brucellosis: A Case Report.Clinical case reports · 2026Article
- Association between serum Klotho and thrombocytopenia in middle-aged and older adults: A cross-sectional study based on NHANES.Medicine · 2026Article
- Refractory Primary Immune Thrombocytopenia With Bleeding and Thrombosis: A Case Report.The American journal of case reports · 2026Article
- Miliary Tuberculosis With Immune Thrombocytopenia in 50-Year-Old Ethiopian Woman: A Case Report and Brief Review of Literature.Clinical case reports · 2026Article
- Thromboelastography-Guided Laparoscopic Splenectomy in a Patient With Immune Thrombocytopenia and Recent Drug-Eluting Stent Placement: A Case Report.Case reports in anesthesiology · 2026Article
- Corticosteroids plus statins in patients with primary immune thrombocytopenia and hyperlipidemia: A multicenter retrospective cohort study.Therapeutic advances in hematology · 2026Article
- A design for an efficient functional panel that determines platelet exhaustion levels to differentiate responder and non-responder ITP patients.Scientific reports · 2025Article
- Haemostasis alterations in immune thrombocytopenia and their clinical significance.Research and practice in thrombosis and haemostasis · 2025Article
- Unveiling the Hemostatic Signature of Prematurity: A Prospective Rotational Thromboelastometry-Based Analysis.Medicina (Kaunas, Lithuania) · 2025Article
- Cancer treatment-induced thrombocytopenia: diagnosis, mechanisms and management.Frontiers in immunology · 2025Review
- Eltrombopag-Induced Cerebral Venous Thrombosis: A Case Report and Literature Review.Case reports in hematology · 2025Article
- High-Risk Bleeding in Acute Myeloid Leukemia: Clinical Presentation, Laboratory Markers, and Mortality Trends.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
- Expression of Human Thrombomodulin Prevents Early Thrombocytopenia and Thrombotic Microangiopathy in Pig-to-Nonhuman Primate Orthotopic Liver Xenotransplantation.XenotransplantationArticle
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Authors and funding
13 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The bleeding risk in immune thrombocytopenia (ITP) is related not only to low platelet count but also to the presence of platelet dysfunction. However, diagnosing a concomitant platelet dysfunction is challenging as most of the available platelet function assays (PFAs) require a platelet count of greater than 100,000/μL. Sonoclot coagulation and platelet function analyzer works on the principle of viscoelastometry, and results remain unaffected by the platelet counts. To assess the platelet function in adult acute ITP patients with the help of sonoclot coagulation and platelet function analyzer and correlate it with the risk of bleeding. Newly diagnosed acute ITP patients with a platelet count less than 20,000/μL were divided into two groups based on WHO bleeding grade: ITP non-bleeder (ITP-NB) group (WHO bleeding grade ≤1) and ITP bleeder (ITP-B) group (WHO bleeding grade ≥2). Platelet function was assessed by sonoclot in both groups. The patients without significant bleeding (ITP-NB) were followed up monthly for six months with the assessment of platelet function during each contact. Eighty patients (30 ITP-B and 50 ITP-NB) were prospectively included in this study. The median age of patients in the two groups was 37 years and 30 years, respectively. The female-to-male ratio was 4:1 and 1:1 in ITP-B and ITP-NB groups. The median platelet count in ITP-B and ITP-NB was 12000/μL (range 1000-19000/μL) and 8000/μL (range 1000-19000/μL), respectively. Mean platelet functions by sonoclot in both groups were lower than the normal cut-off (>1.6). However, the mean platelet function in the ITP-B group (0.2 + 0.17) was significantly lower than the ITP-NB group (1.2 ± 0.52) (p = 0.01). During the follow-up period of 6 months, patients in ITP-NB with a normal platelet function (>1.6) on sonoclot had lesser episodes (one episode) of clinically significant bleeding than patients with a low platelet function (4 episodes). Patients with acute severe thrombocytopenia and bleeding phenotype have a greater abnormality on platelet function by sonoclot than patients with non-bleeding phenotype. This information may help in taking therapeutic decisions in patients with acute ITP.
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