Glanzmann's thrombasthenia medical therapy
|
Glanzmann's thrombasthenia |
|
Differentiating Glanzmann's thrombasthenia from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Glanzmann's thrombasthenia medical therapy On the Web |
|
American Roentgen Ray Society Images of Glanzmann's thrombasthenia medical therapy |
|
Risk calculators and risk factors for Glanzmann's thrombasthenia medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2] Associate Editor(s)-in-Chief: Omer Kamal, M.D.[3]
Overview
The treatment of bleeding episodes in patients with Glanzmann's thrombasthenia includes local measures with or without anti-fibrinolytic therapy first, followed by platelet transfusion, and rFVIIa if bleeding persists. However, the majority of cases of Glanzmann's thrombasthenia bleeds are self-limited and only require supportive care. Other options include desmopressin (DDAVP) which increases tissue plasminogen activator (tPA), FVIII, and von Willebrand factor (VWF) in plasma. However, it has no significant effect on platelet disorders. rFVIIa manages bleeding in most patients with Glanzmann's thrombasthenia.
Medical Therapy
The treatment of bleeding episodes in patients with Glanzmann's thrombasthenia includes local measures with or without anti-fibrinolytic therapy first, followed by platelet transfusion, and rFVIIa if bleeding persists. However, the majority of cases of Glanzmann's thrombasthenia bleeds are self-limited and only require supportive care.[1] Other options include:
- Desmopressin (DDAVP): Increases the levels of tissue plasminogen activator (tPA), FVIII, and von Willebrand factor (VWF) in plasma, but it has no significant effect on platelet disorders[2]
- rFVIIa: Manages bleeding in most patients with Glanzmann's thrombasthenia [3][4]
- Rituximab: Anti-CD20 monoclonal antibody [5]
- Bevacizumab: Anti-VEGF monoclonal antibody [3]
- Hematopoietic stem cell transplantation[2]
- Gene therapy[6][2]
- Platelet transfusion: This is a temporizing measure. It can be complicated by volume overload and the development of anti-platelet antibodies.
References
- ↑ Solh T, Botsford A, Solh M (2015). "Glanzmann's thrombasthenia: pathogenesis, diagnosis, and current and emerging treatment options". J Blood Med. 6: 219–27. doi:10.2147/JBM.S71319. PMC 4501245. PMID 26185478.
- ↑ 2.0 2.1 2.2 Fiore M, Nurden AT, Nurden P, Seligsohn U (October 2012). "Clinical utility gene card for: Glanzmann thrombasthenia". Eur. J. Hum. Genet. 20 (10). doi:10.1038/ejhg.2012.151. PMC 3449071. PMID 22781097.
- ↑ 3.0 3.1 Stevens RF, Meyer S (December 2002). "Fanconi and Glanzmann: the men and their works". Br. J. Haematol. 119 (4): 901–4. PMID 12472566.
- ↑ Nurden AT, Ruan J, Pasquet JM, Gauthier B, Combrié R, Kunicki T, Nurden P (March 2002). "A novel 196Leu to Pro substitution in the beta3 subunit of the alphaIIbbeta3 integrin in a patient with a variant form of Glanzmann thrombasthenia". Platelets. 13 (2): 101–11. doi:10.1080/09537100220122466. PMID 11897046.
- ↑ Morel-Kopp MC, Melchior C, Chen P, Ammerlaan W, Lecompte T, Kaplan C, Kieffer N (December 2001). "A naturally occurring point mutation in the beta3 integrin MIDAS-like domain affects differently alphavbeta3 and alphaIIIbbeta3 receptor function". Thromb. Haemost. 86 (6): 1425–34. PMID 11776310.
- ↑ Solh T, Botsford A, Solh M (2015). "Glanzmann's thrombasthenia: pathogenesis, diagnosis, and current and emerging treatment options". J Blood Med. 6: 219–27. doi:10.2147/JBM.S71319. PMC 4501245. PMID 26185478.