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遗传性血小板减少症的诊断与治疗。

Diagnosis and management of inherited thrombocytopenias.

机构信息

Department of Internal Medicine, University of Pavia-IRCCS, Policlinico San Matteo Foundation, Pavia, Italy.

出版信息

Semin Thromb Hemost. 2013 Mar;39(2):161-71. doi: 10.1055/s-0032-1333540. Epub 2013 Feb 8.

Abstract

The number of recognized causes of inherited thrombocytopenias has grown in the past 10 years and there are now more than 18 thrombocytopenic disorders with characterized genetic mutations. Moreover, the pathogenic mechanisms of many forms of inherited thrombocytopenia have been identified and prognosis of different disorders, ranging from unfavorable to very good, has been defined. In addition, for some inherited thrombocytopenias, therapies are now available to improve both survival and quality of life for persons with these conditions. Therefore, it is important to recognize when a low platelet count reflects an inherited disorder, and establish a correct diagnosis; however, this remains a challenge because documented evidences about these diseases are scarce. In this review, we address how to diagnose inherited thrombocytopenia, how to differentiate these conditions from immune thrombocytopenia, present a new and simple diagnostic algorithm, and discuss the different therapeutic options. We also emphasize that further research on these disorders is needed, as about half of patients with inherited thrombocytopenias have a disease that is not yet characterized.

摘要

在过去的 10 年中,已识别的遗传性血小板减少症的病因数量有所增加,现在已有超过 18 种血小板减少症与特征性基因突变有关。此外,许多形式的遗传性血小板减少症的发病机制已经确定,不同疾病的预后(从不利到非常好)已经确定。此外,对于某些遗传性血小板减少症,现在已经有治疗方法可以改善这些疾病患者的生存和生活质量。因此,重要的是要认识到血小板计数低反映的是遗传性疾病,并建立正确的诊断;然而,这仍然是一个挑战,因为这些疾病的文献证据很少。在这篇综述中,我们将讨论如何诊断遗传性血小板减少症,如何将这些疾病与免疫性血小板减少症区分开来,提出一种新的简单的诊断算法,并讨论不同的治疗选择。我们还强调需要进一步研究这些疾病,因为大约一半的遗传性血小板减少症患者的疾病尚未确定。

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