Uzun Günalp, Bakchoul Tamam, Lengerke Claudia, Moyses Margarete
Medizinische Klinik, Innere Medizin II, Hämatologie, Onkologie, klinische Immunologie und Rheumatologie, Universitätsklinikum Tübingen, Universität Tübingen, Otfried-Müller-Straße 10, 72076, Tübingen, Deutschland.
Inn Med (Heidelb). 2024 Dec;65(12):1225-1237. doi: 10.1007/s00108-024-01815-y. Epub 2024 Nov 26.
Immune thrombocytopenia (ITP) is an acquired thrombocytopenia caused by an autoimmune reaction against platelets in the blood and against megakaryocytes in the bone marrow. The indication for treatment is based on the bleeding symptoms and patient-specific factors. This article presents the current 2023 expert report that also forms the basis for the updated version of the Onkopedia guideline, which is expected in the course of 2024. In addition to the background to pathogenesis and pathophysiology, the article discusses clinical manifestations and diagnostics, as well as first-, second- and third-line therapy, including the management of emergency situations. Practice-relevant recommendations are given on the use and side effects of glucocorticoids, as well as on therapy with thrombopoietin receptor agonists (TRA), including the withdrawal regimen, and on treatment with a syk inhibitor.
免疫性血小板减少症（ITP）是一种获得性血小板减少症，由针对血液中血小板和骨髓中巨核细胞的自身免疫反应引起。治疗指征基于出血症状和患者的具体因素。本文介绍了当前的2023年专家报告，该报告也是预计在2024年发布的Onkopedia指南更新版本的基础。除了发病机制和病理生理学背景外，本文还讨论了临床表现、诊断方法，以及一线、二线和三线治疗，包括紧急情况的处理。针对糖皮质激素的使用和副作用、血小板生成素受体激动剂（TRA）治疗（包括撤药方案）以及脾酪氨酸激酶抑制剂治疗给出了与实践相关的建议。
