Loading...
Publication
Trombocitopenia imune: revisão bibliográfica da abordagem diagnóstica e terapêutica
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 1.3 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
A trombocitopenia imune é uma doença hematológica autoimune adquirida, caracterizada pelo decréscimo isolado do número de plaquetas no sangue, resultante de um processo de destruição autoimune das mesmas. Tal ocorre devido a um desequilíbrio entre as células imunológicas efetoras e reguladoras que culmina na formação de autoanticorpos direcionados contra as plaquetas, responsáveis pelo aumento da destruição das plaquetas circulantes e pelo comprometimento da produção de novas plaquetas pela medula óssea. A trombocitopenia imune pode ser classificada em dois subtipos principais, de acordo com a sua causa subjacente: primária e secundária. A primária é a forma mais comum e ocorre quando não há uma condição subjacente identificável, apresentando-se como trombocitopenia isolada. A secundária está associada a outras patologias ou ao uso de medicamentos. Embora possa surgir em qualquer faixa etária, esta patologia é mais prevalente em adultos, acima dos 60 anos. Enquanto na idade pediátrica a doença tende a ser de caráter agudo e autolimitado, na idade adulta, evolui frequentemente para uma condição crónica, exigindo monitorização contínua e intervenção terapêutica prolongada. A incidência estimada é de cerca de 3,3 casos por 100.000 pessoas por ano, com uma prevalência de aproximadamente 9,5 casos por 100.000 adultos, o que ressalta a relevância desta patologia como problema de saúde pública. O diagnóstico é realizado principalmente por exclusão, com base numa avaliação clínica detalhada e em exames laboratoriais, de modo a excluir possíveis causas secundárias. A terapêutica de primeira linha inclui o uso de corticosteroides e de imunoglobulina intravenosa em casos que exijam rápida elevação do número de plaquetas. Os agonistas do recetor da trombopoietina são muito utilizados como terapêutica de segunda linha. O farmacêutico desempenha um papel essencial na gestão da trombocitopenia imune, nomeadamente no aconselhamento, na adesão à terapêutica e na deteção de efeitos adversos, colaborando com outros profissionais de saúde para garantir uma abordagem terapêutica eficaz. Palavras-chave: Trombocitopenia imune; Púrpura trombocitopénica idiopática; Corticosteroides; Farmacoterapia da trombocitopenia imune.
Immune thrombocytopenia is an acquired autoimmune hematologic disorder characterized by an isolated reduction in platelet count, resulting from an autoimmune destruction of these cells. This occurs due to an imbalance between effector and regulatory immune cells, leading to the formation of autoantibodies directed against platelets. As a result, there is an increase in the destruction of circulating platelets and a compromise in the production of new platelets in the bone marrow. Immune thrombocytopenia can be classified in two main diferent subtypes based on its underlying cause: primary and secondary. Primary immune thrombocytopenia is the most common form and occurs when no underlying condition is identified, presenting as isolated thrombocytopenia. Secondary thrombocytopenia is associated with other diseases or with the use of medications. Although it can occur at any age, it is more prevalent in adults, particularly those over 60 years of age. In children, the disease tends to be acute and self-limited, while in adults, it often evolves into a chronic condition, requiring continuous monitoring and prolonged therapeutic interventions. The estimated incidence is approximately 3.3 cases per 100,000 people per year, with a prevalence of around 9.5 cases per 100,000 adults, highlighting the relevance of this condition as a public health issue. The diagnosis is primarily established by exclusion, based on a thorough clinical evaluation and laboratory tests, to rule out possible secondary causes. First-line therapy includes the use of corticosteroids and intravenous immunoglobulin in cases requiring a rapid increase in platelet count. Thrombopoietin receptor agonists are widely used as second-line therapy. Pharmacists play a crucial role in the management of immune thrombocytopenia, particularly in counseling, promoting adherence to therapy, and detecting adverse effects, as well as collaborating with other healthcare professionals to ensure an effective therapeutic approach.
Immune thrombocytopenia is an acquired autoimmune hematologic disorder characterized by an isolated reduction in platelet count, resulting from an autoimmune destruction of these cells. This occurs due to an imbalance between effector and regulatory immune cells, leading to the formation of autoantibodies directed against platelets. As a result, there is an increase in the destruction of circulating platelets and a compromise in the production of new platelets in the bone marrow. Immune thrombocytopenia can be classified in two main diferent subtypes based on its underlying cause: primary and secondary. Primary immune thrombocytopenia is the most common form and occurs when no underlying condition is identified, presenting as isolated thrombocytopenia. Secondary thrombocytopenia is associated with other diseases or with the use of medications. Although it can occur at any age, it is more prevalent in adults, particularly those over 60 years of age. In children, the disease tends to be acute and self-limited, while in adults, it often evolves into a chronic condition, requiring continuous monitoring and prolonged therapeutic interventions. The estimated incidence is approximately 3.3 cases per 100,000 people per year, with a prevalence of around 9.5 cases per 100,000 adults, highlighting the relevance of this condition as a public health issue. The diagnosis is primarily established by exclusion, based on a thorough clinical evaluation and laboratory tests, to rule out possible secondary causes. First-line therapy includes the use of corticosteroids and intravenous immunoglobulin in cases requiring a rapid increase in platelet count. Thrombopoietin receptor agonists are widely used as second-line therapy. Pharmacists play a crucial role in the management of immune thrombocytopenia, particularly in counseling, promoting adherence to therapy, and detecting adverse effects, as well as collaborating with other healthcare professionals to ensure an effective therapeutic approach.
Description
Keywords
Trombocitopenia imune Púrpura trombocitopénica idiopática Corticosteroides Farmacoterapia da trombocitopenia imune