MedElevator
Войти в исследования Hematology (Amsterdam, Netherlands) · 2025
Iraqi consensus recommendations for the diagnosis and management of immune thrombocytopenia.
СтатьяОбзорConsensus StatementНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mjali Ahmed, Francis Matti Bassam, Ghanima Waleed, Provan Drew, Tawfeeq Abbas Nareen, Sahham Naji Alaadin, Saleem Abbas Mohammed, Fadhil Alwan Alaa, F Al Tameemi Waseem, Abdullah Saleh Tareq, A Shubber Mazin, Sabah Noori Ahmed, Majid Al-Saeed Raghad, Shareef Mohammed Amer, Ahmed Al-Anssari Mohammed, M Dawood Qutaiba
Аннотация
BACKGROUND AND OBJECTIVES: The management of ITP has evolved with evidence-based international guidelines. However, Iraq's unique challenges, including variations in clinical practice and treatment disparities, necessitate localized guidance to bridge global recommendations and real-world practice. This expert consensus aims to provide a comprehensive and practical framework for diagnosing and managing ITP within the Iraqi healthcare setting.
METHODS: A 16-member multidisciplinary ITP specialist panel (Iraq, Norway, UK), including hematologists, laboratory experts, and related specialists, conducted a systematic PubMed / PubMed Central / Embase review (January 2003-December 2024) using key terms 'primary immune thrombocytopenia' and 'idiopathic thrombocytopenic purpura' (English human studies, excluding conference abstracts). Using a modified Delphi method, consensus was reached on 43 ITP diagnosis/treatment/management statements. After a single voting round, the panel refined the recommendations to ensure their applicability to Iraq's healthcare system. Final recommendations were categorized using evidence grading system.
RESULTS: Corticosteroids were the preferred first-line therapy, with intravenous immunoglobulin (IVIG) reserved for urgent platelet elevation. The panel discouraged prolonged corticosteroid use due to adverse effects and defined clear criteria for second-line therapies. Thrombopoietin receptor agonists (TPO-RAs) and rituximab were recommended second-line, while splenectomy was considered a last resort, only after the failure of multiple medical therapies. Special populations received tailored recommendations, including pregnant patients, pediatric cases, and high-thrombosis-risk individuals. Recommendations incorporated quality of life, emphasizing patient-centered care and minimizing unnecessary medication exposure.
CONCLUSION: This expert consensus provides a structured, evidence-informed approach to ITP diagnosis and management in Iraq, balancing best practices with local healthcare realities.
METHODS: A 16-member multidisciplinary ITP specialist panel (Iraq, Norway, UK), including hematologists, laboratory experts, and related specialists, conducted a systematic PubMed / PubMed Central / Embase review (January 2003-December 2024) using key terms 'primary immune thrombocytopenia' and 'idiopathic thrombocytopenic purpura' (English human studies, excluding conference abstracts). Using a modified Delphi method, consensus was reached on 43 ITP diagnosis/treatment/management statements. After a single voting round, the panel refined the recommendations to ensure their applicability to Iraq's healthcare system. Final recommendations were categorized using evidence grading system.
RESULTS: Corticosteroids were the preferred first-line therapy, with intravenous immunoglobulin (IVIG) reserved for urgent platelet elevation. The panel discouraged prolonged corticosteroid use due to adverse effects and defined clear criteria for second-line therapies. Thrombopoietin receptor agonists (TPO-RAs) and rituximab were recommended second-line, while splenectomy was considered a last resort, only after the failure of multiple medical therapies. Special populations received tailored recommendations, including pregnant patients, pediatric cases, and high-thrombosis-risk individuals. Recommendations incorporated quality of life, emphasizing patient-centered care and minimizing unnecessary medication exposure.
CONCLUSION: This expert consensus provides a structured, evidence-informed approach to ITP diagnosis and management in Iraq, balancing best practices with local healthcare realities.