Thrombocytopenia
Conditions
Keywords
Validation new test
Brief summary
The drug immune thrombocytopenia (TIM) are the most common drug cytopenias. They result from a peripheral destruction of platelets in the presence of the drug only. They usually involve immunoglobulin G (IgG) directed against either the drug molecule bound to a carrier protein or, by autoimmunity, against a hidden epitope newly exposed as a result of treatment. The most common drugs involved are quinine, some antibiotics, nonsteroidal anti-inflammatory drugs or anticonvulsants but the list is not exhaustive. in the case of new-onset thrombocytopenia and after eliminating other possible causes, a TIM is suspected but the offending drug is difficult to identify in generally poly-medicated patients. Several drugs may be suspected and the clinician uses biology for rapid assistance to the de-prescription and reduces unnecessary therapeutic substitutions in an always difficult clinical situation. The Immunology Laboratory of the University Hospital of Saint-Etienne has developed a biological test of thrombocytopenia induction in the presence of the drug and the patient's serum that is to say its antibodies and complement fractions with cytometry reading flow. This Induction Test in vitro TIM (TITIM) is simple, fast, inexpensive, easy to transfer in hospital laboratories. But this test must be validated on well-documented clinical cases. The purpose of this pilot project is to validate the technical and assess the clinical specificity of the test TITIM for hard imputability drugs validated by a committee of experts combining a posteriori of clinical and biological criteria of routine.
Interventions
BIOLOGICALblood sample
15 ml of blood
Sponsors
Centre Hospitalier Universitaire de Saint Etienne
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* hospitalized patients with suspicion of thrombocytopenia drug * consent signed
Exclusion criteria
* Thrombocytopenia plants such as secondary to the following molecules: antineoplastic (except oxaliplatin which gives TIM), immunosuppressants. * Induced thrombocytopenia heparin and IIb / IIIa glycoproteins (abciximab, tirofiban, epifibatide). * Presence of anti platelet antibodies allogeneic or autoimmune which are part of the MAIPA test. * Patient exposed to at least one suspect molecule does not exist in water-soluble form or drug to which the metabolite is suspected * Patients transfused (plasma, platelets) for less than a month * Patients with an other bloodline
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| TITIM test positivity | at baseline | TITIM test is considered positive when there is a decrease in platelet counts at least 10%. |
Countries
France
Outcome results
None listed