1. Inherited Platelet Disorders: An Updated Overview
- Author
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Maria Luisa Lozano, Agustín Rodriguez-Alén, Verónica Palma-Barqueros, José Rivera, Nuria Revilla, José Ramón González-Porras, Vicente Vicente, Ana Zamora Cánovas, Ana Marín-Quílez, José María Bastida, and Ana M. Sanchez
- Subjects
Blood Platelets ,0301 basic medicine ,medicine.medical_specialty ,Platelet Function Tests ,QH301-705.5 ,Platelet disorder ,medicine.medical_treatment ,Platelet Transfusion ,Review ,Hematopoietic stem cell transplantation ,Disease ,congenital platelet disorders ,030204 cardiovascular system & hematology ,Malignancy ,Catalysis ,Inorganic Chemistry ,03 medical and health sciences ,Rare Diseases ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Clinical significance ,Genetic Testing ,Biology (General) ,Physical and Theoretical Chemistry ,Intensive care medicine ,QD1-999 ,Molecular Biology ,Pathological ,Spectroscopy ,platelet function disorders ,inherited thrombocytopenias ,Hemostasis ,Hematology ,business.industry ,Organic Chemistry ,High-Throughput Nucleotide Sequencing ,General Medicine ,bacterial infections and mycoses ,medicine.disease ,Computer Science Applications ,Chemistry ,030104 developmental biology ,Blood Platelet Disorders ,business - Abstract
Platelets play a major role in hemostasis as ppwell as in many other physiological and pathological processes. Accordingly, production of about 1011 platelet per day as well as appropriate survival and functions are life essential events. Inherited platelet disorders (IPDs), affecting either platelet count or platelet functions, comprise a heterogenous group of about sixty rare diseases caused by molecular anomalies in many culprit genes. Their clinical relevance is highly variable according to the specific disease and even within the same type, ranging from almost negligible to life-threatening. Mucocutaneous bleeding diathesis (epistaxis, gum bleeding, purpura, menorrhagia), but also multisystemic disorders and/or malignancy comprise the clinical spectrum of IPDs. The early and accurate diagnosis of IPDs and a close patient medical follow-up is of great importance. A genotype–phenotype relationship in many IPDs makes a molecular diagnosis especially relevant to proper clinical management. Genetic diagnosis of IPDs has been greatly facilitated by the introduction of high throughput sequencing (HTS) techniques into mainstream investigation practice in these diseases. However, there are still unsolved ethical concerns on general genetic investigations. Patients should be informed and comprehend the potential implications of their genetic analysis. Unlike the progress in diagnosis, there have been no major advances in the clinical management of IPDs. Educational and preventive measures, few hemostatic drugs, platelet transfusions, thrombopoietin receptor agonists, and in life-threatening IPDs, allogeneic hematopoietic stem cell transplantation are therapeutic possibilities. Gene therapy may be a future option. Regular follow-up by a specialized hematology service with multidisciplinary support especially for syndromic IPDs is mandatory.
- Published
- 2021
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