Imperial College London
Alternate

ProfessorAdamWaldman

Faculty of Medicine, Department of Brain Sciences

Visiting Professor
 
 
 
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Contact

 

+44 (0)20 3311 7546adam.waldman

 
 
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Assistant

 

Dr Adam Waldman +44 (0)20 3311 7546

 
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Location

 

Imaging DepartmentCharing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Cooper:2020:10.1182/blood.2020004858,
author = {Cooper, N and Morrison, MA and Vladescu, C and Hart, ACJ and Paul, D and Malik, A and Young, T and Luqmani, A and Atta, M and Sharp, DJ and Bussel, JB and Waldman, AD},
doi = {10.1182/blood.2020004858},
journal = {Blood},
pages = {2875--2880},
title = {Identification of occult cerebral microbleeds in adults with immune thrombocytopenia},
url = {http://dx.doi.org/10.1182/blood.2020004858},
volume = {136},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Management of symptoms and prevention of life-threatening hemorrhage in immune thrombocytopenia (ITP) must be balanced against adverse effects of therapies. Because current treatment guidelines based on platelet count are confounded by variable bleeding phenotypes, there is a need to identify new objective markers of disease severity for treatment stratification. In this cross-sectional prospective study of 49 patients with ITP and nadir platelet counts <30 × 109/L and 18 aged-matched healthy controls, we used susceptibility-weighted magnetic resonance imaging to detect cerebral microbleeds (CMBs) as a marker of occult hemorrhage. CMBs were detected using a semiautomated method and correlated with clinical metadata using multivariate regression analysis. No CMBs were detected in health controls. In contrast, lobar CMBs were identified in 43% (21 of 49) of patients with ITP; prevalence increased with decreasing nadir platelet count (0/4, ≥15 × 109/L; 2/9, 10-14 × 109/L; 4/11, 5-9 × 109/L; 15/25 <5 × 109/L) and was associated with longer disease duration (P = 7 × 10−6), lower nadir platelet count (P = .005), lower platelet count at time of neuroimaging (P = .029), and higher organ bleeding scores (P = .028). Mucosal and skin bleeding scores, number of previous treatments, age, and sex were not associated with CMBs. Occult cerebral microhemorrhage is common in patients with moderate to severe ITP. Strong associations with ITP duration may reflect CMB accrual over time or more refractory disease. Further longitudinal studies in children and adults will allow greater understanding of the natural history and clinical and prognostic significance of CMBs.
AU  - Cooper,N
AU  - Morrison,MA
AU  - Vladescu,C
AU  - Hart,ACJ
AU  - Paul,D
AU  - Malik,A
AU  - Young,T
AU  - Luqmani,A
AU  - Atta,M
AU  - Sharp,DJ
AU  - Bussel,JB
AU  - Waldman,AD
DO  - 10.1182/blood.2020004858
EP  - 2880
PY  - 2020///
SN  - 0006-4971
SP  - 2875
TI  - Identification of occult cerebral microbleeds in adults with immune thrombocytopenia
T2  - Blood
UR  - http://dx.doi.org/10.1182/blood.2020004858
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000600832500009&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://ashpublications.org/blood/article-abstract/136/25/2875/461701/Identification-of-occult-cerebral-microbleeds-in?redirectedFrom=fulltext
UR  - http://hdl.handle.net/10044/1/85997
VL  - 136
ER  -
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