Consensus statement on the diagnosis of immune thrombocytopenia in dogs and cats
LeVine, Dana N. (Auburn University)
Kidd, Linda (Zoetis Animal Health Diagnostics)
Garden, Oliver A. (Louisiana State University)
Brooks, Marjory B. (Cornell University)
Goggs, Robert (Cornell University)
Kohn, Barbara (Freie Universität Berlin)
Mackin, Andrew J. (Mississippi State University)
Eldermire, Erin R. B. (Cornell University)
Chang, Yu-Mei (University of London. Royal Veterinary College)
Allen, Julie (Veterinary Information Network)
Christopherson, Peter W. (Auburn University)
Glanemann, Barbara (University of London)
Maruyama, Haruhiko (Nihon University)
Naskou, Maria C. (Auburn University)
Nielsen, Lise N. (University of Copenhagen)
Shropshire, Sarah (Colorado State University)
Viall, Austin K. (University of California)
Birkenheuer, Adam J. (North Carolina State University)
Forman, Marnin A. (Cornell University Veterinary Specialists)
Hanzlicek, Andrew S. (MiraVista Veterinary Diagnostics)
Langner, Kathrin F. (Western Australian Veterinary Emergency and Specialty)
Lashnits, Erin (University of Wisconsin)
Lunn, Katharine F. (Axiom Veterinary Laboratories)
Makielski, Kelly M. (University of Minnesota)
Roura, Xavier (Universitat Autònoma de Barcelona. Hospital Clínic Veterinari)
Spada, Eva (Università degli Studi di Milano)

Data:	2024
Resum:	Immune thrombocytopenia (ITP) is the most common acquired primary hemostatic disorder in dogs. Immune thrombocytopenia less commonly affects cats but is an important cause of mortality and treatment-associated morbidity in both species. Immune thrombocytopenia remains a diagnosis of exclusion for which diagnostic guidelines are lacking. Primary, or non-associative, ITP refers to autoimmune platelet destruction. Secondary, or associative, ITP arises in response to an underlying disease trigger. However, evidence for which comorbidities serve as ITP triggers has not been systematically evaluated. To identify key diagnostic steps for ITP and important comorbidities associated with secondary ITP, we developed 12 Population Evaluation/Exposure Comparison Outcome (PECO) format questions. These questions were addressed by evidence evaluators utilizing a literature pool of 287 articles identified by the panelists using a structured search strategy. Evidence evaluators, using panel-designed templates and data extraction tools, summarized evidence and created guideline recommendations that then were integrated by diagnosis and comorbidity domain chairs. The revised PECO responses underwent a Delphi survey process to reach consensus on final guidelines. A combination of panel expertise and PECO responses were employed to develop algorithms for diagnosis of ITP in dogs and cats, which also underwent 4 iterations of Delphi review. Comorbidity evidence evaluators employed an integrated measure of evidence (IME) tool to determine evidence quality for each comorbidity; IME values combined with evidence summaries for each comorbidity were integrated to develop ITP screening recommendations, which also were subjected to Delphi review. Commentary was solicited from multiple relevant professional organizations before finalizing the consensus. The final consensus statement provides clinical guidelines for the diagnosis of, and underlying disease screening for, ITP in dogs and cats. The systematic consensus process identified numerous knowledge gaps that should guide future studies. This statement is a companion manuscript to the ACVIM Consensus Statement on the Treatment of Immune Thrombocytopenia.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Autoimmune ; Hemostasis ; Immune-mediated ; Platelet ; Thrombopoietin
Publicat a:	Journal of Veterinary Internal Medicine, Vol. 38 (may 2024) , p. 1958-1981, ISSN 1939-1676

DOI: 10.1111/jvim.16996
PMID: 38752421

24 p, 2.6 MB

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