(Adnkronos) - "La piastrinopenia autoimmune, che noi chiamiamo Itp, è una malattia rara autoimmune, che si può verificare in tutte le fasce di età, quindi dai bambini molto piccoli agli anziani. È molto più frequente negli adulti anziani e in questo caso si riscontra maggiormente nel sesso maschile, ma nella fascia di età centrale, quella che corrisponde all'età fertile della donna, abbiamo in realtà una maggiore incidenza nel sesso femminile. Questo comporta una serie di problematiche particolari”. Così Monica Carpenedo, ematologa del dipartimento di Ematologia e oncologia dell’ospedale Niguarda di Milano, in occasione del 51° congresso nazionale Sie - Società italiana di ematologia, in svolgimento al MiCo di Milano dal 23 al 25 settembre e al quale è presente anche Sobi, azienda biofarmaceutica con focus su malattie ematologiche rare o poco conosciute, e oncoematologia.
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00:00The autoimmune disease is a rare disease, it is an autoimmune disease, but it is a disease that can be verified in all age groups,
00:13therefore in very young children and in the elderly, with differences also from the point of view of the frequency with which we see it.
00:20It is much more frequent in the elderly, in this case it is more frequent in the male sex, but in the central age group,
00:27so let's say the one that corresponds to the fertile age of the woman, we actually have a greater incidence really in the female sex
00:36and this involves a series of particular problems.
00:39This autoimmune disease is a disease that manifests itself with a very sudden decline in the count of platelets,
00:45so the patient often arrives in the emergency room with hemorrhagic symptoms,
00:49then blood from the gums, blood from the nose, spots on the skin of bleeding, hemorrhages
00:55and has an extremely low platelet count, sometimes even below 10,000, and therefore it is necessary to temporarily start therapies.
01:03You understand that in the female sex this type of problem can have a very negative impact,
01:09especially in conjunction with the menstrual cycle and therefore create major problems,
01:15also for example in terms of the possibility of living a normal social life,
01:20because the woman can naturally have great difficulties in managing this aspect of her life.
01:26The other important problem is that in this disease we have recognized over the years a risk of thrombotic events
01:33that is a little higher than that of the normal population, despite the low platelets.
01:37A woman in the fertile age sometimes has the need to use anti-conception therapies,
01:42hormonal therapies that can already increase the risk of thrombosis,
01:45and therefore again in this age group and in this population of female subjects
01:49we can paradoxically have a higher risk of thrombosis than a woman of the same age
01:54without autoimmune plasinopenia and who takes a hormonal therapy.
01:58And then we have the big issue of pregnancy, of course, because our patients with autoimmune plasinopenia,
02:03although they have a chronic disease, they just want a pregnancy,
02:07and in this case it is necessary the close collaboration between the hematologist, the gynecologist and the obstetrician
02:14precisely to try to conduct this pregnancy in the most physiological way possible,
02:19intervening with the drugs when necessary, possibly managing the hemorrhagic problems,
02:24bringing the woman to birth with a platelet count that is ensured as much as possible,
02:29also to avoid, perhaps, the cesarean section, with a particular eye then of attention to the newborn
02:35that in rare cases can give birth to platelets, even if in this case then his platelets are always resolved,
02:41and with all the problems then related, for example, to breastfeeding,
02:44if the mother still needs to do pharmacological therapies for her plasinopenia.
02:48So a world that can be complex but certainly fascinating
02:51in which collaboration between specialists is absolutely necessary.