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inmune" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Sr. Editor:</span>" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e1" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Luis Callejas Rubio, Raquel Ríos Fernandez, Paloma García Martín" "autores" => array:3 [ 0 => array:4 [ "nombre" => "José Luis" "apellidos" => "Callejas Rubio" "email" => array:1 [ 0 => "jlcalleja@telefonica.net" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Raquel" "apellidos" => "Ríos Fernandez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Paloma" "apellidos" => "García Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Enfermedades Sistémicas, Servicio de Medicina Interna, Hospital Universitario Clínico San Cecilio, Granada, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Hematología, Hospital Universitario Clínico San Cecilio, Granada, España" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Guidelines of the Spanish ITP Group for the diagnosis, treatment and follow-up of patients with immune thrombocytopenia" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Hemos leído las Recomendaciones del Grupo Español de la PTI recientemente publicadas en su revista sobre el diagnóstico y el tratamiento de pacientes con trombocitopenia inmune<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>, y nos gustaría hacer unos comentarios al mismo.</p><p id="par0010" class="elsevierStylePara elsevierViewall">En primer lugar estaríamos interesados en conocer la opinión del Grupo sobre un aspecto que puede ser importante desde el punto de vista del diagnóstico y del tratamiento y en el que no se hace referencia en el texto, como es el del papel de <span class="elsevierStyleItalic">Helicobacter pylori</span> y su erradicación en el tratamiento de la PTI, dada la estrecha relación entre ambos<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a>.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Por otro lado, en las recomendaciones de tratamiento se incluyen como fármacos de segunda línea los agonistas de los receptores de la trombopoyetina (TPO-RA), fosfatinib y rituximab. En los pacientes con PTI secundarias las recomendaciones del Grupo indican que las líneas de tratamiento deben tener en cuenta la enfermedad subyacente. En el caso concreto de la PTI asociada a lupus eritematoso sistémico, las guías EULAR recientemente publicadas modifican un poco el algoritmo terapéutico, colocando en el segundo escalón a rituximab y en el tercero a los TPO-RA<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>, recomendando el uso de belimumab en casos de trombocitopenias leves, entre 20 y 50<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>/l. El doble bloqueo con rituximab asociado a belimumab podría ser una prometedora combinación para casos refractarios<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financiación</span><p id="par0020" class="elsevierStylePara elsevierViewall">Este trabajo no ha recibido ningún tipo de financiación.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financiación" ] 1 => array:1 [ "titulo" => "Bibliografía" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines of the Spanish ITP Group for the diagnosis, treatment and follow-up of patients with immune thrombopenia" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Grupo Español de PTI (GEPTI)" "etal" => false "autores" => array:3 [ 0 => "M.L. 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Avarvand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5045/br.2021.2020189" "Revista" => array:6 [ "tituloSerie" => "Blood Res." "fecha" => "2021" "volumen" => "56" "paginaInicial" => "38" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33707351" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "International survey on <span class="elsevierStyleItalic">Helicobacter pylori</span> testing in patients with immune thrombocytopenia: Communication of the platelet immunology scientific and standardization committee" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Platelet Immunology Scientific Standardization Committee" "etal" => true "autores" => array:6 [ 0 => "P. Vishnu" 1 => "J. Duncan" 2 => "N. Connell" 3 => "N. Cooper" 4 => "W. Lim" 5 => "F.T. Rodeghiero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jth.15136" "Revista" => array:6 [ "tituloSerie" => "J Thromb Haemost." "fecha" => "2021" "volumen" => "19" "paginaInicial" => "287" "paginaFinal" => "296" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33070448" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update (n the diagnosis and management of systemic lupus erythematosus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Fanouriakis" 1 => "N. Tziolos" 2 => "G. Bertsias" 3 => "D.T. Boumpas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/annrheumdis-2020-218272" "Revista" => array:6 [ "tituloSerie" => "Ann Rheum Dis." "fecha" => "2021" "volumen" => "80" "paginaInicial" => "14" "paginaFinal" => "25" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33051219" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy, safety and immunological profile of combining rituximab with belimumab for adults with persistent or chronic immune thrombocytopenia: Results from a prospective phase 2b trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Mahévas" 1 => "I. Azzaoui" 2 => "E. Crickx" 3 => "F. Canoui-Poitrine" 4 => "D. Gobert" 5 => "L. Languille" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3324/haematol.2020.259481" "Revista" => array:6 [ "tituloSerie" => "Haematologica." 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