{"id":"https://openalex.org/W7166803137","doi":"https://doi.org/10.56305/001c.162033","title":"Cyclic Thrombocytopenia Complicated by Thrombosis and Successfully Treated With Rituximab: A Diagnostic and Therapeutic Challenge","display_name":"Cyclic Thrombocytopenia Complicated by Thrombosis and Successfully Treated With Rituximab: A Diagnostic and Therapeutic Challenge","publication_year":2026,"publication_date":"2026-07-01","ids":{"openalex":"https://openalex.org/W7166803137","doi":"https://doi.org/10.56305/001c.162033","pmid":"https://pubmed.ncbi.nlm.nih.gov/42405365","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13330566"},"language":"en","primary_location":{"id":"doi:10.56305/001c.162033","doi":"https://doi.org/10.56305/001c.162033","is_oa":true,"landing_page_url":"https://doi.org/10.56305/001c.162033","pdf_url":"https://bhm.scholasticahq.com/article/162033.pdf","source":{"id":"https://openalex.org/S4387292724","display_name":"Journal of Brown Hospital Medicine","issn_l":"2994-5593","issn":["2994-5593"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Brown Hospital Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://bhm.scholasticahq.com/article/162033.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5021751151","display_name":"Jandir Mendon\u00e7a Nic\u00e1cio","orcid":"https://orcid.org/0000-0001-9139-2414","observed_orcids":["https://orcid.org/0000-0001-9139-2414"]},"institutions":[{"id":"https://openalex.org/I59530521","display_name":"Universidade Federal do Vale do S\u00e3o Francisco","ror":"https://ror.org/00devjr72","country_code":"BR","type":"education","lineage":["https://openalex.org/I59530521"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Jandir Mendon\u00e7a Nicacio","raw_affiliation_strings":["Federal University of S\u00e3o Francisco Valley","Hematology Service, University Hospital, Federal University of Vale do S\u00e3o Francisco (HU-UNIVASF/EBSERH)"],"raw_orcid":"https://orcid.org/0000-0001-9139-2414","affiliations":[{"raw_affiliation_string":"Federal University of S\u00e3o Francisco Valley","institution_ids":["https://openalex.org/I59530521"]},{"raw_affiliation_string":"Hematology Service, University Hospital, Federal University of Vale do S\u00e3o Francisco (HU-UNIVASF/EBSERH)","institution_ids":["https://openalex.org/I59530521"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061483856","display_name":"Lucyo Fl\u00e1vio Bezerra Diniz","orcid":"https://orcid.org/0000-0001-7240-3851","observed_orcids":["https://orcid.org/0000-0001-7240-3851"]},"institutions":[{"id":"https://openalex.org/I59530521","display_name":"Universidade Federal do Vale do S\u00e3o Francisco","ror":"https://ror.org/00devjr72","country_code":"BR","type":"education","lineage":["https://openalex.org/I59530521"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Lucyo Fl\u00e1vio Bezerra Diniz","raw_affiliation_strings":["Hematology Service, University Hospital, Federal University of Vale do S\u00e3o Francisco (HU-UNIVASF/EBSERH)"],"raw_orcid":"https://orcid.org/0000-0001-7240-3851","affiliations":[{"raw_affiliation_string":"Hematology Service, University Hospital, Federal University of Vale do S\u00e3o Francisco (HU-UNIVASF/EBSERH)","institution_ids":["https://openalex.org/I59530521"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5104208316","display_name":"Andr\u00e9 Lu\u00eds Magalh\u00e3es Fernandes","orcid":"https://orcid.org/0000-0002-5848-4883","observed_orcids":["https://orcid.org/0000-0002-5848-4883"]},"institutions":[{"id":"https://openalex.org/I4387153231","display_name":"Hospital Universit\u00e1rio Regional de Maring\u00e1","ror":"https://ror.org/03vadg117","country_code":"BR","type":"healthcare","lineage":["https://openalex.org/I123443094","https://openalex.org/I4387153231"]}],"countries":["BR"],"is_corresponding":false,"raw_author_name":"Andre Luis Magalh\u00e3es Fernandes","raw_affiliation_strings":["Hematology Service, Hospital Regional Juazeiro"],"raw_orcid":"https://orcid.org/0000-0002-5848-4883","affiliations":[{"raw_affiliation_string":"Hematology Service, Hospital Regional Juazeiro","institution_ids":["https://openalex.org/I4387153231"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":3.7298,"has_fulltext":true,"cited_by_count":1,"citation_normalized_percentile":{"value":0.86245353,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":91,"max":95},"biblio":{"volume":"5","issue":"3","first_page":"162033","last_page":"162033"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10746","display_name":"Platelet Disorders and Treatments","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10746","display_name":"Platelet Disorders and Treatments","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13374","display_name":"Hematological disorders and diagnostics","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11628","display_name":"Myeloproliferative Neoplasms: Diagnosis and Treatment","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cyclic-thrombocytopenia","display_name":"cyclic thrombocytopenia","score":1.0},{"id":"https://openalex.org/keywords/thrombosis","display_name":"thrombosis","score":0.7129999995231628},{"id":"https://openalex.org/keywords/deep-vein-thrombosis","display_name":"deep vein thrombosis","score":0.8349999785423279},{"id":"https://openalex.org/keywords/pulmonary-hemorrhage","display_name":"pulmonary hemorrhage","score":0.9309999942779541},{"id":"https://openalex.org/keywords/rituximab","display_name":"rituximab","score":0.9639999866485596},{"id":"https://openalex.org/keywords/eltrombopag","display_name":"eltrombopag","score":0.949999988079071},{"id":"https://openalex.org/keywords/thrombopoietin-receptor-agonists","display_name":"thrombopoietin receptor agonists","score":0.9539999961853027},{"id":"https://openalex.org/keywords/thrombotic-risk","display_name":"thrombosis risk","score":0.7739999890327454},{"id":"https://openalex.org/keywords/refractory-thrombocytopenia","display_name":"refractory thrombocytopenia","score":0.9490000009536743},{"id":"https://openalex.org/keywords/platelet-count-fluctuation","display_name":"platelet count fluctuation","score":0.6159999966621399},{"id":"https://openalex.org/keywords/mucocutaneous-bleeding","display_name":"mucocutaneous bleeding","score":0.8510000109672546}],"concepts":[{"id":"https://openalex.org/C2780588981","wikidata":"https://www.wikidata.org/wiki/Q411588","display_name":"Eltrombopag","level":4,"score":0.9538999795913696},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9230999946594238},{"id":"https://openalex.org/C2993327898","wikidata":"https://www.wikidata.org/wiki/Q638729","display_name":"Immune thrombocytopenia","level":3,"score":0.7376000285148621},{"id":"https://openalex.org/C2780653079","wikidata":"https://www.wikidata.org/wiki/Q412323","display_name":"Rituximab","level":3,"score":0.6942999958992004},{"id":"https://openalex.org/C89560881","wikidata":"https://www.wikidata.org/wiki/Q101026","display_name":"Platelet","level":2,"score":0.6739000082015991},{"id":"https://openalex.org/C2780868729","wikidata":"https://www.wikidata.org/wiki/Q261327","display_name":"Thrombosis","level":2,"score":0.6212000250816345},{"id":"https://openalex.org/C2776915898","wikidata":"https://www.wikidata.org/wiki/Q1235195","display_name":"Romiplostim","level":5,"score":0.6139000058174133},{"id":"https://openalex.org/C142424586","wikidata":"https://www.wikidata.org/wiki/Q7307572","display_name":"Refractory (planetary science)","level":2,"score":0.6017000079154968},{"id":"https://openalex.org/C2780011451","wikidata":"https://www.wikidata.org/wiki/Q2751330","display_name":"Venous thrombosis","level":3,"score":0.5286999940872192},{"id":"https://openalex.org/C2778959117","wikidata":"https://www.wikidata.org/wiki/Q430892","display_name":"Deep vein","level":3,"score":0.5192000269889832},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.46299999952316284},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.4519999921321869},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.4050000011920929},{"id":"https://openalex.org/C2777863708","wikidata":"https://www.wikidata.org/wiki/Q424519","display_name":"Thrombopoietin","level":4,"score":0.3788999915122986},{"id":"https://openalex.org/C2778713057","wikidata":"https://www.wikidata.org/wiki/Q18029261","display_name":"Thrombopoietin receptor","level":5,"score":0.35499998927116394},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.3431999981403351},{"id":"https://openalex.org/C8891405","wikidata":"https://www.wikidata.org/wiki/Q1059","display_name":"Immune system","level":2,"score":0.29420000314712524},{"id":"https://openalex.org/C2910090564","wikidata":"https://www.wikidata.org/wiki/Q101026","display_name":"Platelet disorder","level":3,"score":0.2838999927043915},{"id":"https://openalex.org/C2781362458","wikidata":"https://www.wikidata.org/wiki/Q1588755","display_name":"Thrombus","level":2,"score":0.267300009727478},{"id":"https://openalex.org/C3019213423","wikidata":"https://www.wikidata.org/wiki/Q166019","display_name":"Severe bleeding","level":2,"score":0.262800008058548},{"id":"https://openalex.org/C2780525284","wikidata":"https://www.wikidata.org/wiki/Q7882181","display_name":"Bone marrow failure","level":4,"score":0.2563999891281128}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.56305/001c.162033","doi":"https://doi.org/10.56305/001c.162033","is_oa":true,"landing_page_url":"https://doi.org/10.56305/001c.162033","pdf_url":"https://bhm.scholasticahq.com/article/162033.pdf","source":{"id":"https://openalex.org/S4387292724","display_name":"Journal of Brown Hospital Medicine","issn_l":"2994-5593","issn":["2994-5593"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Brown Hospital Medicine","raw_type":"journal-article"},{"id":"pmid:42405365","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42405365","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Brown hospital medicine","raw_type":"Case Reports"},{"id":"pmh:oai:pubmedcentral.nih.gov:13330566","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13330566/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"J Brown Hosp Med","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.56305/001c.162033","doi":"https://doi.org/10.56305/001c.162033","is_oa":true,"landing_page_url":"https://doi.org/10.56305/001c.162033","pdf_url":"https://bhm.scholasticahq.com/article/162033.pdf","source":{"id":"https://openalex.org/S4387292724","display_name":"Journal of Brown Hospital Medicine","issn_l":"2994-5593","issn":["2994-5593"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Brown Hospital Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7166803137.pdf","grobid_xml":"https://content.openalex.org/works/W7166803137.grobid-xml"},"referenced_works_count":12,"referenced_works":["https://openalex.org/W2018409696","https://openalex.org/W2103644808","https://openalex.org/W2313464247","https://openalex.org/W2807575667","https://openalex.org/W3001962550","https://openalex.org/W3105519109","https://openalex.org/W4205896861","https://openalex.org/W4224241395","https://openalex.org/W4385264964","https://openalex.org/W4389608466","https://openalex.org/W4408622661","https://openalex.org/W4416590343"],"related_works":["https://openalex.org/W3105519109","https://openalex.org/W4310108499","https://openalex.org/W4416590343","https://openalex.org/W4406253240","https://openalex.org/W4408622661","https://openalex.org/W4388198990","https://openalex.org/W4212796166","https://openalex.org/W4401357349","https://openalex.org/W6922351698","https://openalex.org/W2014696850"],"abstract_inverted_index":{"Cyclic":[0],"thrombocytopenia":[1,33,43,95],"(CTP)":[2],"is":[3,14],"a":[4,25,29,77,107,138],"rare":[5],"hematologic":[6],"disorder":[7],"characterized":[8],"by":[9],"fluctuating":[10],"platelet":[11,60,111],"counts":[12,61],"and":[13,34,47,76,88,134],"often":[15],"misdiagnosed":[16],"as":[17,41,137],"immune":[18,42],"thrombocytopenia.":[19],"We":[20],"present":[21],"the":[22,121,127],"case":[23,119],"of":[24,31,124,130],"51-year-old":[26],"woman":[27],"with":[28,44,69,83,113,144],"history":[30],"severe":[32],"mucocutane-ous":[35],"bleeding":[36,80],"since":[37],"2012,":[38],"initially":[39],"treated":[40],"corticoster-oids,":[45],"splenectomy,":[46],"azathioprine,":[48],"without":[49],"sustained":[50],"response.":[51],"Over":[52],"time,":[53],"she":[54],"devel-oped":[55],"pronounced":[56],"cyclic":[57,94],"fluctuations":[58],"in":[59,72,110],"(<10,000/mm\u00b3":[62],"to":[63,106],">150,000/mm\u00b3)":[64],"every":[65],"21":[66],"days.":[67],"Treatment":[68],"eltrombopag":[70],"resulted":[71],"deep":[73],"venous":[74],"thrombosis":[75],"major":[78],"pulmonary":[79],"episode":[81],"associated":[82],"anticoagulation.":[84],"After":[85],"secondary":[86],"causes":[87],"bone":[89],"marrow":[90],"disorders":[91],"were":[92],"excluded,":[93],"was":[96],"diag-nosed.":[97],"Rituximab":[98],"(375":[99],"mg/m\u00b2":[100],"weekly":[101],"for":[102,141],"four":[103],"weeks)":[104],"led":[105],"significant":[108,116],"reduction":[109],"oscillations,":[112],"no":[114],"further":[115],"bleeding.":[117],"This":[118],"highlights":[120],"diagnos-tic":[122],"challenges":[123],"CTP,":[125],"underscores":[126],"thrombotic":[128],"risks":[129],"thrombopoietin":[131],"receptor":[132],"agonists,":[133],"supports":[135],"rituximab":[136],"potential":[139],"treatment":[140],"refractory":[142],"cases":[143],"high":[145],"thrombo-hemorrhagic":[146],"risk.":[147]},"counts_by_year":[{"year":2026,"cited_by_count":1}],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-07-02T00:00:00"}
