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.
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