Olivier Descamps 1, Fabian Demeure ², Caroline Wallemacq3, Ann Mertens 4, Ann Verhaegen 5, Johan De Sutter 6, Michel Langlois 7, Ernst Rietzschel 8.Published in the journal : December 2021Category : Actualités thérapeutiques
Familial hypercholesterolemia is a common, yet often underdiagnosed, genetic disease. Nevertheless, this condition is easily manageable provided that the disease is detected early enough and appropriately treated. Our article presents some diagnostic tools for this condition. In a first patient of an as yet unexplored family, referred to as the index patient, we propose to use the DLCN (Dutch Lipid Clinic Network) score, which should be followed by genetic analysis, depending on the case. Once the diagnosis has been confirmed in this index patient, the disease can easily be identified in other first-degree relatives based on a reference table that has presented in this article. This table provides the threshold values of LDL cholesterol concentrations, according to age and gender, at which the existence of familial hypercholesterolemia in a first-degree relative should be suspected. To this article, we have attached a sample letter that can be addressed to family members, designed to alert them on this disease and facilitate the work-up of their general practitioners.
In recent years, the management of primary immune thrombocytopenic purpura (ITP) has undergone a profound change, owing to an improved understanding of its pathophysiology, the development of new targeted therapeutic molecules, and the updated guidelines of numerous scientific societies, including the Belgian Hematology Society (BHS). The purpose of this article is to review the diagnostic methods, describe both the modalities and objectives of treatment in 2021, and discuss the new therapeutic options made available to us.
Despite the therapeutic revolution brought about by direct oral anticoagulants (DOACs) over recent years, low-molecular weight heparins (LMWHs) keep on playing a major role in the antithrombotic management of numerous patients, either as alternatives to AODs or as first-line drugs. The indications for the latter include pregnancy, cancer, or venous thrombo-embolic disease prevention. After a brief summary recalling the main characteristics and properties of LMWHs, this article proposes a practical review that is primarily focused on the current indications for LMWHs and their precautions for use. The article also reminds us that not all LMWHs are to be considered as equivalent. This particularly concerns tinzaparin, exhibiting a higher molecular weight and less renal elimination, thus being an agent of choice in the treatment of venous thromboembolic disease, especially within the neoplasia context.
