{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:12:30Z","timestamp":1791389550944,"version":"4.3.3"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Immune thrombocytopenia (ITP) is a disease characterized by platelet destruction, presenting substantial challenges in clinical practice. The classic first line therapeutic management includes corticosteroids and intravenous immunoglobulins. Although it is less frequent in children than in adults, there is a significant percentage of patients, up to 47% according to the Pediatric and Adult Registry on Chronic ITP, who require second-line or further treatment, due to non-response to the first line treatment or persistence of disease, among other reasons. Several second line approaches for its treatment are currently in use, including increasing platelet production with thrombopoietin receptor agonists. We report the case of a 16-year-old patient with ITP and alopecia areata successfully treated with baricitinib, a reversible and selective JAK 1\/2 inhibitor. Baricitinib is currently in use for the treatment of several autoimmune conditions and has been shown to increase platelet counts in these patients. This phenomenon has been linked to increased TPO signaling and reduced platelet destruction. There are promising preliminary results of adult ITP patients treated with baricitinib. This case report is the first reported use of baricitinib in ITP in the pediatric and adolescent setting, potentially leading to its use in this condition.<\/jats:p>","DOI":"10.3389\/fped.2024.1516039","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T06:39:59Z","timestamp":1735022399000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Baricitinib in pediatric chronic immune thrombocytopenia and associated autoimmune conditions: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"G.","family":"L\u00f3pez de Hontanar Torres","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Zubicaray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Sebasti\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Hern\u00e1ndez-Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Iriondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Sevilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1002\/ajh.25479","article-title":"Second-line treatments in children with immune thrombocytopenia: effect on platelet count and patient-centered outcomes","volume":"94","author":"Grace","year":"2019","journal-title":"Am J Hematol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1056\/NEJMoa2110343","article-title":"Two phase 3 trials of baricitinib for alopecia areata","volume":"386","author":"King","year":"2022","journal-title":"N Engl J Med"},{"key":"B3","volume-title":"FDA Approves First Systemic Treatment for Alopecia Areata","year":"2022"},{"key":"B4","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1002\/phar.2438","article-title":"Baricitinib: a review of pharmacology, safety, and emerging clinical experience in COVID\u221219","volume":"40","author":"Jorgensen","year":"2020","journal-title":"Pharmacotherapy"},{"key":"B5","article-title":"Mean platelet volume changes with baricitinib indicate reduced new platelet production in baricitinib-treated rheumatoid arthritis patients","volume":"70","author":"Giles","year":"2018","journal-title":"Arthritis Rheumatol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1182\/blood-2023-181622","article-title":"Baricitinib in combination with high-dose dexamethasone as first-line treatment for newly diagnosed immune thrombocytopenia: a prospective, multicenter, randomized trial","volume":"142","author":"Zhao","year":"2023","journal-title":"Blood"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1951","DOI":"10.1002\/ajh.27433","article-title":"Safety and efficacy of baricitinib in steroid-resistant or relapsed immune thrombocytopenia: an open-label pilot study","volume":"99","author":"Zhao","year":"2024","journal-title":"Am J Hematol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/S0140-6736(23)00921-2","article-title":"Baricitinib in juvenile idiopathic arthritis: an international, phase 3, randomised, double-blind, placebo-controlled, withdrawal, efficacy, and safety trial","volume":"402","author":"Ramanan","year":"2023","journal-title":"Lancet"},{"key":"B9","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1002\/ajh.25086","article-title":"; intercontinental cooperative ITP study group (ICIS). A comparative prospective observational study of children and adults with immune thrombocytopenia: 2-year follow-up","volume":"93","author":"Schifferli","year":"2018","journal-title":"Am J Hematol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"698","DOI":"10.3109\/08880018.2012.756564","article-title":"Prevalence and clinical significance of antithyroid antibodies in children with immune thrombocytopenic purpura","volume":"30","author":"Bay","year":"2013","journal-title":"Pediatr Hematol Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e27452","DOI":"10.1002\/pbc.27452","article-title":"Role of antithyroid autoimmunity as a predictive biomarker of chronic immune thrombocytopenia","volume":"66","author":"Giordano","year":"2019","journal-title":"Pediatr Blood Cancer"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1516039\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T06:40:01Z","timestamp":1735022401000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1516039\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,24]]},"references-count":11,"alternative-id":["10.3389\/fped.2024.1516039"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1516039","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,24]]},"article-number":"1516039"}}