Immune thrombocytopenia in adults: a prospective cohort study of clinical features and predictors of outcome

Abstract

This prospective observational cohort study aimed to explore the clinical features of incident immune thrombocytopenia in adults and predictors of outcome, while determining if a family history of autoimmune disorder is a risk factor for immune thrombocytopenia. All adults, 18 years of age or older, recently diagnosed with immune thrombocytopenia were consecutively recruited across 21 hospital centers in France. Data were collected at diagnosis and after 12 months. Predictors of chronicity at 12 months were explored using logistic regression models. The association between family history of autoimmune disorder and the risk of developing immune thrombocytopenia was explored using a conditional logistic regression model after matching each case to 10 controls. One hundred and forty-three patients were included: 63% female, mean age 48 years old (Standard Deviation=19), and 84% presented with bleeding symptoms. Median platelet count was 10×10(9)/L. Initial treatment was required in 82% of patients. After 12 months, only 37% of patients not subject to disease-modifying interventions achieved cure. The sole possible predictor of chronicity at 12 months was a higher platelet count at baseline [Odds Ratio 1.03; 95%CI: 1.00, 1.06]. No association was found between outcome and any of the following features: age, sex, presence of either bleeding symptoms or antinuclear antibodies at diagnosis. Likewise, family history of autoimmune disorder was not associated with incident immune thrombocytopenia. Immune thrombocytopenia in adults has been shown to progress to a chronic form in the majority of patients. A lower platelet count could be indicative of a more favorable outcome.

Idiopathic Thrombocytopenia After Omega Gastric Bypass Surgery: A Case Report

“…Of the drugs, antibiotics like Sulfonamides, Ampicillin, Piperacillin, Vancomycin, Rifampin or Antiepileptic agents such as Carbamazepine, Phenytoin, and Quinine could be noted (11). If the patient has not already been taking these drugs, thrombocytopenia occurs in 1 to 2 weeks later, and after stopping, 5 -7 days later becomes normal, and no more treatment is required (9,12). Among the drugs used in this patient, none of them could cause a drop in platelets count.…”

“…In some cases, despite the drop in platelet counts, it maybe still be equal to or greater than 150,000. Therefore, the platelet count should be compared with the initial platelet counts, and recent platelet drop of more than 50% of the initial amount, needs to investigate (9).…”

“…ITP diagnosed by thrombocytopenia below 100,000, and the absence of splenomegaly and secondary causes. The standard treatment is Corticosteroid (8,9). Assistive prescription of intravenous immunoglobulin, sometimes is necessary.…”

Immunthrombozytopenie - aktuelle Diagnostik und Therapie: Empfehlungen einer gemeinsamen Arbeitsgruppe der DGHO, ÖGHO, SGH, GPOH und DGTI

“…Bei der neu diagnostizierten ITP haben 10% aller pädiatrischen und 20-30% aller erwachsenen Patienten gar keine Blutungssymptome [5,32,33]. Bei der chronischen ITP liegt der Anteil der Patienten ohne jegliche Blutungssymptome bei 30-40% [32,34,35].…”

“…Bei der chronischen ITP liegt der Anteil der Patienten ohne jegliche Blutungssymptome bei 30-40% [32,34,35].…”