Immune thrombocytopenic purpura among the children attending at two teaching hospitals

Hafiz, Md. Golam; Mannan, MA; Amin, Syed Khairul; Islam, Aminul; Rahman, Fazlur

doi:10.3329/bmrcb.v34i3.1859

Cited by 2 publications

(1 citation statement)

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“…Zeller and colleagues showed that most childhood ITP cases occurred during winter months (11). In another study performed by Hafiz et al (12), childhood ITP was mostly diagnosed during the summer and at least in the winter. The first study was performed in Nordic countries where the climate is characterized by short, cool summers and long, cold winters.…”

Section: Discussionmentioning

confidence: 97%

Seasonal Association of Immune Thrombocytopenia in Adults

Tombak¹,

Boztepe²,

Tiftik³

et al. 2015

Balkan Med J

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Background:Immune thrombocytopenia (ITP) is an autoimmune disorder. It is characterized by thrombocytopenia due to thrombocyte destruction mediated by autoantibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogenesis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied. Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP. Study Design: Descriptive study. Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hospitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Relation between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated. Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resistant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149). Conclusion: This is the first study showing seasonal association of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Mediterranean climate is seen.

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Section: Discussionmentioning

confidence: 97%