Immunoglobulin A and Immunoglobulin M and Their Relation to Treatment Response in Adult Egyptian Immune Thrombocytopenic Purpura Patients

Abstract

Background: Immune thrombocytopenia (ITP) is a disorder of antibody mediated destruction and inhibition of production of platelets. In general, this is an idiopathic disease, and it is unclear what are the immune factors related to disease predisposition, severity, and especially response to treatment. Objective: The aim of the work was to measure the level of Immunoglobulins M (IgM) and A (IgA) in patients with immune thrombocytopenic purpura (ITP) and to detect their relation to treatment response. Patients and Methods: The serum level of both IgA and IgM were measured by ELISA assay in 60 newly diagnosed ITP patients received standard treatment in the form of steroids. Patients were aged from 16 to 45 years. Results: Median level of IgA was higher in ITP patients at presentation in comparison to average normal population which was of no statistical significance while ITP patients had lower median level of IgM at presentation in comparison to average normal population with no statistically significance. No significant correlation could be detected between level of IgA and IgM and platelets count in ITP patients after one month and 3 months of treatment. This study indicated that non responder patients had IgA level higher than that of responder patients but of no statistically significant difference. (P value=0.536). Conclusion:It could be concluded that statistically significant difference between responder and non-responder ITP patients as regard the level of IgM denotes that patients who had IgM level below the median were more resistant to steroids which is the standard treatment in ITP.