Platelet Antibody Detection in Pediatric Immune Thrombocytopenic Purpura: Evaluation of Three Screening Methods

Biglino, P; Perutelli, P; Mori, Pier Giorgio

doi:10.1046/j.1423-0410.1997.7240242.x

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…3 The patient failed to respond to steroids and vincristine prior to IVIg. 4 The patient failed to respond to steroids prior to IVIg therapy. 5 The patient did not respond to splenectomy, prednisone, dapsone, cyclophosphamide, interferon and vincristine prior to IVIg 6 The patient was previously treated with steroids with partial success.…”

Section: Methodsmentioning

confidence: 98%

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Autoantibody Level Modification in Adult Patients with Idiopathic Thrombocytopenic Purpura following Intravenous Immunoglobulin Treatment

Levy

Sherer²,

Ahmed³

et al. 1998

Nat Immun

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The aim of this study was to determine whether treatment of patients with immune thrombocytopenic purpura (ITP) with intravenous immunoglobulin (IVIg) is associated with a modification in the antiplatelet glycoprotein (GP) antibodies (Abs). Fourteen patients with ITP (11 females and 3 males, mean age 36.6 years, range 18–72) received one to four IVIg treatment courses. The preparation used was ISIVEN that was given in a dose of 2 g/kg body weight in a 5-day schedule and in monthly intervals. Levels of IgG, IgM and IgA isotypes of Abs to GPs IIb/IIIa and Ib/IX were measured before the treatment, and before and after each treatment course. Two patients did not respond to IVIg, 6 had a temporary response, 5 had a sustained response and 1 patient responded well to the treatment but was lost to follow-up. The patients had a high prevalence of serum Abs directed against GPs IIb/IIIa and Ib/IX before the treatment, and the mean IgG isotype levels of both Abs increased after each treatment course, and decreased again before the following course began. Whenever high Ab levels of either isotype (>10 U/ml) were detected before the treatment, they were significantly decreased before the last treatment course. The elevated levels of IgG Abs to IIb/IIIa and Ib/IX after every course are probably a result of displacement of these Abs from Fc receptors by the IVIg, rather than of exogenous infusion of these Abs contained within the IVIg, whereas the decrease in high Ab levels after a few treatment courses results from the immunomodulatory effects of IVIg: suppression of Ab formation, and the presence of anti-idiotypes.

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Section: Methodsmentioning

confidence: 98%

“…These Abs were more frequently detected in either active and/ or non-splenectomized patients, whereas in those who had Abs against Ib/IX, significantly lower platelet counts were observed [3]. Similarly, a higher frequency of circulating Abs was found at the onset of both acute and chronic ITP than in clinical remission [4].…”

Section: Introductionmentioning

confidence: 91%

Autoantibody Level Modification in Adult Patients with Idiopathic Thrombocytopenic Purpura following Intravenous Immunoglobulin Treatment

Levy

Sherer²,

Ahmed³

et al. 1998

Nat Immun

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Anti‐platelet antibody immunoassays in childhood immune thrombocytopenia: a systematic review

et al. 2020

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Background In adult immune thrombocytopenia (ITP), an acquired autoimmune bleeding disorder, anti-platelet autoantibody testing may be useful as a rule-in test. Childhood ITP has different disease characteristics, and the diagnostic and prognostic value of anti-platelet antibody testing remains uncertain.Objective To systematically review the diagnostic accuracy of anti-platelet autoantibody testing in childhood ITP.Methods PubMed and EMBASE were searched for studies evaluating immunoassays in childhood ITP. Study quality was assessed (QUADAS2), and evidence was synthesized descriptively. ResultsIn total, 40 studies (1606 patients) were identified. Nine studies reported sufficient data to determine diagnostic accuracy measures. Anti-platelet IgG antibody testing showed a moderate sensitivity (0Á36-0Á80 platelet-associated IgG [direct test]; 0Á19-0Á39 circulating IgG [indirect test]). In studies that reported control data, including patients with non-immune thrombocytopenia, specificity was very good (0Á80-1Á00). Glycoprotein-specific immunoassays showed comparable sensitivity (three studies) and predominantly identified IgG anti-GP IIb/IIIa antibodies, with few IgG anti-GP Ib/IX antibodies. Anti-platelet IgM antibodies were identified in a substantial proportion of children (sensitivity 0Á62-0Á64 for direct and indirect tests). ConclusionThe diagnostic evaluation of IgG and IgM anti-platelet antibodies may be useful as a rule-in test for ITP. In children with insufficient platelets for a direct test, indirect tests may be performed instead. A negative test does not rule out the diagnosis of ITP. Future studies should evaluate the value of antiplatelet antibody tests in thrombocytopenic children with suspected ITP.

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Platelet Antibody Detection in Pediatric Immune Thrombocytopenic Purpura: Evaluation of Three Screening Methods

Abstract: The individual tests each have a relatively low sensitivity, but the combination of all three increases the diagnostic effectiveness. The finding of platelet antibodies during remission may predict evolution toward a systemic autoimmune state.

Cited by 2 publications

References 23 publications

Autoantibody Level Modification in Adult Patients with Idiopathic Thrombocytopenic Purpura following Intravenous Immunoglobulin Treatment

Autoantibody Level Modification in Adult Patients with Idiopathic Thrombocytopenic Purpura following Intravenous Immunoglobulin Treatment

Anti‐platelet antibody immunoassays in childhood immune thrombocytopenia: a systematic review

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