Prevalence of primary immune thrombocytopenia in Oklahoma

Terrell, Deirdra R.; Beebe, Laura A.; Neas, Barbara R.; Vesely, Sara K.; Segal, Jodi B; George, James N.

doi:10.1002/ajh.23262

Cited by 81 publications

(59 citation statements)

References 27 publications

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“…We also confirmed the overall female predominance as well as male predominance in pediatric and older patients. 5,41 In our study, the frequency of incident ITPs becoming persistent or chronic is also very close to experience-and smaller series-based findings for both adults and children. 15,42,43 As previously said, we could not accurately measure the frequency of complete remission during the persistency phase before the chronic phase: in clinical practice, exposure to rituximab or splenectomy can …”

Section: Discussionsupporting

confidence: 61%

Epidemiology of incident immune thrombocytopenia: a nationwide population-based study in France

Moulis

Palmaro

Montastruc

et al. 2014

Blood

286

250

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Key Points• Incidence of ITP was 2.9/100 000 person-years with age, seasonal, and regional variations; in adults, 18% were secondary. • Severe (gastrointestinal or central nervous system) bleeding at ITP onset was rare (,1%); the risk increased with age.The epidemiology of immune thrombocytopenia (ITP) is not well known. The purpose of this study was to assess ITP incidence at a nationwide level (France) with recent data (mid-2009 to mid-2011; 129 248 543 person-years). The data source is the French health insurance database. We selected cases with diagnosis codes for in-hospital stays and long-term disease attributions, thus restricting our search to ITPs necessitating health care. We studied incidence by age, gender, calendar month, regions, and proportion of secondary ITPs, of ITPs becoming persistent or chronic, and of severe bleeding at disease onset. We identified 3771 incident ITP patients. Incidence was 2.9/100 000 person-years, with peaks among children and in those >60 years of age. ITP was more frequent among males in these subgroups. The incidence was lower in overseas Caribbean French departments, suggesting a lower incidence among Afro-American people. There was a northsouth gradient in mainland France and seasonal variations (peak in winter and nadir in summer). Persistence or chronicity occurred in 36% of children compared with 67% of adults. Among adults, 18% of ITPs were secondary. Malignancy was the main cause (10.9%). Myelodysplastic syndromes were not rare (2.3%). Severe gastrointestinal or central nervous system bleeding at ITP onset was rare (<1%). (Blood. 2014;124(22):3308-3315)

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Section: Discussionsupporting

confidence: 61%

Epidemiology of incident immune thrombocytopenia: a nationwide population-based study in France

Moulis

Palmaro

Montastruc

et al. 2014

Blood

286

250

View full text Add to dashboard Cite

show abstract

“…This prevalence of autoimmune cytopenia is strikingly higher than among the general population, in whom ITP has been estimated to affect between 8 and 12 in 100,000 [14]; AIHA between 1 and 17 per 100,000 [15, 16]; and autoimmune neutropenia 1 in 100,000, among in children aged 1 to 10 years [17]. Compared to the USIDNET Registry, other CVID patient registries report higher prevalence of autoimmune cytopenias: a French report of 408 CVID patients and a US cohort of 473 CVID patients noted one or more autoimmune cytopenia in 14 to 18% of patients [4, 8, 18].…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Cytopenias and Associated Conditions in CVID: a Report From the USIDNET Registry

et al. 2017

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Purpose Autoimmune cytopenia is frequently a presenting manifestation of common variable immune deficiency (CVID). Studies characterizing the CVID phenotype associated with autoimmune cytopenias have mostly been limited to large referral centers. Here, we report prevalence of autoimmune cytopenias in CVID from the USIDNET Registry and compare the demographics and clinical features of patients with and without this complication. Methods Investigators obtained demographic, laboratory, and clinical data on CVID patients within the USIDNET Registry. Patients were considered to have autoimmune cytopenia if they had a diagnosis of hemolytic anemia, immune thrombocytopenia (ITP), or autoimmune neutropenia. Baseline characteristics and associated complications of those with autoimmune cytopenia (+AC) and those without (−AC) were compared. Results Of 990 CVID patients included in the analysis, 10.2% (N = 101) had a diagnosis consistent with autoimmune cytopenia: ITP was diagnosed in 7.4% (N = 73), hemolytic anemia in 4.5% (N = 45), and autoimmune neutropenia in 1% (N = 10). Age at diagnosis, gender, and baseline Ig values did not differ between the +AC and −AC groups. The +AC group was significantly more likely to have one or more other CVID-associated non-infectious complications (OR = 2.9; 95%-CI: 1.9–4.6, P < 0.001), including lymphoproliferation, granulomatous disease, lymphomas, hepatic disease, interstitial lung diseases, enteropathy, and organ-specific autoimmunity. Conclusions Autoimmune cytopenias are a common manifestation in CVID and are likely to be associated with other non-infectious CVID-related conditions. In light of prior studies showing increased morbidity and mortality in CVID patients with such complications, a diagnosis of autoimmune cytopenia may have prognostic significance in CVID.

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“…OUMC is the largest single site of hematologists in medical practice in the State of Oklahoma with 22 of the state’s 93 hematologists, including four of the state’s six pediatric hematologists, during this period. (8)…”

Section: Methodsmentioning

confidence: 99%

Determining a definite diagnosis of primary immune thrombocytopenia by medical record review

Terrell¹,

Beebe²,

Vesely³

et al. 2012

American J Hematol

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Objective To establish a method to identify patients with primary immune thrombocytopenia (ITP) utilizing administrative data from diverse data sources that would be appropriate for epidemiologic studies of ITP, regardless of patients’ age and source of health care. Study Design and Setting Medical records of the Oklahoma University Medical Center, 1995–2004, were reviewed to document the accuracy of the administrative code ICD-9-CM 287.3 for identifying children and adults with ITP, using novel, explicit levels of evidence to identify patients with a definite diagnosis. The proportion of patients diagnosed by hematologists compared to non-hematologists and the proportion of patients diagnosed as outpatients compared to inpatients were determined. Results For children, age <16 years, 323 outpatient medical records were reviewed; 225 adult outpatient medical records were reviewed. The positive predictive value for the administrative code for identifying patients with a definite diagnosis of ITP by a hematologist was 0.72 in children and 0.69 in adults. In 98% of children and 92% of adults seen as outpatients, the definite diagnosis of ITP was established by a hematologist. One hundred eighteen child and 141 adult inpatient medical records were reviewed. In 95% of children and 83% of adults, the definite diagnosis of ITP by a hematologist was established as an outpatient. Conclusion This study confirmed the previously reported positive predictive value for the administrative code for identifying patients with ITP. Additionally, it was determined that analysis of hematologists’ outpatient administrative codes identified most children and adults with ITP.

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Prevalence of primary immune thrombocytopenia in Oklahoma

Cited by 81 publications

References 27 publications

Epidemiology of incident immune thrombocytopenia: a nationwide population-based study in France

Epidemiology of incident immune thrombocytopenia: a nationwide population-based study in France

Autoimmune Cytopenias and Associated Conditions in CVID: a Report From the USIDNET Registry

Determining a definite diagnosis of primary immune thrombocytopenia by medical record review

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