Platelet count, previous infection and FCGR2B genotype predict development of chronic disease in newly diagnosed idiopathic thrombocytopenia in childhood: Results of a prospective study

Marrie Bruin, Marc Bierings, Cuno Uiterwaal, Tom Révész, Lonneke Bode, Marie Elize Wiesman, Taco Kuijpers, Rienk Tamminga, Masja De Haas*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

55 Citations (Scopus)

Abstract

About 25-30% of children with acute idiopathic thrombocytopenia (ITP) develop chronic disease. It is not well known which patient characteristics influence the course of the ITP. A prospective study in 60 children with newly diagnosed ITP was performed. The aim of the study was to identify patient characteristics at the onset of thrombocytopenia that predicts the progression to chronic ITP. Clinical data and blood samples were collected at several time points during the first 6 months of the disease. Variables predicting chronic disease, as calculated in a multivariate logistic regression analysis, were a platelet count >10 × 109/1 at the onset [odds ratio (OR) 1·1, 95% confidence interval (CI) 1·01-1·14], the absence of infection shortly before the onset of the disease (OR 4·8, CI 1·16-19·57) and FGR2B-232I/T genotype (OR 7·9, CI 0·96-65·27). The latter may point at an immune-modulating role of FcγR11b in ITP. Although only three patients had serious bleeds, 35 patients received immune-modulating treatment for low platelet counts only. Seventeen patients were treated with intravenous immunoglobulin (IVIG) and 18 patients received corticosteroids. Patient variables did not differ between these treatment groups. However, patients receiving IVIG had significantly lower risk for chronic disease.

Original languageEnglish
Pages (from-to)561-567
Number of pages7
JournalBritish Journal of Haematology
Volume127
Issue number5
DOIs
Publication statusPublished - Dec 2004
Externally publishedYes

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