TY - JOUR
T1 - Platelet count, previous infection and FCGR2B genotype predict development of chronic disease in newly diagnosed idiopathic thrombocytopenia in childhood
T2 - Results of a prospective study
AU - Bruin, Marrie
AU - Bierings, Marc
AU - Uiterwaal, Cuno
AU - Révész, Tom
AU - Bode, Lonneke
AU - Wiesman, Marie Elize
AU - Kuijpers, Taco
AU - Tamminga, Rienk
AU - De Haas, Masja
PY - 2004/12
Y1 - 2004/12
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=10344253785&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2141.2004.05235.x
DO - 10.1111/j.1365-2141.2004.05235.x
M3 - Article
C2 - 15566359
AN - SCOPUS:10344253785
SN - 0007-1048
VL - 127
SP - 561
EP - 567
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 5
ER -