Contributions
Abstract: EP1153
Type: E-Poster Presentation
Session title: Platelet disorders
Background
Background: Previous reports have suggested an increased frequency of autoantibodies (AutoAbs) in patients (pts) with ITP. However, the features of those ITP pts bearing AutoAbs have not been fully elucidated thus far.
Aims
Aims: To describe real world characteristics at diagnosis and evaluate disease outcome in pts with primary ITP and elevated at least one of antinuclear antibodies (ANA), rheumatoid factor (RF), antiphospholipid (APL) Abs or antithyroid Abs. Data from the national database (ITP registry) operated under the auspices of the Hellenic Society of Hematology was used.
Methods
Methods: The Greek ITP registry recruits pts (n=1514, to date) nationally through a network of 26 sites. In the present study we retrospectively analyzed data from pts with primary ITP aged over 18 years, who were diagnosed from 1979 to 2020
Results
Results: The total number of evaluable pts was 554. Pts were excluded from the study if they had a diagnosis of systemic lupus erythematosus, rheumatoid arthritis, thyroid disorder or antiphospholipid syndrome at the time of ITP initial presentation Of the 420 pts tested for ANA, 94 (22.4%) were positive with a titer of ≥ 1/160. There was no difference in age, sex or frequency of concurrently used medications between ANA+ and ANA- pts. However, the median platelet count at diagnosis was significantly lower in ANA+ pts (21.8x109/L, interquartile range: 5.7-30.5x109/L; P=0.048) than in ANA- pts (28.2x109/L, interquartile range: 8-43.3x109/L; P=0.048). Furthermore in ANA+ pts epistaxis and oral cavity bleeding were more frequently observed than in ANA- pts (P=0.0477 and P=0.0008; respectively). Of the 416 pts tested for RF, 20 (4.9%) were positive. RF+ and RF- pts had similar age and sex distribution as well as frequency of concurrently used medications and platelet counts at diagnosis. However, epistaxis and oral cavity bleeding were more frequently observed in RF+ pts than in RF- ones (P=0.021 and P=0.0445; respectively). Of the 208 pts tested for APL antibodies and of the 75 pts tested for antithyroid Abs, 24 (11.5%) and 19 (25%) were positive, respectively. Neither APL Ab+ nor antithyroid Ab+ pts had distinctive features in terms of age, sex, frequency of concurrently used medications platelet count at diagnosis or location of bleeding, as compared to APL Ab- and antithyroid Ab- pts, respectively. The frequency of antiplatelet Ab positivity, the overall response to treatment and the frequency of chronic ITP development did differ between positive and negative patients for any of the aforementioned autoimmune markers.
Conclusion
Summary/Conclusion: The presence of elevated ANA or RF characterizes ITP patients with distinct presentation. However neither response to treatment nor the development of chronic disease seems to be influenced by these autoAbs. On the other hand neither the presence of APL Abs nor antithyroid Abs did seems to affect the clinical profile of the pts. Additional studies are warranted to confirm our results and probe more deeply in the significance of autoimmune markers in ITP
Keyword(s): Thrombocytopenia
Abstract: EP1153
Type: E-Poster Presentation
Session title: Platelet disorders
Background
Background: Previous reports have suggested an increased frequency of autoantibodies (AutoAbs) in patients (pts) with ITP. However, the features of those ITP pts bearing AutoAbs have not been fully elucidated thus far.
Aims
Aims: To describe real world characteristics at diagnosis and evaluate disease outcome in pts with primary ITP and elevated at least one of antinuclear antibodies (ANA), rheumatoid factor (RF), antiphospholipid (APL) Abs or antithyroid Abs. Data from the national database (ITP registry) operated under the auspices of the Hellenic Society of Hematology was used.
Methods
Methods: The Greek ITP registry recruits pts (n=1514, to date) nationally through a network of 26 sites. In the present study we retrospectively analyzed data from pts with primary ITP aged over 18 years, who were diagnosed from 1979 to 2020
Results
Results: The total number of evaluable pts was 554. Pts were excluded from the study if they had a diagnosis of systemic lupus erythematosus, rheumatoid arthritis, thyroid disorder or antiphospholipid syndrome at the time of ITP initial presentation Of the 420 pts tested for ANA, 94 (22.4%) were positive with a titer of ≥ 1/160. There was no difference in age, sex or frequency of concurrently used medications between ANA+ and ANA- pts. However, the median platelet count at diagnosis was significantly lower in ANA+ pts (21.8x109/L, interquartile range: 5.7-30.5x109/L; P=0.048) than in ANA- pts (28.2x109/L, interquartile range: 8-43.3x109/L; P=0.048). Furthermore in ANA+ pts epistaxis and oral cavity bleeding were more frequently observed than in ANA- pts (P=0.0477 and P=0.0008; respectively). Of the 416 pts tested for RF, 20 (4.9%) were positive. RF+ and RF- pts had similar age and sex distribution as well as frequency of concurrently used medications and platelet counts at diagnosis. However, epistaxis and oral cavity bleeding were more frequently observed in RF+ pts than in RF- ones (P=0.021 and P=0.0445; respectively). Of the 208 pts tested for APL antibodies and of the 75 pts tested for antithyroid Abs, 24 (11.5%) and 19 (25%) were positive, respectively. Neither APL Ab+ nor antithyroid Ab+ pts had distinctive features in terms of age, sex, frequency of concurrently used medications platelet count at diagnosis or location of bleeding, as compared to APL Ab- and antithyroid Ab- pts, respectively. The frequency of antiplatelet Ab positivity, the overall response to treatment and the frequency of chronic ITP development did differ between positive and negative patients for any of the aforementioned autoimmune markers.
Conclusion
Summary/Conclusion: The presence of elevated ANA or RF characterizes ITP patients with distinct presentation. However neither response to treatment nor the development of chronic disease seems to be influenced by these autoAbs. On the other hand neither the presence of APL Abs nor antithyroid Abs did seems to affect the clinical profile of the pts. Additional studies are warranted to confirm our results and probe more deeply in the significance of autoimmune markers in ITP
Keyword(s): Thrombocytopenia