الفهرس | Only 14 pages are availabe for public view |
Abstract Primary immune thrombocytopenia, or idiopathic thrombocytopenic purpura (ITP), is an autoimmune disorder characterized by isolated thrombocytopenia due to accelerated platelet destruction and impaired platelet production. Autoantibodies against platelet surface glycoproteins (GP), such as GPIIb/IIIa and GPIb/IX complexes, play major roles in both platelet destruction and impaired platelet production. The diagnosis of ITP is a process of exclusion. First, it has to be determined that there are no blood abnormalities other than a low platelet count, and no physical signs other than bleeding. Then, secondary causes (5–10 percent of suspected ITP cases) should be excluded. Although corticosteroids and splenectomy remain central to the treatment of ITP, a new class of drugs, i.e., thrombopoietin receptor agonists (TPO-RAs) and rituximab, have substantially broadened the therapeutic options for refractory ITP patients. In our study we enrolled about 60 newly diagnosed ITP patients aged from 16-65yrs from hematology department at ain shams university hospital prospectively from February 2017 to January 2018 after taking an informed consent. The patients divided into 2 groups: group I were responder to the standard treatment (steroids). group II were non-responder to standard treatment. We measured serum IgM and IgA in immune thrombocytopenic purpura and its correlation to treatment response. We concluded that statistically significant difference between responder and non-responder ITP patients as regard the level of IgM as the patients who had IgM level below the median were more resistant to steroid which is the standard treatment in ITP. On the other hand there was no significant difference in the level of IgA between responder and non-responder ITP patients. IgA and IgM could be a good prognostic indicator for treatment response in ITP patients but this can be documented by further studies among high population of ITP patients. |