Relevance of antiphospholipid antibody profile in the clinical outcome of ITP: a single-centre study

Objectives: The relevance of detecting antibodies against anticardiolipin, β2-glycoprotein I (β2gpI) or lupus anticoagulant (LA), collectively called antiphospholipid autoantibodies (APA), in subjects with immune thrombocytopenia (ITP) is still a debated issue. In particular, whether APA profile may...

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Bibliographic Details
Published in:Hematology (Luxembourg) 2019-01, Vol.24 (1), p.134-138
Main Authors: Frison, Luca, Lombardi, Annamaria, Caputo, Ilaria, Semenzato, Gianpietro, Fabris, Fabrizio, Vianello, Fabrizio
Format: Article
Language:English
Subjects:
Adult
Aged
Antibodies, Antiphospholipid - blood
antiphospholipid antibodies
Disease-Free Survival
Female
Humans
lupus anticoagulans
Male
Middle Aged
Purpura, Thrombocytopenic, Idiopathic - blood
Purpura, Thrombocytopenic, Idiopathic - complications
Purpura, Thrombocytopenic, Idiopathic - mortality
Purpura, Thrombocytopenic, Idiopathic - therapy
Survival Rate
Thrombocytopenia' immune thrombocytopenia
Thrombosis - blood
Thrombosis - etiology
Thrombosis - mortality
Thrombosis - therapy
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Summary:Objectives: The relevance of detecting antibodies against anticardiolipin, β2-glycoprotein I (β2gpI) or lupus anticoagulant (LA), collectively called antiphospholipid autoantibodies (APA), in subjects with immune thrombocytopenia (ITP) is still a debated issue. In particular, whether APA profile may affect the clinical course of ITP is unknown. Methods: In this study, we report our experience in a cohort of ITP patients with APA with specific interest to the relevance of different antiphospholipid antibody profiles in clinical outcome and response to treatment. Results: Thirty-seven out of 159 patients (23.2%) fulfilling ITP criteria had a platelet count ≤50 × 10 9 /L and tested positive at APA at ITP onset. Twenty-three (62.1%) patients received at least one line of treatment for ITP. Fourteen subjects (37.8%) showing triple positivity for APA showed a significantly lower median platelet count compared to other APA patients (p = .006). Among these ITP subjects with triple positivity, 85.7% needed a treatment because of low platelet count compared to 47.8% ITP patients with non-triple-positive APA (p = .0094). ITP/APA subjects who received immunosuppressors had a higher rate of thrombosis (p = .024) as well as thrombosis developed in subjects who were on steroid therapy at a significantly higher dosage than subjects who did not develop thrombotic episodes (p 
ISSN:1607-8454
1607-8454
DOI:10.1080/10245332.2018.1532649