Primary versus secondary immune thrombocytopenia in adults; a comparative analysis of clinical and laboratory attributes in newly diagnosed patients in Southern Pakistan
- Author:
Sadia Sultan
;
Syed Ijlal Ahmed
;
Sania Murad
;
Syed Mohammed Irfan
- Publication Type:Journal Article
- Keywords:
IT;
Secondary;
Primary;
HCV;
Helicobacter pylori
- From:
The Medical Journal of Malaysia
2016;71(5):269-274
- CountryMalaysia
- Language:English
-
Abstract:
Back ground: Immune thrombocytopenic purpura (ITP) is a
hemorrhagic diathesis, characterized by platelets
destruction alongside impaired production. Patients from
Asian regions often exhibit distinctive characteristics in
comparison to the western patients. We accomplished this
study to evaluate the prevalence of primary versus
secondary ITP along with the comparative analysis between
them. The secondary objective was to determine the
etiological spectrum of secondary ITP.
Methods: We illustrate the results of a large cohort of newly
diagnosed adults ITP from southern Pakistan. The study
extended from January 2009-December 2013. Complete
blood counts, HbsAg, Anti-HCV, ANA, stool for Helicobacterpylori
were done on all. HIV, TSH, anti-dsDNA, RA factor,
APLA and direct coombs test were evaluated in cases where
indicated.
Results: A total of 417 patients were included with a mean
age of 40.95±14.82 years. Primarily disease was observed in
the 3rd decade of life. Male to female ratio was 1:1.5. Mean
platelets count was 46.21±27.45x109
/l. At diagnosis 43.16%
(n=180) patients had hemorrhagic manifestations whilst
56.8% (n=237) were asymptomatic. None of the patient
presented with visceral, retropharyngeal or intracranial
bleed. The prevalence of secondary ITP was substantially
higher (64.8%) as compared to primary ITP (35.2%).
Secondary ITP was predominantly seen in HCV reactive
patients (24.4%) followed by helicobacter-pylori infection
(11%). Nevertheless 16.4% patients had underlying
autoimmune disorders. Providentially no study subject was
found to be HIV reactive.
Conclusions: Our study revealed predominance of
secondary ITP. However bleeding manifestations and degree
of thrombocytopenia were high in primary-ITP. Infectious
etiology followed by autoimmune disorders is mainly
implicated for secondary ITP in our setting.
- Full text:P020170208358101328882.pdf
