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Significance of antinuclear antibodies in primary immune thrombocytopenia: results of the CARMEN registry
- Source :
- Blood Adv
- Publication Year :
- 2020
- Publisher :
- American Society of Hematology, 2020.
-
Abstract
- Prior studies have demonstrated an increased prevalence of autoimmune markers in patients with immune thrombocytopenia (ITP). Clinical experience has suggested that there may be an association between autoimmune markers and poor outcomes in ITP, but current guidelines do not encourage routine testing in these patients. We retrospectively assessed the prevalence of autoimmune markers in adult patients with ITP from our institutional database and used multiple logistic regression analyses to test for an association between autoimmune marker positivity and thrombotic events or clinical remission. We also assessed whether positivity for common autoimmune markers was associated with positivity for platelet autoantibodies. There was a high rate of autoimmune marker positivity in this population, with antinuclear antibody (65%), antithyroid peroxidase antibody (31%), and direct antiglobulin (29%) the most commonly found. Antithyroid peroxidase antibody positivity was associated with a lower probability of remission (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.09-0.79; P = .017). Lupus anticoagulant positivity was associated with a higher rate of thrombosis (OR, 8.92; 95% CI, 1.94-40.95; P = .005), and antinuclear antibody was strongly associated with thrombosis (P = .001). There was no relation between platelet autoantibody positivity and the presence of autoimmune markers. These results suggest that many patients with ITP have a state of immune dysregulation that extends beyond platelet autoantibodies and that certain autoimmune markers may be prognostically useful in this disorder.
- Subjects :
- Adult
Male
Anti-nuclear antibody
Autoimmunity
Prevalence
Humans
Medicine
Registries
Aged
Autoantibodies
Aged, 80 and over
Purpura, Thrombocytopenic, Idiopathic
business.industry
Thrombosis
Hematology
Middle Aged
Platelets and Thrombopoiesis
Prognosis
Immune thrombocytopenia
Purpura
Antibodies, Antinuclear
Immunology
Commentary
Female
Disease Susceptibility
medicine.symptom
business
Biomarkers
Subjects
Details
- ISSN :
- 24739537 and 24739529
- Volume :
- 4
- Database :
- OpenAIRE
- Journal :
- Blood Advances
- Accession number :
- edsair.doi.dedup.....48e2d2bb5e2ec17bad23c1d7424596dc