PB0847 - Management of adult idiopathic thrombocytopenic purpura (ITP) patients with antinuclear antibody (ANA)

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Munira Borhany, MBBS, MCPS, FCPS, FRCP (Edin), FRCPath

Consultant Haematologist
Haemophilia Welfare Society, Karachi
Karachi, Sindh, Pakistan

Co-Author(s)

SZ

Sidra Zafar

Clinical Research Associate
National Institute of Blood Diseases and Bone Marrow Transplantation
Karachi, Sindh, Pakistan
MA

Madiha Abid

Clinical Research Associate
National Institute of Blood diseases and Bone Marrow Transplantation, Street 2/A, Block 17, Gulshan-e-Iqbal, KDA Scheme 24, Karachi, Sindh, Pakistan.
Karachi, Sindh, Pakistan
TS

Tahir Shamsi

consultant Hematologist
National Institute of Blood Diseases and Bone Marrow Transplantation
Karachi, Sindh, Pakistan

Background: Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by persistent thrombocytopenia due to autoantibody binding to platelet antigens causing their premature destruction by the reticuloendothelial system.

Aims: Following study was conducted to determine the likelihood of positive ANA markers in adult ITP patients and other autoimmune conditions along with their management.

Methods: This prospective observational study was conducted from January to December 2021 after taking informed consent. Patient’s medical history, clinical data and outcome was collected using patients performa and analyzed using SPSS version 23.

Results: A total of 143 patients were screened for ANA. This includes 38 males (26.6%), 105 females (73.4%) with a median age of 38 years (IQR-25), 94 acute ITP (64.7%) and 49 chronic ITP (34.3%). ANA markers were positive in 41(28.7%), AMA and ASMA in 28(19.6%) patients. The frequency of positive ANA was higher in females 32(78%) as compared to males 8(22%) and in acute 25(61.0%) as compared to chronic 16(39%) ITP patients. Among 41(27.3%) positive ANA patients, 6(15.38%) had systemic lupus erythematosus (SLE) and 1(2.4%) patient had hypothyroidism. Lab parameters showed significant difference with median platelet (24 IQR-49 vs 81 IQR-178 vs 82.5 IQR-150) x109/L and hemoglobin (12.05 g/dl IQR-3 vs 12.06 IQR-2 vs 12.40 IQR 2) from baseline to 3 months and follow-up with (p value= ≤0.001).Frequency of bleeding symptoms is presented in Figure 1. Skin related complications observed includes alopecia in 3(2.09%) and skin rashes in 4(2.79%), whereas 11(7.6%) patients had history of abortions. Overall treatment response is presented in Table 1.

Conclusion(s): Overall treatment response with first and second line therapy in acute (90.4%) and chronic (94.9%) ITP patients was observed to be effective with decreased bleeding symptoms. However prevalence of 28.7% of ANA indicates concerns for developing other autoimmune conditions such as SLE.