There was no record of intra cranial hemorrhage or hemoptysis. Findings Peripheral platelet counts ranged from less than 1??109/L up to 100??109/L with the mean of 42.91??30.03??109/L. The platelet antibody was not demonstrable in 33 (71.7?%) patients, while the antibody titer of 1 1:8 detected in 6 (13?%) and the titer of 1 1:16 and 1:32 reported in 5 (10.9?%) and 2 (4.3?%) patients, respectively. platelet count and antibody level (r?=??0 0.59; test and value of less than 0.05 was considered as significance level. Results Patients Characteristics A total of 46 patients with ITP were studied, among which 26 (56.5?%) were female resulting in a female to male ratio of 1 1.3:1. The mean age of the patients was 38.9??19.7?years ranging from 14 to 86?years. The clinical signs were variable including, petechiae, purpura (41?%), epistaxis (41?%), hematuria (11?%), GI bleeding (9?%) and bleeding from gums (26?%) and conjunctiva (7?%). There was no record of intra cranial hemorrhage or hemoptysis. Findings Peripheral platelet counts ranged from less than 1??109/L up to 100??109/L with the mean of 42.91??30.03??109/L. The platelet antibody was not demonstrable in 33 (71.7?%) patients, while the antibody titer of 1 1:8 detected in 6 (13?%) and the titer of 1 1:16 and 1:32 reported in 5 (10.9?%) and 2 (4.3?%) patients, respectively. Considering the antibody level of 1:16 as the cut-off point, 7 (15.2?%) of the patients showed a positive platelet antibody while, 39 (84.8?%) patients had a negative assay. The main characteristics of antibody-positive and antibody-negative ITP patients are illustrated in Table?1. Table?1 Characteristics of antibody-positive and antibody-negative AKT Kinase Inhibitor ITP patients
Mean age, (years)(Mean??SD)40.3??25*38.62??190.839, T-testGender, (Males/Females)3/417/220.65, 2 testPlatelet count (109/L)(Mean??SD)10.42??11.3548.74??28.60.001, T-testPlatelet antibody titer (Mean??SD)1/4.17??8.042C<0.001, T-test Open in a separate window *P??p?p?p?=?0.015) and (r?=?0.435; p?=?0.02), respectively. The clinical bleeding signs in ITP patients according to the results of platelet antibody analysis have been outlined in Table?2. Table?2 Distribution of clinical bleeding signs in antibody-positive and antibody-negative ITP patients
Overall bleeding diathesis, n (%)6 (85.7)20 (51.3)0.091, 2 testGI bleeding, n (%)2 (28.6)2 (5.1)0.104, 2 testEpistaxis, n (%)6 (85.7)13 (33.3)0.015, 2 testGingival bleeding, n (%)4 (57.1)8 (20.5)0.65, 2 testHematuria, n (%)3 (42.9)2 (5.1)0.02, 2 testPetechiae, purpura, n (%)5 (71.4)14 (35.9)0.091, 2 testConjuctival bleeding, n (%)2 (28.6)1 (2.6)0.056, 2 test Open in a separate window No significant correlation was Rabbit Polyclonal to Claudin 3 (phospho-Tyr219) detected between the platelet antibodies and patients gender (p?=?0.65). Clinical Outcome and Follow Up For each patient, the follow-up period started right after the initial diagnosis and they were followed for about 12?months. Among 39 patients with negative serum platelet antibody, 13 patients missed the follow up and 17 patients never require therapy. Of the AKT Kinase Inhibitor nine patients who treated with corticosteroids, five cases responded to therapy, while the others failed the treatment and three of them underwent splenectomy. Out of the seven patients with positive platelet antibody assay, three patients missed the follow up. Among the others, three patients treated with corticosteroids, while two cases had complete response and splenectomy was performed for the nonresponder patient. Also, none of the patients underwent bone marrow examination for ITP diagnosis. Discussion The pathogenic effect of platelet auto antibodies in ITP has been clearly established. Furthermore, a positive antibody assay provides strong evidence for the presence of ITP. This study determined demographic characteristics and presenting AKT Kinase Inhibitor manifestations of Iranian patients with ITP. The platelet antibodies involved in ITP most often direct toward certain platelet membrane glycoproteins, either the GP IIb/IIIa or GP Ib/IX complexes. Nevertheless; some patients shows autoantibodies against multiple platelet antigenic.
