Abstract
Although the presence of antiphospholipid antibodies (APLA) in immune thrombocytopenic purpura (ITP) has been reported, their clinical significance is not clear. The present study investigated APLA profiles in relation to the clinical stages of ITP. We studied APLA in 40 patients in three stages of ITP: exacerbation/relapse (n = 7), stable (n = 14) and remission (n = 19). Both IgG and IgM APLA to six target antigens were measured by enzyme-linked immunosorbent assay: β2-glycoprotein 1 (β2GP1), cardiolipin, phosphatidylcholine, phosphatidylserine, phosphatidylethanolamine and factor VII/VIIa. The central finding was that APLA were common in ITP but differed significantly in disease stages, being highest in exacerbation (86% positive), intermediate in stable disease (57%) and lowest in remission (42%). In exacerbations, APLA were predominantly of IgG class, while in stable disease, IgM predominated. During remission, APLA often became undetectable. Both the frequency and titres of APLA were significantly higher during exacerbation than remission. An inverse correlation was found between platelet count and nearly all APLA (except β2GP1). Sequential study of six patients revealed that APLA tended to emerge and rise with exacerbation, concurrently with new episodes of bleeding and became undetectable during remission. These findings raise the possibility that APLA may play a role in the exacerbation and remission of ITP or they may be a consequence of platelet destruction.
| Original language | English |
|---|---|
| Pages (from-to) | 366-372 |
| Number of pages | 7 |
| Journal | British Journal of Haematology |
| Volume | 128 |
| Issue number | 3 |
| DOIs | |
| State | Published - Feb 1 2005 |
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Keywords
- β2-glycoprotein 1
- Antiphospholipid antibodies
- Bleeding
- Cardiolipin
- Immune thrombocytopenic purpura
ASJC Scopus subject areas
- Hematology
Cite this
Antiphospholipid antibodies in immune thrombocytopenic purpura tend to emerge in exacerbation and decline in remission. / Bidot, Carlos J.; Jy, Wenche; Horstman, Lawrence L.; Ahn, Eugene R.; Jimenez, Joaquin J; Yaniz, Miriam; Lander, Gabriela; Ahn, Yeon.
In: British Journal of Haematology, Vol. 128, No. 3, 01.02.2005, p. 366-372.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Antiphospholipid antibodies in immune thrombocytopenic purpura tend to emerge in exacerbation and decline in remission
AU - Bidot, Carlos J.
AU - Jy, Wenche
AU - Horstman, Lawrence L.
AU - Ahn, Eugene R.
AU - Jimenez, Joaquin J
AU - Yaniz, Miriam
AU - Lander, Gabriela
AU - Ahn, Yeon
PY - 2005/2/1
Y1 - 2005/2/1
N2 - Although the presence of antiphospholipid antibodies (APLA) in immune thrombocytopenic purpura (ITP) has been reported, their clinical significance is not clear. The present study investigated APLA profiles in relation to the clinical stages of ITP. We studied APLA in 40 patients in three stages of ITP: exacerbation/relapse (n = 7), stable (n = 14) and remission (n = 19). Both IgG and IgM APLA to six target antigens were measured by enzyme-linked immunosorbent assay: β2-glycoprotein 1 (β2GP1), cardiolipin, phosphatidylcholine, phosphatidylserine, phosphatidylethanolamine and factor VII/VIIa. The central finding was that APLA were common in ITP but differed significantly in disease stages, being highest in exacerbation (86% positive), intermediate in stable disease (57%) and lowest in remission (42%). In exacerbations, APLA were predominantly of IgG class, while in stable disease, IgM predominated. During remission, APLA often became undetectable. Both the frequency and titres of APLA were significantly higher during exacerbation than remission. An inverse correlation was found between platelet count and nearly all APLA (except β2GP1). Sequential study of six patients revealed that APLA tended to emerge and rise with exacerbation, concurrently with new episodes of bleeding and became undetectable during remission. These findings raise the possibility that APLA may play a role in the exacerbation and remission of ITP or they may be a consequence of platelet destruction.
AB - Although the presence of antiphospholipid antibodies (APLA) in immune thrombocytopenic purpura (ITP) has been reported, their clinical significance is not clear. The present study investigated APLA profiles in relation to the clinical stages of ITP. We studied APLA in 40 patients in three stages of ITP: exacerbation/relapse (n = 7), stable (n = 14) and remission (n = 19). Both IgG and IgM APLA to six target antigens were measured by enzyme-linked immunosorbent assay: β2-glycoprotein 1 (β2GP1), cardiolipin, phosphatidylcholine, phosphatidylserine, phosphatidylethanolamine and factor VII/VIIa. The central finding was that APLA were common in ITP but differed significantly in disease stages, being highest in exacerbation (86% positive), intermediate in stable disease (57%) and lowest in remission (42%). In exacerbations, APLA were predominantly of IgG class, while in stable disease, IgM predominated. During remission, APLA often became undetectable. Both the frequency and titres of APLA were significantly higher during exacerbation than remission. An inverse correlation was found between platelet count and nearly all APLA (except β2GP1). Sequential study of six patients revealed that APLA tended to emerge and rise with exacerbation, concurrently with new episodes of bleeding and became undetectable during remission. These findings raise the possibility that APLA may play a role in the exacerbation and remission of ITP or they may be a consequence of platelet destruction.
KW - β2-glycoprotein 1
KW - Antiphospholipid antibodies
KW - Bleeding
KW - Cardiolipin
KW - Immune thrombocytopenic purpura
UR - http://www.scopus.com/inward/record.url?scp=13444269020&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=13444269020&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2141.2004.05314.x
DO - 10.1111/j.1365-2141.2004.05314.x
M3 - Article
C2 - 15667539
AN - SCOPUS:13444269020
VL - 128
SP - 366
EP - 372
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
IS - 3
ER -