Antiphospholipid antibodies in immune thrombocytopenic purpura tend to emerge in exacerbation and decline in remission

Carlos J. Bidot, Wenche Jy, Lawrence L. Horstman, Eugene R. Ahn, Joaquin J Jimenez, Miriam Yaniz, Gabriela Lander, Yeon Ahn

Research output: Contribution to journalArticle

34 Citations (Scopus)

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 languageEnglish
Pages (from-to)366-372
Number of pages7
JournalBritish Journal of Haematology
Volume128
Issue number3
DOIs
StatePublished - Feb 1 2005

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Antiphospholipid Antibodies
Idiopathic Thrombocytopenic Purpura
Immunoglobulin M
Glycoproteins
Immunoglobulin G
Factor VIIa
Factor VII
Cardiolipins
Phosphatidylserines
Phosphatidylcholines
Platelet Count
Blood Platelets
Enzyme-Linked Immunosorbent Assay
Hemorrhage

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 journalArticle

Bidot, Carlos J. ; Jy, Wenche ; Horstman, Lawrence L. ; Ahn, Eugene R. ; Jimenez, Joaquin J ; Yaniz, Miriam ; Lander, Gabriela ; Ahn, Yeon. / Antiphospholipid antibodies in immune thrombocytopenic purpura tend to emerge in exacerbation and decline in remission. In: British Journal of Haematology. 2005 ; Vol. 128, No. 3. pp. 366-372.
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