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<p>Immune thrombocytopenia (ITP) is an acquired autoimmune disorder with wide variability in clinical presentations and etiologic spectrum across different parts of the world. we prospectively studied patients with ITP and actively tested them for secondary causes leading of thrombocytopenia. All consecutively registered patients with immune thrombocytopenia (platelet count &lt; 100,000/uL) were enrolled, and their baseline clinical and laboratory parameters were recorded. To identify secondary causes of ITP, patients underwent tests for complete blood count, liver and renal function, autoimmune disorders, thyroid dysfunction, H. pylori infection, Coombs test, and bone marrow examination. A comparative study was conducted to analyze these parameters between patients with primary and secondary ITP. Three hundred sixteen patients with treatment naïve ITP were enrolled. Proportion of patients with acute, persistent, and chronic ITP was 129 (41%), 99 (31%), and 88(28%), respectively. Total 202(64%) patients presented with history of bleeding &amp; WHO grade 1, 2, 3 and 4 bleeding was present in 97(31%), 68(21%), 21(7%), and 16(5%) patients, respectively. Grades 3 and 4 bleeding was more common in primary ITP than secondary ITP (p = 0.04). Secondary causes of ITP were detected in 125(39.4%) of patients. Hypothyroidism N = 68(21.5%) and H. pylori infection N = 34(11.4%) were two most common causes of secondary ITP. Fatigue emerged as a common symptom and it was more prevalent in patients with secondary ITP 61(49%) than with primary ITP 65(34%). A baseline bone marrow examination did not detect any secondary cause of ITP in our study cohort. Significant differences were observed in the clinical and laboratory profiles of patients with primary and secondary ITP. Patients with secondary ITP were generally older and reported greater fatigue. However, patients with primary ITP had a higher likelihood of experiencing grade 3/4 bleeding. Based on our findings, a baseline bone marrow examination may be deemed unnecessary for evaluating newly diagnosed cases of ITP.</p>

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Primary Versus Secondary Immune Thrombocytopenia in Adults: A Comparative Analysis of Clinical and Laboratory Parameters in Newly Diagnosed ITP Patients from North India

  • 期刊论文

  • 发表日期：

    2025年8月14日

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  • Rajeev Sandal,
  • Aditya Jandial,
  • Kundan Mishra,
  • Jasmina Ahluwalia,
  • Neelam Varma,
  • Vishal Sharma,
  • Shalmoli Bhattacharya,
  • Charanpreet Singh,
  • Arihant Jain,
  • Alka Khadwal,
  • Pankaj Malhotra,
  • Gaurav Prakash

摘要

Immune thrombocytopenia (ITP) is an acquired autoimmune disorder with wide variability in clinical presentations and etiologic spectrum across different parts of the world. we prospectively studied patients with ITP and actively tested them for secondary causes leading of thrombocytopenia. All consecutively registered patients with immune thrombocytopenia (platelet count < 100,000/uL) were enrolled, and their baseline clinical and laboratory parameters were recorded. To identify secondary causes of ITP, patients underwent tests for complete blood count, liver and renal function, autoimmune disorders, thyroid dysfunction, H. pylori infection, Coombs test, and bone marrow examination. A comparative study was conducted to analyze these parameters between patients with primary and secondary ITP. Three hundred sixteen patients with treatment naïve ITP were enrolled. Proportion of patients with acute, persistent, and chronic ITP was 129 (41%), 99 (31%), and 88(28%), respectively. Total 202(64%) patients presented with history of bleeding & WHO grade 1, 2, 3 and 4 bleeding was present in 97(31%), 68(21%), 21(7%), and 16(5%) patients, respectively. Grades 3 and 4 bleeding was more common in primary ITP than secondary ITP (p = 0.04). Secondary causes of ITP were detected in 125(39.4%) of patients. Hypothyroidism N = 68(21.5%) and H. pylori infection N = 34(11.4%) were two most common causes of secondary ITP. Fatigue emerged as a common symptom and it was more prevalent in patients with secondary ITP 61(49%) than with primary ITP 65(34%). A baseline bone marrow examination did not detect any secondary cause of ITP in our study cohort. Significant differences were observed in the clinical and laboratory profiles of patients with primary and secondary ITP. Patients with secondary ITP were generally older and reported greater fatigue. However, patients with primary ITP had a higher likelihood of experiencing grade 3/4 bleeding. Based on our findings, a baseline bone marrow examination may be deemed unnecessary for evaluating newly diagnosed cases of ITP.