Journal
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
Volume 111, Issue 7, Pages 370-379Publisher
ELSEVIER TAIWAN
DOI: 10.1016/j.jfma.2011.06.025
Keywords
antecedent of preceding illness; human leukocyte antigen; ITP; major histocompatibility complex; pediatric immune thrombocytopenia; pediatric immune thrombocytopenic purpura
Categories
Funding
- Shin Kong Wu Ho-Su Memorial Hospital in Taipei, Taiwan [SKH-8302-97-DR-22]
- Hematology Society of Taiwan in Taipei
Ask authors/readers for more resources
Background/Purpose: Immune thrombocytopenia (ITP) is a heterogeneous autoimmune disorder with diverse response rates to treatments that include corticosteroids, intravenous immunoglobulins (IVIG), and splenectomy. The predisposing causes of this autoimmune disorder, one of which is immunogenetic susceptibility, have not been fully determined. We investigated whether clinical features and human leukocyte antigen (HLA) genotypes influence the occurrence, treatment response, and disease duration of childhood ITP in Taiwan. Methods: We performed HLA genotyping of 70 Taiwanese children with ITP and of 70 healthy controls and compared the data. Demographic data were also collected and evaluated. Results: The frequencies of heterozygous HLA-A11 and the HLA-Cw1 allele were both significantly decreased in the ITP group (p = 0.0160 and p = 0.0089, respectively), whereas the frequency of heterozygous HLA-DQ5 was significantly increased in the ITP group (p = 0.0057). Patients with HLA-DRB1*11 or -DRB1*15 were more likely to respond poorly to corticosteroids than IVIG (p = 0.0446 and p = 0.0008, respectively). In addition, we observed a positive association between HLA-A11 homozygosity and the development of persistent or chronic ITP [odds ratio (OR) = 6.3165, p = 0.0479]. The presence of HLA-DRB1*08 was, however, negatively correlated with the development of persistent or chronic ITP (OR = 0.1729, p = 0.0657). Children with antecedent of preceding illness (API) and with a younger age of onset were more likely to experience a better treatment response and shorter course of ITP. Conclusion: We suggest that API, age of onset, and particular HLA class I and class II alleles, may be involved in and influence the occurrence and disease duration of childhood ITP, as well as responses to different therapeutic approaches. Copyright (c) 2012, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available