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Clinically significant newly presenting autoimmune thrombocytopenic purpura in adults: a prospective study of a population-based cohort of 245 patients

Lookup NU author(s): Dr Annette Neylon, Dr Peter Saunders, Professor Stephen Proctor, Dr Penelope Taylor

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Abstract

The true incidence and prognosis of autoimmune thrombocytopenic purpura (ITP) in adults is unknown. We present the results of a prospective study in a population-based cohort of newly presenting adults (greater than or equal to16 years) with ITP and platelet count of <50 x 10(9)/l, which took place between 1 January 1993 and 31 December 1999 in the former Northern Health Region in the UK (population 3.08 million). A total of 245 cases were confirmed by bone marrow examination with a median follow-up of 60 months (range 6-78 months). There were 134 females/111 males (1.2:1). Overall incidence was 1.6 per 10 5 per annum. Absolute incidence was similar for both sexes, with highest age-specific incidence in those aged >60 years. Thirty patients (12%) presented with frank bleeding, and 28% were asymptomatic. Forty-five patients (18%) received no treatment, and 135 (55%) received first-line treatment only. Thirty patients (12%) underwent splenectomy. There were four deaths (1.6%) from bleeding and/or the complications of therapy in this cohort, but only one was in the acute phase of the illness. The majority of patients (155 out of 245) achieved remission (platelet count >100 x 10(9)/l), with a further 59 (24%) in partial remission with no symptoms (platelet count 30-100 x 10(9)/l). This population-based study suggests that the traditional view of adult ITP as being a predominantly chronic disease that preferentially affects females needs to be modified.


Publication metadata

Author(s): Neylon, A., Saunders, P. W. G., Howard, M. R., Proctor, S. J., Taylor, P. R. A.

Publication type: Article

Publication status: Published

Journal: British Journal of Haematology

Year: 2003

Volume: 122

Issue: 6

Pages: 966-974

ISSN (print): 0007-1048

ISSN (electronic): 1365-2141

URL: http://dx.doi.org/10.1046/j.1365-2141.2003.04547.x

DOI: 10.1046/j.1365-2141.2003.04547.x


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