Clinically significant newly presenting autoimmune thrombocytopenic purpura in adults: a prospective study of a population‐based cohort of 245 patients
Top Cited Papers
Open Access
- 3 September 2003
- journal article
- review article
- Published by Wiley in British Journal of Haematology
- Vol. 122 (6), 966-974
- https://doi.org/10.1046/j.1365-2141.2003.04547.x
Abstract
Summary. 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 (≥ 16 years) with ITP and platelet count of < 50 × 109/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 105 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 × 109/l), with a further 59 (24%) in partial remission with no symptoms (platelet count 30–100 × 109/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.Keywords
This publication has 16 references indexed in Scilit:
- Intravenous immunoglobulin or high-dose methylprednisolone, with or without oral prednisone, for adults with untreated severe autoimmune thrombocytopenic purpura: a randomised, multicentre trialThe Lancet, 2002
- Morbidity and mortality in adults with idiopathic thrombocytopenic purpuraBlood, 2001
- Drug-Induced ThrombocytopeniaAnnals of Internal Medicine, 1998
- Long-Term observation of 208 adults with chronic idiopathic thrombocytopenic purpuraAmerican Journal Of Medicine, 1995
- Fate of therapy failures in adult idiopathic thrombocytopenic purpuraAmerican Journal Of Medicine, 1980
- Adult idiopathic thrombocytopenic purpura: Clinical findings and response to therapyAmerican Journal Of Medicine, 1980
- Chronic Idiopathic Thrombocytopenic PurpuraArchives of Internal Medicine, 1973
- Idiopathic thrombocytopenic purpura. Long-term results of treatment and the prognostic significance of response to corticosteroidsArchives of Internal Medicine, 1972
- IDIOPATHIC AND SECONDARY THROMBOCYTOPENIC PURPURA: CLINICAL STUDY AND EVALUATION OF 381 CASES OVER A PERIOD OF 28 YEARSAnnals of Internal Medicine, 1960
- THE TREATMENT OF IDIOPATHIC THROMBOCYTOPENIC PURPURA A REVIEW OF NINETY-THREE CASESThe Lancet, 1958