Clinical characteristic and prognostic analysis of elderly primary immune thrombocytopenia

doi:10.3969/j.issn.1006-7795.2018.02.022

Abstract

Abstract: Objective To explore the clinical features and prognostic factors of elderly-onset primary immune thrombocytopenia(ITP) and provide more evidence for the treatment of it.Methods Totally 177 cases of ITP were selected from the Second Hospital of Shanxi Medical University hospitalized patients (2013.06.01-2017.06.01) to summarize the clinical-data, including clinical manifestation,laboratory findings, treatment, therapeutic effect,prognosis of scheme.ITP of patients older than 60 years were defined as elderly-onset ITP. Results The data were collected from 177 ITP cases, and 48 of those were elderly-onset ITP.The ratio of male to female was 1:1, with an average age of (68.17±6.47)years. There were 30(62.5%) cases of newly diagnosed ITP,6(12.5%) cases of persistent ITP and 12(25%) cases of chronic ITP.After the treatment of rhTPO,rhTPO combined with dexamethasone,IVIG, IVIG combined with dexamethasone or high dose-dexamethasone, 40 patients got remission and the overall remission rate was 83%.The ANA was positive in 54.2% of elderly-onset ITPs,which was significantly higher than that in the no-elderly-onset ITP group(P<0.05);The proportion of cases with bleeding score above two was 77.1% in elderly-onset ITPs, which was significantly higher than that in the no-elderly-onset ITP group(P<0.05).With a median follow-up of 9.5 monthes(range from 0.5 to 40.0 monthes),there were 12 patients who finally replased.The replase rate was 30% and the median replase time was one month(range 0.5 to14 monthes).The lower percentage of NK cell was the risk factor for replase(P<0.05).Conclusion Elderly-onset ITP has higher bleeding scores and more underlying diseases such hypertensions and diabetes mellitus.Therefore, these patients need more attention in clinical practice and treatment for preventing complication should be started actively. Elderly-onset ITP was more likely to have positive ANA, suggesting that connective tissue diseases need to be excluded before making the diagnosis of ITP. The lower percentage of NK cell was the risk factor for replase in elderly-onset ITP,and further studies are needed to explore the underlying mechanism.

Key words: primary immune thrombocytopenia, clinical characteristic, prognostic analysis, elderly

CLC Number:

R558

Chen Yu, Wang Meifang, Cheng Fangfang, Shen Xing, Zhao Lidong, Yang Linhua. Clinical characteristic and prognostic analysis of elderly primary immune thrombocytopenia[J]. Journal of Capital Medical University, 2018, 39(2): 277-281.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2018.02.022

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2018/V39/I2/277

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