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Clinically significant newly presenting autoimmune thrombocytopenic purpura in adults: a prospective study of a population‐based cohort of 245 patients
Author(s) -
Neylon Annette J.,
Saunders Peter W. G.,
Howard Martin R.,
Proctor Stephen J.,
Taylor Penelope R. A.
Publication year - 2003
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2003.04547.x
Subject(s) - medicine , incidence (geometry) , splenectomy , prospective cohort study , population , asymptomatic , cohort , thrombocytopenic purpura , pediatrics , cumulative incidence , cohort study , surgery , platelet , physics , spleen , environmental health , optics
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 × 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 × 10 9 /l), with a further 59 (24%) in partial remission with no symptoms (platelet count 30–100 × 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.