Premium
The HLA‐system in immune thrombocytopenic purpura: its relation to the outcome of therapy
Author(s) -
Gratama J. W.,
D'Amaro J.,
Koning J. de,
Den Ottolander G. J.
Publication year - 1984
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 - 10.1111/j.1365-2141.1984.tb03956.x
Subject(s) - splenectomy , thrombocytopenic purpura , prednisone , medicine , immunology , human leukocyte antigen , immune system , antigen , spleen
S ummary . The distribution of HLA‐A, ‐B, ‐C and ‐DR antigens was investigated in 154 patients with immune thrombocytopenia (99 adults and 55 children). An increased frequency of HLA‐Bw56 (a split of HLA‐Bw22) was found both in the adults (RR = 4.30) as well as in the children (RR =7.91). Differences in HLA antigen distributions have also been analysed in patient subgroups with a good and a bad response to corticosteroids and splenectomy. The frequency of HLA‐DR4 was low in those patients with a good response to prednisone as compared with those with a poor response. The opposite was found in splenectomized patients. In 22 patients who did not respond to splenectomy, LB4 (a local split of HLA‐DR4) was completely absent. These results suggest that HLA‐DR4 (LB4) may be a predictive marker for therapy in ITP patients, i.e. a bad response to corticosteroids and a favourable outcome of splenectomy. However, none of the differences were significant after correction was made for the number of antigens tested.