Autoantibodies against platelet membrane glycoproteins in children with
acute and chronic immune thrombocytopenic purpura
P Berchtold, R McMillan, P Tani, S Sommerville-Nielsen and VS Blanchette
Department of Basic and Clinical Research, Research Institute of Scripps
Clinic, La Jolla, CA.
The autoimmune nature of chronic immune thrombocytopenic purpura (ITP) in
adults is widely accepted. In contrast, the pathogenetic mechanism in acute
and chronic ITP in children is not known. In this report, we studied 39
children with destructive thrombocytopenia, 15 patients with acute ITP and
24 patients with chronic ITP. Platelet autoantibodies to platelet
glycoprotein IIb/IIIa were detected in 14 of 24 patients (58.3%) in the
chronic ITP group and in four of 15 (26.7%) with acute ITP. Binding ratios
(+/- SD) of positive patients were significantly greater (P = .01) in
chronic ITP (8.0 +/- 9.1) when compared with those of acute ITP where the
binding ratios were only slightly above the normal range (1.9 +/- 0.4). The
results show that autoantibodies against platelet glycoproteins are present
in the majority of children with chronic ITP confirming the autoimmune
nature of this disorder. The minimal elevation seen in the positive
children with acute ITP suggests a different pathogenetic mechanism. These
data suggest that this approach may be useful in differentiating acute from
chronic ITP patients.
Volume 74,
Issue 5,
pp. 1600-1602,
10/01/1989
Copyright © 1989 by The American Society of Hematology
