Involvement of Autoimmune Diseases in the Pathogenesis of Chronic Immune Thrombocytopenic Purpura

Mădălina Mocanu¹, Magda Bădescu^1*, Manuela Ciocoiu¹, Codruţa Bădescu², Cristina Elena Iancu³, Oana Bădulescu¹

¹Department of Pathophysiology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania.
²Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania.
³Deparment of Pharmaceutical Science II, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania.

DOI: 10.4236/jbise.2015.83014                

Abstract

Chronic immune thrombocytopenic purpura (ITP) is a condition based on an immune-mediated mechanism that determines the premature hyperdestruction of the thrombocytes in peripheral blood, as well as their deficient synthesis at the level of the bone marrow. The chronic immune purpura could be of primary, idiopathic cause, as well as of secondary cause, occurring in the context of other pathologies. The characteristic of the primary form of the disease is the presence of isolated thrombocytopenia, defined by a platelet count under 100,000/mm3 in peripheral blood, in the absence of supporting causes for thrombocytopenia. In the secondary form of the disease, the decreased platelet count is due to associated pathologies involving an immune mechanism, responsible for the occurrence of thrombocytopenia. This study aims to emphasize the involvement of autoimmune diseases, such as systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid polyarthritis or antiphospholipid syndrome in the pathogenesis of secondary thrombocytopenia. Furthermore, the study was conducted on a sample of 40 patients, divided into two groups: The first group comprising asymptomatic patients diagnosed with thrombocytopenia following routine tests, and the second group comprising patients with hemorrhagiparous symptomatology (petechiae, ecchymoses, epistaxis, gingivorrhagia), who went to the doctor in order to determine the etiology of the hemorrhagiparous syndrome. The average value of the thrombocytopenia of the patients included in the study was of 60.20 ± 19.75 × 103/μL. Laboratory investigations performed in order to establish the etiology of thrombocytopenia showed that 80% of patients presented positive antiplatelet antibodies. Moreover, 20% of the patients in the study showed positive anti-double-stranded DNA, 20% were identified with IgG anticardiolipin antibodies, while antinuclear antibodies were present in 10% of the patients.

Keywords

Thrombocytopenic Purpura, Antiplatelet Antibodies, Systemic Lupus Erythematosus, Antiphospholipid Syndrome

Conflicts of Interest

The authors declare no conflicts of interest.

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