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KMID : 1130320080510111217
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Korean Journal of Pediatrics
2008 Volume.51 No. 11 p.1217 ~ p.1221
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Prevalence and clinical significance of the positive antinuclear antibody in children with idiopathic thrombocytopenic purpura
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Jeon So-Eun
Park Seong-Shik
Lim Young-Tak
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Abstract
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Purpose: An association between idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE) has been recognized for decades because thrombocytopenia is the first manifestation in some patients with SLE. However, the risk of later development of SLE in childhood ITP is currently unknown. We retrospectively evaluated the incidence and clinical significance of the positive antinuclear antibody (ANA) in children with acute ITP.
Methods: This study was retrospectively performed to review the clinical and laboratory characteristics in 7 7 children diagnosed to have acute ITP and admitted to the Pusan National University Hospital between January 2 0 0 3 and December 2 0 0 6 . Patients tested positive for ANA were regularly followed-up for at least 1 2 months for symptoms indicative of SLE.
Results: Seventy-seven children were included in the study; 3 8 males (4 9 .4%) and 3 9 females (5 0 .5 %), the mean age was 4 .5 years. Sixteen (2 0 .8%) ITP patients had a positive ANA, with a median titer of 1 :3 2 0 . The mean age of the patients with positive ANA was 9 .3 years, which is much older than 3 .3 years for patients with negative ANA (P< 0 .0 5 ). The positive ANA group was predominantly female (8 1 .3%) compared to the negative ANA group (P< 0 .0 5 ). There was no statistically significant difference in mean platelet counts between both groups. No statistically significant difference was found in ANA positivity and progression to chronic ITP or SLE. After the median follow-up of 3 2 months, SLE was diagnosed only in one ITP patient with positive ANA.
Conclusion: Our data demonstrated that ANA positivity is often found in children with acute ITP. Large-scale studies should be considered to determine the significance of ANA positivity in childhood ITP for the later development of SLE.
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KEYWORD
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Idiopathic thrombocytopenic purpura, Antinuclear antibody, Systemic lupus erythematosus
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