Altintas Abdullah, Pasa Semir, Cil Timucin, Bayan Kadim, Gokalp Deniz, Ayyildiz Orhan
Faculty of Medicine, Departmant of Hematology, Dicle University, Diyarbakir, Turkey.
Platelets. 2008 Jun;19(4):252-7. doi: 10.1080/09537100801894651.
The association of chronic idiopathic thrombocytopenic purpura (cITP) and thyroid autoimmune diseases (TAD) is a known but an uncommon condition. Celiac disease (CD), which is characterized by malabsorption and villous atrophy that occur as a consequence of the ingestion of wheat gluten may also be related to other autoimmune disorders. In this study, we investigated the prevalence of thyroid anti-microsomal (TAMA) and anti-thyroglobulin (TATA) auto antibodies, anti-gliadin (AGA) IgG, IgA, anti-endomisium (EMA) IgG and IgA antibodies in 74 patients with cITP and in 162 healthy controls. TATA positivity was found in 29, and TAMA positivity in 19 out of 74 patients; and in 16 and 18 out of 162 controls respectively (p < 0.0001 and p = 0.005, respectively). TAD was diagnosed in 29 of cITP patients. AGA IgG positivity was found in 17, and IgA was present in five out of 74 patients; and AGA IgG was found in 19, and IgA was detected in 4 out of 162 controls (p = 0.032 and p = 0.143, respectively). EMA IgG positivity was found in six out of 74 patients and in nine out of 162 control subjects (p = 0.566). EMA IgA positivity was found in two out of 74 patients and in one out of 162 controls (p = 0.232). We showed that the prevalence of TAD and related autoantibodies are higher in patients with cITP. We suggest that, patients with cITP should be followed up for development of TAD. In addition, all CD related auto antibodies were found to be more frequent in patients with cITP, but only the AGA IgG reached to the clinical significance. None of the CD related auto antibody positive patients developed clinically manifested CD. Large-scale designed studies are needed to clarify the long-term impact and importance of these CD related auto antibodies in patients with cITP.
慢性特发性血小板减少性紫癜（cITP）与甲状腺自身免疫性疾病（TAD）之间的关联是一种已知但并不常见的情况。乳糜泻（CD）以摄入小麦麸质后出现吸收不良和绒毛萎缩为特征，它也可能与其他自身免疫性疾病有关。在本研究中，我们调查了74例cITP患者和162名健康对照者中甲状腺抗微粒体（TAMA）和抗甲状腺球蛋白（TATA）自身抗体、抗麦醇溶蛋白（AGA）IgG、IgA、抗内膜（EMA）IgG和IgA抗体的患病率。在74例患者中，发现29例TATA阳性，19例TAMA阳性；在162名对照者中，分别有16例和18例阳性（p值分别<0.0001和p = 0.005）。29例cITP患者被诊断为TAD。在74例患者中，发现17例AGA IgG阳性，5例IgA阳性；在162名对照者中，AGA IgG阳性者有19例，IgA阳性者有4例（p值分别为0.032和p = 0.143）。在74例患者中有6例EMA IgG阳性，在162名对照者中有9例阳性（p = 0.566）。在74例患者中有2例EMA IgA阳性，在162名对照者中有1例阳性（p = 0.232）。我们发现cITP患者中TAD及相关自身抗体的患病率更高。我们建议，应对cITP患者进行随访以观察TAD的发生情况。此外，发现所有与CD相关的自身抗体在cITP患者中更为常见，但只有AGA IgG具有临床意义。没有一例与CD相关的自身抗体阳性患者出现临床表现为CD的情况。需要开展大规模设计研究以阐明这些与CD相关的自身抗体对cITP患者的长期影响及重要性。
