Chiang Ming-Ru, Wei Chang-Ching, Muo Chin-Shin, Fu Lin-Shien, Li Tsai-Chung, Kao Chia-Hung
Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan.
1] Department of Nephrology, Children's Hospital, China Medical University Hospital, Taichung, Taiwan [2] College of Medicine, China Medical University, Taichung, Taiwan.
Pediatr Res. 2015 Apr;77(4):597-601. doi: 10.1038/pr.2015.6. Epub 2015 Jan 12.
Growing evidence has revealed a link between autoimmune and allergic diseases. However, few studies have assessed the relationship between allergic diseases and primary immune thrombocytopenia (ITP), an autoimmune disease frequently occurring in children. This population-based case-control study investigated the association between common allergic diseases and the subsequent risk of developing ITP during childhood.
This study investigated 1,203 children younger than 18 y of age who were diagnosed with ITP between 1998 and 2008, as well as 4,812 frequency-matched controls. The odds ratios of the association between ITP and preexisting allergic diseases were calculated.
Children with every type of allergic disease examined in this study (except asthma) exhibited an increased risk of developing ITP; the lowest adjusted odds ratio (aOR) was 1.39 for allergic conjunctivitis (95% confidence interval (CI) = 1.09-1.79), whereas the greatest aOR was 1.84 for allergic rhinitis (95% CI = 1.49-2.27). The aORs increased with the number of concurrent allergic diseases to 2.89 (95% CI = 1.98-4.22) for children with at least three allergic diseases.
Children with atopic diathesis have a greater risk of subsequently developing ITP. The fundamental determinants of this relationship warrant further study.
越来越多的证据表明自身免疫性疾病与过敏性疾病之间存在联系。然而，很少有研究评估过敏性疾病与儿童常见的自身免疫性疾病原发性免疫性血小板减少症（ITP）之间的关系。这项基于人群的病例对照研究调查了常见过敏性疾病与儿童期患ITP后续风险之间的关联。
本研究调查了1998年至2008年间诊断为ITP的1203名18岁以下儿童，以及4812名频率匹配的对照。计算了ITP与既往过敏性疾病之间关联的比值比。
本研究中检查的每种过敏性疾病患儿（哮喘除外）患ITP的风险均增加；变应性结膜炎的最低校正比值比（aOR）为1.39（95%置信区间（CI）=1.09-1.79），而变应性鼻炎的最大aOR为1.84（95%CI=1.49-2.27）。对于至少患有三种过敏性疾病的儿童，aOR随着并发过敏性疾病数量的增加而增加至2.89（95%CI=1.98-4.22）。
特应性体质儿童随后患ITP的风险更高。这种关系的根本决定因素值得进一步研究。
