Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan.
Sci Rep. 2019 Nov 15;9(1):16923. doi: 10.1038/s41598-019-53165-7.
Immune thrombocytopenic purpura (ITP) is characterized by thrombocytopenia and bleeding diathesis. Pancreatitis is a very rare complication but may be fatal. We analyzed data of newly diagnosed ITP patients, excluding those with a history of splenectomy, unknown sex or date of birth, or preexisting pancreatitis at the time of ITP diagnosis, and compared these with selected age-, gender-, and index-year-matched controls, using the Taiwan National Health Insurance Research Database from 1996 to 2013. The study enrolled 100,177 ITP patients and 100,177 controls. We found that pancreatitis risk was higher in secondary ITP patients, regardless of age group, gender, baseline Charlson comorbidity index (CCI) score, history of biliary stone, hyperlipidemia, or alcoholism, than in the control population. Primary ITP patients with CCI score 1 and without biliary tract stone history also showed a higher pancreatitis risk than the controls. The incidence rate and cumulative incidence of pancreatitis were increased in primary, secondary, and unspecified ITP cases. These phenomena may be related to the presence of autoantibodies against glycoprotein IIb/IIIa, or to IgG4, microparticle obstruction, or sclerosis. We noted a direct association between ITP and the development of pancreatitis in Taiwan population.
免疫性血小板减少性紫癜（ITP）的特征为血小板减少和出血倾向。胰腺炎是一种非常罕见的并发症，但可能致命。我们分析了从 1996 年至 2013 年台湾全民健康保险研究数据库中排除了曾行脾切除术、性别或出生日期不详、或在 ITP 诊断时已有胰腺炎病史的新诊断 ITP 患者的数据，并与选定的年龄、性别和指数年匹配的对照组进行比较。本研究纳入了 100,177 例 ITP 患者和 100,177 例对照。我们发现，继发性 ITP 患者的胰腺炎风险高于对照组，无论年龄组、性别、基线 Charlson 合并症指数（CCI）评分、胆管结石史、高脂血症或酗酒史。CCI 评分为 1 分且无胆管结石病史的原发性 ITP 患者也比对照组有更高的胰腺炎风险。原发性、继发性和未特指的 ITP 病例的发病率和累积发病率均增加。这些现象可能与针对糖蛋白 IIb/IIIa 的自身抗体有关，或者与 IgG4、微粒阻塞或硬化有关。我们注意到 ITP 与台湾人群中胰腺炎的发生之间存在直接关联。
