Nasr Nourhan Mohamed, Ayad Alia Abdelaziz, Abdelghaffar Noha Khalifa, Mohamed Marwa Salah
Department of Internal Medicine, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
Blood Res. 2025 May 6;60(1):29. doi: 10.1007/s44313-025-00078-2.
Immune thrombocytopenia (ITP) is an autoimmune condition characterized by low platelet count and increased risk of bleeding. Several pathophysiological processes contribute to the disease, including complement activation by autoantibodies bound to platelet surfaces. This study aimed to assess complement levels in ITP patients and determine their correlation with clinical presentation and disease severity.
This case-control study enrolled 40 patients (both sexes, aged 18-40 years) with primary ITP and 40 healthy controls. All participants underwent a comprehensive health assessment, thorough physical examination, laboratory investigations, and abdominal ultrasound. These included a complete blood count (CBC) with blood film, renal and hepatic function tests, hepatitis B surface antigen (HBsAg), hepatitis C virus antibodies (HCV-Abs), human immunodeficiency virus (HIV) antibodies, hepatitis B core antibody (HBcAb), C-reactive protein (CRP), antinuclear antibody (ANA), thyroid-stimulating hormone (TSH), erythrocyte sedimentation rate (ESR), serum complement levels (C3 and C4), and Helicobacter pylori antigen in stool.
Mean C3 and C4 levels were significantly lower in patients with ITP than in healthy controls. A statistical significant negative correlation was found between CRP and C4 levels in ITP patients. However, no statistically significant relationship was observed between C3 and C4 levels and platelet count in ITP patients, regardless of the presence of bleeding complications.
Complement levels were significantly lower in patients with ITP than in healthy controls. Complement levels were also significantly lower in treatment-naïve patients than in patients who received treatment. Therefore, complement levels could serve as a valuable laboratory test for disease activity.
免疫性血小板减少症（ITP）是一种自身免疫性疾病，其特征为血小板计数低和出血风险增加。多种病理生理过程导致该疾病，包括与血小板表面结合的自身抗体激活补体。本研究旨在评估ITP患者的补体水平，并确定其与临床表现和疾病严重程度的相关性。
本病例对照研究纳入了40例（男女不限，年龄18 - 40岁）原发性ITP患者和40例健康对照者。所有参与者均接受了全面的健康评估、详细的体格检查、实验室检查和腹部超声检查。这些检查包括血常规（CBC）及血涂片、肾功能和肝功能检查、乙肝表面抗原（HBsAg）、丙肝病毒抗体（HCV - Abs）、人类免疫缺陷病毒（HIV）抗体、乙肝核心抗体（HBcAb）、C反应蛋白（CRP）、抗核抗体（ANA）、促甲状腺激素（TSH）、红细胞沉降率（ESR）、血清补体水平（C3和C4）以及粪便中的幽门螺杆菌抗原。
ITP患者的平均C3和C4水平显著低于健康对照者。在ITP患者中，CRP与C4水平之间存在统计学显著的负相关。然而，无论是否存在出血并发症，ITP患者的C3和C4水平与血小板计数之间均未观察到统计学显著关系。
ITP患者的补体水平显著低于健康对照者。初治患者的补体水平也显著低于接受治疗的患者。因此，补体水平可作为疾病活动度的一项有价值的实验室检查指标。
