Gök Veysel, Ozcan Alper, Mutlu Fatma Türkan, Yılmaz Ebru, Kocak Göl Deniz, Ozay Mustafa, Demir Baver, Taskiran Hüseyin, Bas Hasan, Mutlu Mehmet Burak, Dogan Muhammet Ensar, Bisgin Atil, Somekh Ido, Rohlfs Meino, Dundar Munis, Ozkul Yusuf, Klein Christoph, Karakukcu Musa, Unal Ekrem
Division of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, Erciyes University, Kayseri, Türkiye.
Division of Pediatric Hematology and Oncology, Department of Pediatrics, Kayseri City Hospital, Kayseri, Türkiye.
Res Pract Thromb Haemost. 2025 Apr 24;9(4):102873. doi: 10.1016/j.rpth.2025.102873. eCollection 2025 May.
Inherited platelet disorders (IPDs) are characterized by thrombocytopenia, platelet dysfunction, or both, leading to recurrent bleeding and diagnostic challenges. Advances in genetic testing have significantly improved early and accurate diagnoses.
This study aimed to evaluate the clinical and genetic spectrum of IPDs, identify diagnostic challenges, and assess outcomes of therapeutic interventions.
We conducted a retrospective cohort study of 50 IPD patients. We performed clinical evaluations, peripheral smear analyses, and genetic testing to identify causative variants. Correlation between platelet counts, bleeding severity, and the effectiveness of treatments, such as hematopoietic stem cell transplantation and thrombopoietin receptor agonists, was analyzed.
A total of 54.5% of cases showed autosomal dominant inheritance. Diagnostic delays were common, with many patients initially misdiagnosed as having immune thrombocytopenic purpura (ITP). There was a moderate, negative, statistically significant correlation between platelet counts and bleeding severity. Peripheral smear findings, such as stomatocytosis and macrothrombocytopenia, provided critical diagnostic clues. We identified novel mutations in , , , , and genes, which expanded our understanding of IPDs. Different treatment modalities were used. Hematopoietic stem cell transplantation was performed in severe systemic cases, such as Wiskott-Aldrich syndrome. Sitosterolemia was treated with ezetimibe. Thrombopoietin receptor agonists reduced bleeding in some patients.
Integrating genetic, clinical, and laboratory findings is essential in providing accurate diagnoses and management of IPDs. Early genetic diagnosis and personalized therapeutic strategies improve outcomes. Future research should focus on functional studies of novel mutations and refining treatment protocols to enhance care for this complex population.
遗传性血小板疾病(IPD)的特征是血小板减少、血小板功能障碍或两者兼具,导致反复出血和诊断挑战。基因检测的进展显著改善了早期和准确诊断。
本研究旨在评估IPD的临床和基因谱,识别诊断挑战,并评估治疗干预的结果。
我们对50例IPD患者进行了一项回顾性队列研究。我们进行了临床评估、外周血涂片分析和基因检测以识别致病变异。分析了血小板计数、出血严重程度与造血干细胞移植和血小板生成素受体激动剂等治疗效果之间的相关性。
共54.5%的病例显示常染色体显性遗传。诊断延迟很常见,许多患者最初被误诊为免疫性血小板减少性紫癜(ITP)。血小板计数与出血严重程度之间存在中度、负性、统计学显著的相关性。外周血涂片结果,如口形红细胞症和巨大血小板减少症,提供了关键的诊断线索。我们在 、 、 、 和 基因中发现了新的突变,这扩展了我们对IPD的认识。使用了不同的治疗方式。在严重的全身性病例中,如维斯科特-奥尔德里奇综合征,进行了造血干细胞移植。谷甾醇血症用依泽替米贝治疗。血小板生成素受体激动剂在一些患者中减少了出血。
整合基因、临床和实验室结果对于准确诊断和管理IPD至关重要。早期基因诊断和个性化治疗策略可改善结果。未来的研究应专注于新突变的功能研究和完善治疗方案,以加强对这一复杂人群的护理。