Predicting acute vs chronic childhood idiopathic thrombocytopenic purpura
R. H. Tomar and M. J. Stuart
We studied 12 children with idiopathic thrombocytopenic purpura (ITP) to
determine if selected immune measurements could prospectively distinguish
chronic ITP from acute ITP. Immunologic assessment included immunoglobulin
levels, T- and B-cell enumeration, in vitro lymphocyte stimulation by
phytohemagglutinin, and a screen for autoantibodies. The most consistent
difference observed was that unstimulated lymphocytes in chronic ITP had an
increased basal rate of thymidine incorporation. The same assays were
performed on eight other children in whom the diagnosis of chronic ITP
already had been established. A similar abnormality was found in this
group. Study of lymphocyte proliferation in patients with ITP appears
useful in predicting the course of the disease.