Anti-glycoprotein autoantibodies are related to bleeding severity in children with newly diagnosed ITP and very low platelet counts

Shuyue Dong; Hao Gu; Jialu Zhang; Lingling Fu; Xingjuan Xie; Jingyao Ma; Jie Ma; Zhenping Chen; Runhui Wu

doi:10.1002/pbc.30094

Anti-glycoprotein autoantibodies are related to bleeding severity in children with newly diagnosed ITP and very low platelet counts

Pediatr Blood Cancer. 2023 Feb;70(2):e30094. doi: 10.1002/pbc.30094. Epub 2022 Nov 15.

Authors

Shuyue Dong¹, Hao Gu^{2

3}, Jialu Zhang¹, Lingling Fu¹, Xingjuan Xie¹, Jingyao Ma¹, Jie Ma¹, Zhenping Chen², Runhui Wu¹

Affiliations

¹ Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
² Hematologic Disease Laboratory, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China.
³ Department of Immunology, Ministry of Education Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

PMID: 36377718
DOI: 10.1002/pbc.30094

Abstract

Background and objective: Immune thrombocytopenia (ITP) is an autoimmune-mediated hemorrhagic disease. Anti-glycoprotein autoantibodies play a key role in the pathophysiology of ITP, but the relationship between platelet-specific antibodies and bleeding severity is unclear. This study aimed to analyze the relationship between anti-glycoprotein autoantibodies and bleeding severity in children with newly diagnosed ITP and platelet count less than 10 × 10⁹ /L.

Method: This was a single-center prospective observational study that analyzed children with newly diagnosed ITP and platelet count less than 10 × 10⁹ /L between June 2018 and September 2021 at our hospital. The children were classified into the mild and severe groups based on the bleeding scores. The type and titer of anti-glycoprotein autoantibodies were detected using an enzyme-linked immunosorbent assay (ELISA) kit (PAKAUTO). We analyzed the relationship between bleeding severity and anti-glycoprotein autoantibodies.

Results: A total of 86 cases were enrolled, including 42 in the mild group and 44 in the severe group. Patients with anti-GPIIb/IIIa or anti-GPIb/IX antibodies suffered more severe bleeding than patients without them (χ² = 7.303, p = .007; χ² = 3.875, p = .049), but there was no significant difference between patients with or without anti-GPIa/IIa antibodies (χ² = 0.745, p = .388). When antibodies were analyzed together, patients with three antibodies suffered more severe bleeding than those without three antibodies (χ² = 5.053, p = .025). Patients with higher antibody titer in the eluent, but not in the plasma, suffered more severe bleeding in all three antibodies (Z = -2.389, p = .017; Z = -2.108, p = .035; Z = -2.557, p = .011).

Conclusion: Anti-glycoprotein autoantibodies led to more severe bleeding in children under 18 years of age without drug treatment with newly diagnosed ITP and platelet count less than 10 × 10⁹ /L.

Keywords: anti-glycoprotein autoantibodies; bleeding severity; children; primary immune thrombocytopenia.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Autoantibodies
Blood Platelets
Child
Humans
Platelet Count
Platelet Glycoprotein GPIb-IX Complex
Purpura, Thrombocytopenic, Idiopathic*
Thrombocytopenia*

Substances

Autoantibodies
Platelet Glycoprotein GPIb-IX Complex