Secondary immune thrombocytopenia (ITP): a retrospective audit on a single tertiary referral centre

Abstract

Aims To review the outcome of secondary ITP using recently published international working group guidelines. Methods 422 possible ITP cases (1/1/2005-1/6/2010) were examined at St George Hospital: medical records, laboratory databases. Results 139 ITP (67 primary, 72 secondary): median age 54, platelet count 51 × 10 9 /L, females 60%. Eighteen patients with autoimmune disease were younger (median age 43), had lower initial platelet counts (median 13 × 10 9 /L) and required more frequent treatment at presentation than primary ITP (72% versus 52%). In eight ITP-SLE patients, 6 month 84% RR (response rate: platelet count ≥30 × 10 9 /L, double baseline, no bleeding) compared with only 36% in primary ITP. Eleven ITP-lymphoproliferative disease and six ITP-HCV had 6 month RR 56% and 33%, respectively. Twenty-nine patients were tested for Helicobacter pylori: 13 patients with serology positive for H. pylori but did not achieve a complete response, four cases of ITP -H. pylori were established after achieving a complete response following eradication. Discussion Outcomes in secondary ITP are diverse and merit further observational studies to better differentiate their natural histories.