Evaluation of immunodeficiency in children with acute immune thrombocytopenia

INTRODUCTION AND OBJECTIVE: Immune thrombocytopenia (ITP) is an autoimmune disease characterized by isolated thrombocytopenia and is the most common cause of thrombocytopenia in children. It may be the first finding in patients with primary immunodeficiency and is the most common hematological finding of primary immunodeficiency disorders. Our aim is to determine whether serum immunoglobulin and lymphocyte subgroup levels of children with ITP are different from healthy children and whether these levels are related to treatment response. MATERIALS AND METHODS: Thirty patients who were followed up in Sakarya University Training and Research Hospital Pediatric Hematology and Oncology Clinic between 2018 and 2021 due to ITP were retrospectively analyzed. Immunoglobulin isotypes, IgG subtypes and lymphocyte subgroup levels of the patients were compared with the age and sex-appropriate control group, age-appropriate reference values. And their treatment responses are evaluated during the follow up examinations. RESULTS: In our study, 30 patients with acute ITP and 30 healthy children were examined. Although there was no significant difference between the immunoglobulin and lymphocyte subgroup levels of the patients and the control group, in 33.3% of the patients suggesting common variable immunodeficiency; in 6.6% combined immunodeficiency and in 6.6% IgA – IgG subgroup deficiency was considered. Younger age and low IgG level compared to age-appropriate reference ranges were found to increase the rate of positive response to treatment on the 7th day after diagnosis. CONCLUSION: In our study, a suspicion of immunodeficiency was found in 46.5% of the patients diagnosed with acute ITP. It was understood that age and IgG level of the patient could be used to predict the treatment response rate on the 7th day after diagnosis in acute ITP. Keywords: Childhood, Acute immune thrombocytopenia, Immunodeficiency