Primary immunodeficiencies, autoimmune hyperthyroidism, coeliac disease and systemic lupus erythematosus in childhood immune thrombocytopenia

Acta Paediatr. 2021 Feb;110(2):643-651. doi: 10.1111/apa.15593. Epub 2020 Oct 13.

Abstract

Aim: To evaluate the cumulative prevalence of coeliac disease, systemic lupus erythematosus, autoimmune hyperthyroidism and primary immunodeficiencies in children with either newly diagnosed/persistent or chronic immune thrombocytopenia (ITP).

Methods: Monocentric retrospective analysis of the clinical and biochemical features of 330 consecutive patients with ITP referred to our Pediatric Hematology Unit between January 2009 and December 2018.

Results: The prevalence of systemic lupus erythematosus (0.3%), coeliac disease (0.3%) and autoimmune hyperthyroidism (0.6%) was not increased compared to general paediatric population. Of note, the prevalence of underlying primary immunodeficiencies was 2.4%, remarkably higher than the general paediatric population (P = .005). All the patients diagnosed with immunodeficiency developed either bi-/trilinear cytopenia or splenomegaly.

Conclusion: Whilst autoimmune and immunological screening is already recommended at the onset of immune thrombocytopenia, we recommend that primary immunodeficiencies be regularly screened during follow-up, especially in case of additional cytopenia or lymphoproliferation.

Keywords: ITP; autoimmune disease; children; primary immunodeficiencies.

Publication types

  • Review

MeSH terms

  • Celiac Disease* / complications
  • Celiac Disease* / epidemiology
  • Child
  • Humans
  • Hyperthyroidism*
  • Lupus Erythematosus, Systemic* / complications
  • Lupus Erythematosus, Systemic* / epidemiology
  • Purpura, Thrombocytopenic, Idiopathic* / epidemiology
  • Purpura, Thrombocytopenic, Idiopathic* / etiology
  • Retrospective Studies