Clinical and Applied Thrombosis/Hemostasis (Nov 2021)

Chronic Refractory Immune Thrombocytopenia Is Associated With Variants in Immune Genes

  • Shasha Zhao MD,
  • Jingyao Ma MD,
  • Xiaojing Zhu MM,
  • Jialu Zhang MM,
  • Runhui Wu MD

DOI
https://doi.org/10.1177/10760296211059813
Journal volume & issue
Vol. 27

Abstract

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The pathogenesis of chronic refractory immune thrombocytopenia (C/RITP) is mechanistically complex and considerably varies across patients. Few studies have focused on the genetic characteristics of C/RITP in children. The aim of this study was to analyze and summarize the clinical manifestations and genetic characteristics of C/RITP children with mutations in immune-related genes. In the study, 51 children with variants in immune-related genes (mutation group) and 103 children with no abnormal mutations (control group) were enrolled. Children in the mutation group showed severity of hemorrhage, a higher incidence of abnormal immunological indices, and an increased expression of SLE biomarkers. The number of peripheral T and B lymphocytes in the mutation group significantly increased. Nine patients (17.6%) had probable pathogenic variant genes associated with primary immunodeficiencies ( TNFRSF13B , CARD11 , CBL , and RAG2 ), and 42 patients (82.4%) had variants of uncertain significance in 23 genes. C/RITP patients with variants in immune-related genes had more severe bleeding, abnormal immunological indices, and an increased expression of SLE biomarker. Next-generation sequenciong (NGS) might be a useful way to differentiate those patients from C/RITP.