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Anti-glycoprotein autoantibodies are related to bleeding severity in children with newly diagnosed ITP and very low platelet counts  
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  • Shuyue Dong,
  • Hao Gu,
  • Jialu Zhang,
  • Lingling Fu,
  • Xingjuan Xie,
  • Jingyao Ma,
  • Jie Ma,
  • Zhenping Chen,
  • Runhui Wu
Shuyue Dong
Capital Medical University

Corresponding Author:[email protected]

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Hao Gu
Capital Medical University
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Jialu Zhang
Capital Medical University
Lingling Fu
Capital Medical University
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Xingjuan Xie
Capital Medical University
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Jingyao Ma
Capital Medical University
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Jie Ma
Capital Medical University
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Zhenping Chen
Capital Medical University
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Runhui Wu
Capital Medical University
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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 <10×109/L. Method: This was a single-center prospective observational study that analyzed children with newly diagnosed ITP and platelet count <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 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 (c2=7.303, p=0.007; c2=3.875, p=0.049), but there was no significant difference between patients with or without anti-GPIa/IIa antibody (c2=0.745, p=0.388). When antibodies were analyzed together, patients with three antibodies suffered more severe bleeding than those without three antibodies (c2=5.053, p=0.025). 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=0.017; Z=-2.108, p=0.035; Z=-2.557, p=0.011). 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 <10×109/L.
27 Jun 2022Submission Checks Completed
27 Jun 2022Assigned to Editor
27 Jun 2022Submitted to Pediatric Blood & Cancer
30 Jun 2022Reviewer(s) Assigned
08 Jul 2022Review(s) Completed, Editorial Evaluation Pending
09 Jul 2022Editorial Decision: Revise Major
01 Oct 20221st Revision Received
01 Oct 2022Submission Checks Completed
01 Oct 2022Assigned to Editor
08 Oct 2022Reviewer(s) Assigned
17 Oct 2022Review(s) Completed, Editorial Evaluation Pending
18 Oct 2022Editorial Decision: Revise Minor
19 Oct 2022Submission Checks Completed
19 Oct 2022Assigned to Editor
19 Oct 20222nd Revision Received
20 Oct 2022Review(s) Completed, Editorial Evaluation Pending
20 Oct 2022Editorial Decision: Accept