Risk of thrombosis associated with antiphospholipid antibodies in immune thrombocytopenia: a retrospective study of 152 patients
Résumé
CONTEXT Immune thrombocytopenia (ITP) is associated with both bleeding and thrombotic events. Antiphospholipid antibodies (APL) are frequently found during ITP, but their involvement in this increased thrombotic risk is still debated.
OBJECTIVES We conducted an observational retrospective monocentric study to evaluate the bleeding and thrombotic risks associated with APL positivity in ITP.
METHODS One hundred and fifty-two patients diagnosed with ITP were retrospectively included in our study, with a mean follow-up of 105 months. ITP associated with connective tissue diseases such as systemic lupus were not excluded. ITP related to neoplasia, myelodysplastic syndrome of chronic viral infection were excluded. Conventional risk factors for venous and arterial events were collected.
RESULTS Twenty-five patients (16.4%) were positive for at least 1 APL. The frequency and severity of bleeding events were not influenced by APL status. Eighteen patients (11.8%) developed 20 thromboembolic events, with a Hazard ratio of APL-positive to APL-negative patients for thrombosis was 7.15 (95% confidence interval 2.52-20.24), after adjusting for confounding factors. The arterial risk was superior to the venous risk.
CONCLUSION APL positivity in ITP is frequent and associated with a higher risk of venous and arterial thrombotic events. Systematic screening of APL status in ITP seems useful to identify patients at high-risk to experience thrombosis.
Origine : Fichiers produits par l'(les) auteur(s)