Lupus anticoagulant in immune thrombocytopenic purpura

Antibodies against phospholipid antigens (APA) have been demonstrated in adult idiopathic(immune) thrombocytopenic purpura (ITP), but their clinical and pathogenetic significance has remained elusive. Also there are no such studies available in pediatric ITP cases. In this study, the prevalence and clinical significance of APAs were investigated in pediatric patients with ITP.

Forty newly diagnosed ITP patients (age 2-13 years) were prospectively studied. They were evaluated for the presence of lupus anticoagulant (LA).

Eleven patients (27.5%) were LA positive at the time of diagnosis. No statistically significant differences were found between the LA-positive and LA-negative groups regarding gender, initial platelet counts, or response to methyl prednisolone therapy. After 6 months of follow up, 5 of the 11 LA-positive cases were still positive for LA. The frequency of LA positivity found in this pediatric age group was similar to that reported in adult patients.

In view of the fact that in adult patients with ITP, the persistent presence of APAs is an important risk factor for the development of antiphospholipid syndrome, the same may also hold true for pediatric ITP patients, and thus 'demands long term follow up for these patients.