Immune Thrombocytopenia and Obesity: Predictive Relationship

Chronic refractory immune thrombocytopenia (ITP) is defined as the failure of any modality to maintain the platelet count above 20 × 10³/μL for an appreciable time without unacceptable toxicity. To date, certain predictive factors have been associated with refractory ITP. However, none of the published studies has declared the possible association between obesity and refractory ITP.

We present the cases of 3 children with ITP who failed to achieve remission on different therapeutic approaches including rituximab, vincristine, and romiplostim. The 3 children had obesity as a common feature.

We present these cases to propose a possible association between obesity and refractoriness of ITP to different therapeutic approaches and to emphasize the need for further study to establish whether a causal relationship exists.