Immune Thrombocytopenic Purpura Clinical Trial
Official title:
Retrospective Study of Splenic Immunological Markers as Predictive Factors for Response to Splenectomy in Adult Patients Affected by a Immune Thrombocytopenic Purpura
The aim of this study is to determine histological immunological parameters, sought on splenectomy pieces that may explain the failure or success of splenectomy in patients with ITP who had a splenectomy to treat their ITP(Immune thrombocytopenic purpura).
Immune thrombocytopenic purpura (ITP) is a rare autoimmune thrombocytopenia whose incidence
is 2 to 5 cases / 100,000 inhabitants / year. The potentially serious haemorrhagic risk is
the major issue of management. A recent international consensus conference classifies PTI
according to the duration of thrombocytopenia: acute ITP (<3 months), persistent ITP (3-12
months) and chronic ITP (> 12 months) (Rodeghiero 2009). In the acute or persistent phase,
polyvalent immunoglobulins (IVIG) and / or corticosteroids are proposed. In the chronic
phase, splenectomy is a possible cure for 70% of patients. No predictor of treatment response
is known.
The pathophysiology of ITP is multifactorial: platelet phagocytosis, mediated by
autoantibody, macrophages of the reticuloendothelial system, and destruction in the spleen,
genetic background and / or environmental factor favoring the role of certain lymphocyte
subpopulations, cytotoxic or regulatory T, via their cytokine environment, abnormalities of
thrombopoiesis.
At present, no predictive factor of splenectomy success has been identified. The aim of this
study is to determine histological immunological parameters, sought on splenectomy pieces
that may explain the failure or success of splenectomy in patients with ITP who had a
splenectomy to treat their ITP.
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