Małopłytkowość immunologiczna

Małopłytkowość immunologiczna
Epidemiologia

Immunologiczna małopłytkowość (ITP) to autoimmunologiczne schorzenie charakteryzujące się zmniejszoną liczbą płytek krwi, prowadzące do zaburzeń hemostazy. Roczna zachorowalność wynosi 1,6-3,9/100 000 u dorosłych i 1-6,4/100 000 u dzieci, przy czym rozpowszechnienie jest wyższe, szczególnie u dorosłych (9,5-23,6/100 000). Choroba wykazuje bimodalny rozkład wiekowy i różnice płciowe: u dzieci częściej dotyka chłopców, a u dorosłych kobiet (szczyt zachorowań około 60. roku życia). Przebieg u dzieci jest zwykle ostry i samoograniczający się (70-80% remisji w 3-6 miesięcy), natomiast u dorosłych często przewlekły (66,7% przypadków). Wtórne ITP stanowi 8,7-20% przypadków i jest związane z chorobami podstawowymi. Występują sezonowe wahania zachorowalności, zwłaszcza u dzieci, co sugeruje rolę infekcji wirusowych jako czynników wyzwalających.

Epidemiologia immunologicznej małopłytkowości (ITP)

Częstość występowania i rozpowszechnienie
Rozkład wiekowy i płciowy
ITP u dzieci a ITP u dorosłych
ITP pierwotne a wtórne
Wahania sezonowe
Różnice geograficzne i etniczne
Chorobowość i śmiertelność
Nadzór i monitorowanie
Globalne trendy epidemiologiczne
Kolejne rozdziały

Epidemiologia immunologicznej małopłytkowości (ITP)

Immunologiczna małopłytkowość (ITP) jest stosunkowo rzadkim schorzeniem autoimmunologicznym charakteryzującym się zmniejszoną liczbą płytek krwi, co prowadzi do zaburzeń hemostazy. Epidemiologia tej choroby różni się w zależności od wieku, płci i lokalizacji geograficznej.¹²

Częstość występowania i rozpowszechnienie

Roczna zachorowalność na ITP u dorosłych szacowana jest na poziomie 1,6-3,9 przypadków na 100 000 osobolat, natomiast u dzieci wynosi około 1-6,4 przypadków na 100 000 osób.³⁴ Dane te mogą jednak nie odzwierciedlać pełnej skali problemu, ponieważ wiele łagodnych przypadków, szczególnie u dzieci, może nie być diagnozowanych z powodu samoograniczającego charakteru choroby.⁵

Rozpowszechnienie (chorobowość) ITP jest znacznie wyższe niż zachorowalność, szczególnie u dorosłych, u których choroba ma często charakter przewlekły. Wskaźniki chorobowości szacowane są na około 9,5-23,6 na 100 000 osób dorosłych, podczas gdy u dzieci wynoszą około 4,6 na 100 000.⁶⁷ Według badań przeprowadzonych w stanie Maryland w USA, rozpowszechnienie ITP skorygowane względem wieku oszacowano na 9,5 na 100 000 osób.⁸

Populacja	Roczna zachorowalność (na 100 000)	Rozpowszechnienie (na 100 000)
Dzieci	1-6,4	4,6
Dorośli	1,6-3,9	9,5-23,6
Populacja ogólna (USA)	3,3	9,5-11,2
Francja	2,9	–
Algieria	0,85	5,65

Rozkład wiekowy i płciowy

ITP wykazuje interesujący rozkład w zależności od wieku i płci. U dzieci choroba może wystąpić w każdym wieku, jednak szczytowa zachorowalność występuje w wieku 2-5 lat oraz w okresie dojrzewania.⁹¹⁰ W populacji pediatrycznej ITP częściej dotyka chłopców niż dziewczynki.¹¹

Wśród młodych dorosłych i osób w średnim wieku (18-45 lat) proporcje ulegają odwróceniu – choroba znacznie częściej dotyka kobiety, co przypisuje się wpływowi estrogenów, które mogą promować autoimmunizację.¹²¹³ Szczytowa zachorowalność u dorosłych przypada na około 60 rok życia, a po 60 roku życia częstość występowania choroby jest podobna u mężczyzn i kobiet.¹⁴¹⁵

Badania epidemiologiczne przeprowadzone w północno-wschodniej Brazylii pokazały niezwykle wysoką przewagę kobiet we wszystkich grupach wiekowych (82,35%), z ogólnym stosunkiem kobiet do mężczyzn wynoszącym 4,7:1.¹⁶ Ta wyraźna przewaga płci żeńskiej sugeruje, że czynniki etniczne i geograficzne mogą mieć znaczący wpływ na rozkład płci w ITP.¹⁷

ITP u dzieci a ITP u dorosłych

Przebieg kliniczny ITP znacząco różni się między dziećmi a dorosłymi. U dzieci choroba ma najczęściej charakter ostry, często poprzedzony infekcją wirusową.¹⁸ Większość pediatrycznych przypadków ITP (około 70-80%) ulega samoistnej remisji w ciągu 3-6 miesięcy bez konieczności leczenia.¹⁹²⁰

Natomiast u dorosłych ITP ma zazwyczaj charakter przewlekły. Według ogólnokrajowego badania populacyjnego przeprowadzonego we Francji, tylko 35,7% dzieci z pierwotnym ITP rozwinie postać przetrwałą lub przewlekłą, podczas gdy u dorosłych ITP stanie się przetrwałe lub przewlekłe w 66,7% przypadków.²¹²² Prawdopodobieństwo trwałej remisji u dorosłych szacuje się na 20-40%.²³

Czynniki przyczyniające się do rozwoju ITP u dorosłych nie są w pełni poznane, ale podejrzewa się, że związany z wiekiem spadek funkcji układu odpornościowego, choroby współistniejące i stosowane leki mogą odgrywać rolę w rozwoju choroby.²⁴²⁵

ITP pierwotne a wtórne

Większość przypadków ITP to postać pierwotna (idiopatyczna), występująca bez związku z innymi chorobami. Jednak znaczna część pacjentów cierpi na ITP wtórne, związane z chorobami podstawowymi.²⁶

Według różnych badań, wtórne ITP stanowi od 8,7% do 20% wszystkich przypadków. W badaniu przeprowadzonym w Brazylii wtórne ITP stanowiło 9,6% z 187 przypadków u dorosłych.²⁷ Natomiast badanie przeprowadzone w Etiopii wykazało, że 19,2% uczestników miało wtórne ITP, co jest porównywalne z badaniami z Malezji (23%) i wyższe niż w badaniach z Niemiec (9%).²⁸

ITP wtórne często wykazuje rozkład bimodalny, z jednym szczytem u młodych dorosłych (18-27 lat) i drugim u starszych dorosłych (powyżej 68 lat). W badaniu brazylijskim zaobserwowano również liniowy wzrost częstości występowania wtórnego ITP między 38 a 68 rokiem życia.²⁹

Wahania sezonowe

Interesującym aspektem epidemiologii ITP są wahania sezonowe, szczególnie widoczne w populacji pediatrycznej. U dzieci z ITP zaobserwowano wzrost zachorowalności wiosną i wczesnym latem, kiedy infekcje wirusowe są powszechne.³⁰³¹ Badanie francuskie wykazało sezonową zmienność ITP z najwyższą zachorowalnością zimą i najniższą latem.³²

Według danych z USA, szczyt zachorowalności przypada na styczeń, a minimum w miesiącach letnich we wszystkich grupach wiekowych, prawdopodobnie z powodu infekcji wirusowych.³³ Obserwacje te potwierdzają hipotezę, że czynniki wirusowe mogą być istotnym czynnikiem wyzwalającym ITP, szczególnie u dzieci.³⁴

Różnice geograficzne i etniczne

Epidemiologia ITP wykazuje znaczne różnice w zależności od lokalizacji geograficznej i pochodzenia etnicznego. Badania przeprowadzone w Algierii wykazały znacznie niższą zachorowalność (0,85 na 100 000 populacji) w porównaniu z danymi z Europy i Stanów Zjednoczonych.³⁵ Różnice te mogą wynikać z czynników genetycznych, środowiskowych lub różnic w systemach raportowania i diagnostyki.

Ciekawe obserwacje pochodzą z badań przeprowadzonych w północno-wschodniej Brazylii, gdzie profil demograficzny pacjentów z ITP wykazywał podobieństwa do profili z Francji, ale różnił się od populacji skandynawskiej, brytyjskiej, amerykańskiej i azjatyckiej. Sugeruje to, że czynniki geograficzne i etniczne mogą mieć istotny wpływ na rozkład wieku i płci w ITP.³⁶

Osoby rasy czarnej i pochodzenia niehiszpańskiego rzadziej rozwijają ITP, co sugeruje, że w tych populacjach należy podejrzewać alternatywne rozpoznanie lub wtórne ITP.³⁷

Chorobowość i śmiertelność

Główną przyczyną długoterminowej chorobowości i śmiertelności u pacjentów z ITP są krwawienia. Najgroźniejszym powikłaniem jest krwotok śródczaszkowy, który stanowi najczęstszą przyczynę zgonu w związku z ITP.³⁸

Częstość występowania krwotoku śródczaszkowego szacuje się na około 0,5% u dzieci i 1,5% u dorosłych.³⁹⁴⁰ Większość przypadków krwotoku śródczaszkowego występuje u pacjentów, których liczba płytek jest mniejsza niż 10×10^9/L.⁴¹

Ciężkie krwawienia występują u około 10% dorosłych i 20% dzieci z nowo zdiagnozowanym lub przewlekłym ITP.⁴² Czynniki predykcyjne ciężkiego krwawienia obejmują obecność ciężkiej małopłytkowości (liczba płytek <10 000-20 000/μL), wcześniejsze drobne krwawienia, starszy wiek (powyżej 60 lat), jednoczesne stosowanie leków predysponujących do krwawienia oraz płeć męska.⁴³

ITP wiąże się również ze zwiększonym ryzykiem powikłań zakrzepowo-zatorowych, zarówno żylnych jak i tętniczych, nowotworów hematologicznych oraz ogólnej śmiertelności w porównaniu z populacją ogólną.⁴⁴⁴⁵ Badanie populacyjne wykazało 1,3-2,2-krotny wzrost śmiertelności u dorosłych pacjentów z ITP w porównaniu z populacją ogólną, związany z epizodami krwawienia, zakażeniami i zdarzeniami sercowo-naczyniowymi.⁴⁶

W badaniu przeprowadzonym w Wielkiej Brytanii zauważono, że ITP powoduje około 60% wyższy wskaźnik śmiertelności w porównaniu z osobami bez ITP dopasowanymi pod względem płci i wieku.⁴⁷

Nadzór i monitorowanie

Ze względu na złożoność obrazu klinicznego ITP i różnorodność przebiegu choroby u różnych pacjentów, nadzór i monitorowanie stanowią istotne elementy zarządzania tą chorobą. Brak czułych i swoistych testów diagnostycznych dla ITP oraz duża liczba innych potencjalnych przyczyn małopłytkowości sprawiają, że rozpoznanie ITP pozostaje wyzwaniem.⁴⁸

W celu lepszego monitorowania epidemiologii ITP utworzono kilka rejestrów i baz danych administracyjnych. We Francji powstała ogólnokrajowa prospektywna kohorta dorosłych pacjentów z nowo zdiagnozowanym epizodem ITP, pierwotnie w celu zbadania związku między ekspozycją na powszechne szczepionki a ryzykiem rozwoju ITP.⁴⁹

W Wielkiej Brytanii przeprowadzono badanie nadzorcze nad ciężkim pierwotnym ITP w ciąży, mające na celu oszacowanie aktualnej częstości występowania oraz opisanie zarządzania i leczenia ciężkiego ITP w ciąży.⁵⁰

Identyfikacja pacjentów z wysokim ryzykiem ciężkiego krwawienia pozostaje dużym wyzwaniem, ale ma kluczowe znaczenie dla wczesnego rozpoczęcia leczenia w celu zapobiegania śmiertelnemu krwotokowi. Do oceny ciężkości krwawienia u pacjentów z ITP stosuje się kilka narzędzi, z których narzędzie Buchanana dla dzieci i skala Page’a dla dorosłych są najczęściej używane.⁵¹ W ocenie ciężkości krwawienia u pacjentów z ITP można również stosować specyficzne dla ITP narzędzie oceny krwawienia (ITP-BAT).⁵²

Dane z rejestru CARMEN-France wskazują, że ekspozycja na leki przeciwzakrzepowe jest głównym czynnikiem ryzyka ciężkiego krwawienia u bardzo starszych pacjentów z ITP w wieku ≥ 80 lat, u których potrzebne jest ściślejsze monitorowanie.⁵³

Globalne trendy epidemiologiczne

Globalnie, ITP dotyka więcej kobiet niż mężczyzn, z wyższą zachorowalnością u starszych pacjentów.⁵⁴ Jednak dane dotyczące epidemiologii i schematów leczenia ITP są ograniczone i różnią się w różnych krajach.

Według badań epidemiologicznych przeprowadzonych w siedmiu głównych rynkach (7MM), obejmujących Stany Zjednoczone, pięć krajów UE (Niemcy, Hiszpanię, Włochy, Francję i Wielką Brytanię) oraz Japonię, całkowita liczba zdiagnozowanych przypadków ITP wynosiła około 147 174 w 2017 roku i oczekuje się, że liczba ta wzrośnie w okresie 2017-2028.⁵⁵

W Stanach Zjednoczonych, przewlekła populacja dorosłych z ITP szacowana jest na około 60 000, z kobietami przewyższającymi liczebnie mężczyzn w stosunku około 2 do 1, co spowodowało, że ITP została oznaczona jako choroba sieroca.⁵⁶

W Hiszpanii, w pierwszym badaniu dostarczającym ogólną perspektywę sytuacji hiszpańskiej populacji z ITP pod względem epidemiologii, trendów leczenia, zasobów opieki zdrowotnej i kosztów, chorobowość i roczna zachorowalność na 100 000 oszacowano odpowiednio na 10,8 (2,8 u pacjentów z przewlekłym ITP) i 1,5 (0,3 u pacjentów z przewlekłym ITP).⁵⁷

Badania te podkreślają, że ITP nadal stanowi znaczące wyzwanie dla systemów opieki zdrowotnej na całym świecie, a lepsze zrozumienie jego epidemiologii może pomóc w rozwoju polityk zdrowia publicznego, modelowaniu kosztów opieki zdrowotnej i aktualizacji programów nauczania używanych w edukacji zdrowotnej.⁵⁸

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Materiały źródłowe

#1 Epidemiology and Clinical Manifestations of Immune Thrombocytopenia – PubMed
https://pubmed.ncbi.nlm.nih.gov/30868551/
Immune thrombocytopenia (ITP) occurs with an incidence rate of 1.6 to 3.9 per 100,000 patient-years, which increases with age and has a slight female preponderance. […] Over long-term follow-up, ITP is also associated with an increased risk of venous and arterial thromboembolism, haematologic malignancy and overall mortality than the general population.
#2 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/779545-overview
The annual incidence of immune thrombocytopenia (ITP) is estimated to be five cases per 100,000 children and two cases per 100,000 adults, but those data are not from large population-based studies. […] Most cases of acute ITP, particularly in children, are mild and self-limited and may not receive medical attention. Therefore, estimated incidences of ITP are difficult to determine and are likely to understate the full extent of the disease. The age-adjusted prevalence of ITP in Maryland was reported as 9.5 per 100,000 persons by Segal and Powe. […] A French study reported an incidence of ITP of 2.9 cases per 100,000 person-years, with peaks in children and in those older than 60 years of age and a higher frequency of ITP in males in these subgroups. ITP showed seasonal variation, with a peak in winter and a nadir in summer.
#3 Immune Thrombocytopenia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK562282/
The annual incidence of pediatric ITP is estimated to be between 1 and 6.4 cases per 100,000 people. […] Researchers suggest this figure should be higher because it is based on reported symptomatic hospitalized cases, not total ITP cases. […] Pediatric ITP can present at any age, but peak incidences occur at ages 2 to 5 and adolescence. […] The condition is more common among male than female children from infancy to childhood. […] The opposite is true among adolescents and young adults (ie, 18 to 45 years). […] Predominance among women in these age groups is attributed to estrogens effects, which can promote autoimmunity. […] ITP may be acute or chronic. […] The acute form is more frequent in childhood, often prefaced by a viral infection. […] Most children have a self-limiting course, typically spontaneously recovering within 3 months.
#4 Immune Thrombocytopenia | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/23385
The annual incidence of pediatric ITP is estimated to be between 1 and 6.4 cases per 100,000 people. […] Pediatric ITP can present at any age, but peak incidences occur at ages 2 to 5 and adolescence. […] The condition is more common among male than female children from infancy to childhood. […] The opposite is true among adolescents and young adults (ie, 18 to 45 years). […] Predominance among women in these age groups is attributed to estrogens effects, which can promote autoimmunity. […] ITP may be acute or chronic. […] The acute form is more frequent in childhood, often prefaced by a viral infection. […] Most children have a self-limiting course, typically spontaneously recovering within 3 months. […] The chronic form more often affects adults, and the inciting factor is usually unclear.
#5 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/779545-overview
The annual incidence of immune thrombocytopenia (ITP) is estimated to be five cases per 100,000 children and two cases per 100,000 adults, but those data are not from large population-based studies. […] Most cases of acute ITP, particularly in children, are mild and self-limited and may not receive medical attention. Therefore, estimated incidences of ITP are difficult to determine and are likely to understate the full extent of the disease. The age-adjusted prevalence of ITP in Maryland was reported as 9.5 per 100,000 persons by Segal and Powe. […] A French study reported an incidence of ITP of 2.9 cases per 100,000 person-years, with peaks in children and in those older than 60 years of age and a higher frequency of ITP in males in these subgroups. ITP showed seasonal variation, with a peak in winter and a nadir in summer.
#6 Pathophysiology, Clinical Manifestations and Diagnosis of Immune Thrombocytopenia: Contextualization from a Historical Perspective
https://www.mdpi.com/2038-8330/16/2/21
ITP is a rare disease with an annual incidence that varies from 1.1 to 12.5/100,000 inhabitants/year, being similar between children and adults. […] According to a nationwide population-based study in France, the natural history of pediatric ITP is different from that of adults since only 35.7% of children with primary ITP will progress to persistent or chronic disease, while adult primary ITP will become persistent or chronic in 66.7% of the cases. […] Overall, the incidence is slightly higher in women. […] The prevalence is higher in adults, being 4.6 per 100,000 inhabitants of pediatric age and 9.5â23.6 per 100,000 inhabitants of adult age.
#7 Immune Thrombocytopenia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK562282/
The chronic form more often affects adults, and the inciting factor is usually unclear. […] However, aging-related immune decline, comorbidities, and drugs are thought to contribute to the condition’s development in adults. […] Approximately 25% of children in the United States develop persistent or chronic ITP, where thrombocytopenia-associated bleeding can be life-threatening. […] Seasonal fluctuations have been noted among children with ITP, with the conditions incidence rising in the spring and early summer when viral infections are common. […] ITP’s annual incidence in adults is estimated to be 1 to 6 cases per 100,000 people. […] However, the condition is more of a chronic disease in adults, so the prevalence is approximately 12 per 100,000 cases. […] Peak incidence in adults occurs around 60 years old. […] However, incidence increases with age. […] ITP’s incidence beyond age 60 is nearly similar between male and female adults.
#8 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/779545-overview
The annual incidence of immune thrombocytopenia (ITP) is estimated to be five cases per 100,000 children and two cases per 100,000 adults, but those data are not from large population-based studies. […] Most cases of acute ITP, particularly in children, are mild and self-limited and may not receive medical attention. Therefore, estimated incidences of ITP are difficult to determine and are likely to understate the full extent of the disease. The age-adjusted prevalence of ITP in Maryland was reported as 9.5 per 100,000 persons by Segal and Powe. […] A French study reported an incidence of ITP of 2.9 cases per 100,000 person-years, with peaks in children and in those older than 60 years of age and a higher frequency of ITP in males in these subgroups. ITP showed seasonal variation, with a peak in winter and a nadir in summer.
#9 Immune Thrombocytopenia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK562282/
The annual incidence of pediatric ITP is estimated to be between 1 and 6.4 cases per 100,000 people. […] Researchers suggest this figure should be higher because it is based on reported symptomatic hospitalized cases, not total ITP cases. […] Pediatric ITP can present at any age, but peak incidences occur at ages 2 to 5 and adolescence. […] The condition is more common among male than female children from infancy to childhood. […] The opposite is true among adolescents and young adults (ie, 18 to 45 years). […] Predominance among women in these age groups is attributed to estrogens effects, which can promote autoimmunity. […] ITP may be acute or chronic. […] The acute form is more frequent in childhood, often prefaced by a viral infection. […] Most children have a self-limiting course, typically spontaneously recovering within 3 months.
#10 Immune Thrombocytopenia | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/23385
The annual incidence of pediatric ITP is estimated to be between 1 and 6.4 cases per 100,000 people. […] Pediatric ITP can present at any age, but peak incidences occur at ages 2 to 5 and adolescence. […] The condition is more common among male than female children from infancy to childhood. […] The opposite is true among adolescents and young adults (ie, 18 to 45 years). […] Predominance among women in these age groups is attributed to estrogens effects, which can promote autoimmunity. […] ITP may be acute or chronic. […] The acute form is more frequent in childhood, often prefaced by a viral infection. […] Most children have a self-limiting course, typically spontaneously recovering within 3 months. […] The chronic form more often affects adults, and the inciting factor is usually unclear.
#11 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/779545-overview
The primary cause of long-term morbidity and mortality in patients with immune thrombocytopenia (ITP) is hemorrhage. […] Spontaneous or accidental trauma-induced intracranial hemorrhage is the most frequent cause of death in association with ITP. […] Most cases of intracranial hemorrhage occur in patients whose platelet counts are less than 10 109/L ( 10 103/L). […] In one study, 17% of children experienced a major hemorrhage. […] The estimated frequency of intracranial hemorrhage in adults with ITP is 1.5%. […] In children, ITP is more common in boys than in girls. […] In middle-aged adults, women are affected more frequently than men. […] Children may develop ITP at any age, but the incidence peaks in children aged 1-6 years. […] Adults may be affected at any age, but most cases are diagnosed in women aged 30-40 years.
#12 Immune Thrombocytopenia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK562282/
The annual incidence of pediatric ITP is estimated to be between 1 and 6.4 cases per 100,000 people. […] Researchers suggest this figure should be higher because it is based on reported symptomatic hospitalized cases, not total ITP cases. […] Pediatric ITP can present at any age, but peak incidences occur at ages 2 to 5 and adolescence. […] The condition is more common among male than female children from infancy to childhood. […] The opposite is true among adolescents and young adults (ie, 18 to 45 years). […] Predominance among women in these age groups is attributed to estrogens effects, which can promote autoimmunity. […] ITP may be acute or chronic. […] The acute form is more frequent in childhood, often prefaced by a viral infection. […] Most children have a self-limiting course, typically spontaneously recovering within 3 months.
#13 Epidemiology of immune thrombocytopenia: study of adult patients at a referral hematology service in Northeastern Brazil | Hematology, Transfusion and Cell Therapy
https://www.htct.com.br/en-epidemiology-immune-thrombocytopenia-study-adult-avance-S2531137923025853
The predominance of females observed in this study (154/187; 82.35 %) in all age brackets was expected with similar findings being reported by studies on ITP incidence in a range of other countries. […] In this study, secondary ITP accounted for 9.6 % of the 187 adult cases. This figure is slightly higher than that of Schoonen et al. (8.7 %), but considerably lower than the incidences reported by Cines et al. (20 %) and Moulis et al. (18 %). […] The age and gender distribution in this study was similar to that of the French population studied by Grimaldi-Bensouda et al. but different from that reported for Scandinavian, UK, US and Asian populations, suggesting the importance of geographical and ethnic factors. The finding of 56.8 % of European ancestry in the genetic pool of the population of Cear, and the historical connection with immigrants from southern Europe, possibly overlapping with France, is not without relevance.
#14 Immune Thrombocytopenia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK562282/
The chronic form more often affects adults, and the inciting factor is usually unclear. […] However, aging-related immune decline, comorbidities, and drugs are thought to contribute to the condition’s development in adults. […] Approximately 25% of children in the United States develop persistent or chronic ITP, where thrombocytopenia-associated bleeding can be life-threatening. […] Seasonal fluctuations have been noted among children with ITP, with the conditions incidence rising in the spring and early summer when viral infections are common. […] ITP’s annual incidence in adults is estimated to be 1 to 6 cases per 100,000 people. […] However, the condition is more of a chronic disease in adults, so the prevalence is approximately 12 per 100,000 cases. […] Peak incidence in adults occurs around 60 years old. […] However, incidence increases with age. […] ITP’s incidence beyond age 60 is nearly similar between male and female adults.
#15 Immune Thrombocytopenia | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/23385
However, aging-related immune decline, comorbidities, and drugs are thought to contribute to the condition’s development in adults. […] Approximately 25% of children in the United States develop persistent or chronic ITP, where thrombocytopenia-associated bleeding can be life-threatening. […] Seasonal fluctuations have been noted among children with ITP, with the conditions incidence rising in the spring and early summer when viral infections are common. […] ITP’s annual incidence in adults is estimated to be 1 to 6 cases per 100,000 people. […] However, the condition is more of a chronic disease in adults, so the prevalence is approximately 12 per 100,000 cases. […] Peak incidence in adults occurs around 60 years old. […] However, incidence increases with age. […] ITP’s incidence beyond age 60 is nearly similar between male and female adults.
#16 Epidemiology of immune thrombocytopenia: study of adult patients at a referral hematology service in Northeastern Brazil | Hematology, Transfusion and Cell Therapy
https://www.elsevier.es/pt-revista-hematology-transfusion-cell-therapy-396-avance-resumen-epidemiology-immune-thrombocytopenia-study-adult-S2531137923025853?referer=buscador
Immune thrombocytopenia (ITP) is an acquired bleeding disorder observed in the clinical practice. Little is known about its epidemiology in Brazil. The present study was conducted at a hematology referral center which covers a population of over 8 million in 184 municipalities in the state of Cear. The purpose of this study was to draw a demographic profile of adult ITP patients with regard to sex, age, geographical origin and distribution across the state, and the proportion of secondary ITP. The sample consisted of 187 adult ITP patients attending the Walter Cantdio University Hospital in 2015. The median follow-up time was 67 months (range: 1 month to 29 years). Female sex (n = 154; 82.35 %) was strongly prevalent in all age brackets, with an overall female/male ratio of 4.7:1. Secondary ITP (18/187; 9.6 %) displayed a bimodal distribution and a linear increase between 38 and 68 years of age. The results of this survey on the epidemiology of ITP in Brazil suggest that ethnic and geographical factors may have a great impact on age and sex distribution and on the distribution of secondary ITP.
#17 Epidemiology of immune thrombocytopenia: study of adult patients at a referral hematology service in Northeastern Brazil | Hematology, Transfusion and Cell Therapy
https://www.htct.com.br/en-epidemiology-immune-thrombocytopenia-study-adult-avance-S2531137923025853
The predominance of females observed in this study (154/187; 82.35 %) in all age brackets was expected with similar findings being reported by studies on ITP incidence in a range of other countries. […] In this study, secondary ITP accounted for 9.6 % of the 187 adult cases. This figure is slightly higher than that of Schoonen et al. (8.7 %), but considerably lower than the incidences reported by Cines et al. (20 %) and Moulis et al. (18 %). […] The age and gender distribution in this study was similar to that of the French population studied by Grimaldi-Bensouda et al. but different from that reported for Scandinavian, UK, US and Asian populations, suggesting the importance of geographical and ethnic factors. The finding of 56.8 % of European ancestry in the genetic pool of the population of Cear, and the historical connection with immigrants from southern Europe, possibly overlapping with France, is not without relevance.
#18 Immune Thrombocytopenia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK562282/
The annual incidence of pediatric ITP is estimated to be between 1 and 6.4 cases per 100,000 people. […] Researchers suggest this figure should be higher because it is based on reported symptomatic hospitalized cases, not total ITP cases. […] Pediatric ITP can present at any age, but peak incidences occur at ages 2 to 5 and adolescence. […] The condition is more common among male than female children from infancy to childhood. […] The opposite is true among adolescents and young adults (ie, 18 to 45 years). […] Predominance among women in these age groups is attributed to estrogens effects, which can promote autoimmunity. […] ITP may be acute or chronic. […] The acute form is more frequent in childhood, often prefaced by a viral infection. […] Most children have a self-limiting course, typically spontaneously recovering within 3 months.
#19 Immune thrombocytopenic purpura – Wikipedia
https://en.wikipedia.org/wiki/Immune_thrombocytopenic_purpura
Epidemiology: The incidence of ITP is estimated at 50100 new cases per million per year, with children accounting for half of that number. […] At least 70 percent of childhood cases will end up in remission within six months, even without treatment. […] ITP is usually chronic in adults and the probability of durable remission is 2040 percent. […] The male to female ratio in the adult group varies from 1:1.2 to 1.7 in most age ranges (childhood cases are roughly equal for both sexes) and the median age of adults at the diagnosis is 5660. […] In the United States, the adult chronic population is thought to be approximately 60,000 with women outnumbering men approximately 2 to 1, which has resulted in ITP being designated an orphan disease. […] The mortality rate due to chronic ITP varies but tends to be higher relative to the general population for any age range. […] In a study conducted in Great Britain, it was noted that ITP causes an approximately 60 percent higher rate of mortality compared to sex- and age-matched subjects without ITP.
#20 Diagnosis and management of typical, newly diagnosed primary immune thrombocytopenia (ITP) of childhood | Canadian Paediatric Society
https://cps.ca/documents/position/immune-thrombocytopenia
Newly diagnosed primary immune thrombocytopenia (ITP) typically occurs in healthy children and is characterized by immune-mediated destruction of otherwise normal platelets. ITP affects approximately 5 in 100,000 children per year, most commonly between age 2 to 5 years. Typical natural history is self-resolution within 6 months, which occurs in 75% to 80% of cases, with some of the remaining children resolving within a year of diagnosis. The most serious complication of ITP is intracranial hemorrhage, which occurs in approximately 0.17% to 0.6% of cases. […] How best to manage cases of typical ITP in children remains unclear. Management options include observation without specific treatment or active therapy with corticosteroids, intravenous immunoglobulin (IVIG) or with anti-D immunoglobulin (anti-D) for Rh-positive children.
#21 Pathophysiology, Clinical Manifestations and Diagnosis of Immune Thrombocytopenia: Contextualization from a Historical Perspective
https://www.mdpi.com/2038-8330/16/2/21
ITP is a rare disease with an annual incidence that varies from 1.1 to 12.5/100,000 inhabitants/year, being similar between children and adults. […] According to a nationwide population-based study in France, the natural history of pediatric ITP is different from that of adults since only 35.7% of children with primary ITP will progress to persistent or chronic disease, while adult primary ITP will become persistent or chronic in 66.7% of the cases. […] Overall, the incidence is slightly higher in women. […] The prevalence is higher in adults, being 4.6 per 100,000 inhabitants of pediatric age and 9.5â23.6 per 100,000 inhabitants of adult age.
#22
https://haematologica.org/article/view/7816
Our results show that a large majority of adults with newly diagnosed ITP are likely to develop a chronic form of the disease after one year. In our sample, only 37% of patients spontaneously recovered, i.e. without the need for disease-modifying treatment such as rituximab or splenectomy. […] Our results confirm that sex and age are not risk factors for chronicity. […] A familial history of autoimmune disorder was found in 9 (8.3%) out of the 109 case-patients explored. […] Overall, having a first-degree relative with a history of autoimmune disorder was not associated with increased odds of developing ITP. […] The study confirms that ITP is more common in women than men, and is frequently associated with cutaneous bleeding, even if life-threatening bleeding is rare.
#23 Immune thrombocytopenic purpura – Wikipedia
https://en.wikipedia.org/wiki/Immune_thrombocytopenic_purpura
Epidemiology: The incidence of ITP is estimated at 50100 new cases per million per year, with children accounting for half of that number. […] At least 70 percent of childhood cases will end up in remission within six months, even without treatment. […] ITP is usually chronic in adults and the probability of durable remission is 2040 percent. […] The male to female ratio in the adult group varies from 1:1.2 to 1.7 in most age ranges (childhood cases are roughly equal for both sexes) and the median age of adults at the diagnosis is 5660. […] In the United States, the adult chronic population is thought to be approximately 60,000 with women outnumbering men approximately 2 to 1, which has resulted in ITP being designated an orphan disease. […] The mortality rate due to chronic ITP varies but tends to be higher relative to the general population for any age range. […] In a study conducted in Great Britain, it was noted that ITP causes an approximately 60 percent higher rate of mortality compared to sex- and age-matched subjects without ITP.
#24 Immune Thrombocytopenia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK562282/
The chronic form more often affects adults, and the inciting factor is usually unclear. […] However, aging-related immune decline, comorbidities, and drugs are thought to contribute to the condition’s development in adults. […] Approximately 25% of children in the United States develop persistent or chronic ITP, where thrombocytopenia-associated bleeding can be life-threatening. […] Seasonal fluctuations have been noted among children with ITP, with the conditions incidence rising in the spring and early summer when viral infections are common. […] ITP’s annual incidence in adults is estimated to be 1 to 6 cases per 100,000 people. […] However, the condition is more of a chronic disease in adults, so the prevalence is approximately 12 per 100,000 cases. […] Peak incidence in adults occurs around 60 years old. […] However, incidence increases with age. […] ITP’s incidence beyond age 60 is nearly similar between male and female adults.
#25 Immune Thrombocytopenia | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/23385
However, aging-related immune decline, comorbidities, and drugs are thought to contribute to the condition’s development in adults. […] Approximately 25% of children in the United States develop persistent or chronic ITP, where thrombocytopenia-associated bleeding can be life-threatening. […] Seasonal fluctuations have been noted among children with ITP, with the conditions incidence rising in the spring and early summer when viral infections are common. […] ITP’s annual incidence in adults is estimated to be 1 to 6 cases per 100,000 people. […] However, the condition is more of a chronic disease in adults, so the prevalence is approximately 12 per 100,000 cases. […] Peak incidence in adults occurs around 60 years old. […] However, incidence increases with age. […] ITP’s incidence beyond age 60 is nearly similar between male and female adults.
#26
https://step2.medbullets.com/heme/120241/immune-thrombocytopenia-itp
Epidemiology […] Demographics […] 1-7 years of age commonly in children […] […] […] Primary immune thrombocytopenia (ITP) […] immune-mediated thrombocytopenia without an underlying condition […] […] […] Secondary ITP […] immune-mediated thrombocytopenia with an underlying condition (e.g., HIV infection)
#27 Epidemiology of immune thrombocytopenia: study of adult patients at a referral hematology service in Northeastern Brazil | Hematology, Transfusion and Cell Therapy
https://www.htct.com.br/en-epidemiology-immune-thrombocytopenia-study-adult-avance-S2531137923025853
The predominance of females observed in this study (154/187; 82.35 %) in all age brackets was expected with similar findings being reported by studies on ITP incidence in a range of other countries. […] In this study, secondary ITP accounted for 9.6 % of the 187 adult cases. This figure is slightly higher than that of Schoonen et al. (8.7 %), but considerably lower than the incidences reported by Cines et al. (20 %) and Moulis et al. (18 %). […] The age and gender distribution in this study was similar to that of the French population studied by Grimaldi-Bensouda et al. but different from that reported for Scandinavian, UK, US and Asian populations, suggesting the importance of geographical and ethnic factors. The finding of 56.8 % of European ancestry in the genetic pool of the population of Cear, and the historical connection with immigrants from southern Europe, possibly overlapping with France, is not without relevance.
#28 Treatment outcomes and adherence to treatment in patients with immune thrombocytopenia in two Ethiopian teaching hospitals: a retrospective cohort study | Scientific Reports
https://www.nature.com/articles/s41598-024-62372-w
The incidence of ITP varies and is most common in young adults, particularly women of childbearing age, with a female-to-male ratio of 2 to 1 and an estimated 1.6-4.4 per 100,000 person-years. […] According to the guidelines of the American Society of Hematology (ASH) of 2019, ITP is classified into primary and secondary forms depending on the cause. […] In this study, 19.2% of study participants had secondary ITP, which is comparable with studies conducted in Malaysia (23%) and higher than studies conducted in Germany (9%). […] Most epidemiologic data suggest that women are more commonly affected by ITP during their childbearing age and that the prevalence after menopause is similar to that of men. […] The highest complete response rate was achieved at 12 months compared to at 3 and 6 months, and they adhered to their treatments.
#29 SciELO Brazil – Epidemiology of immune thrombocytopenia: study of adult patients at a referral hematology service in Northeastern Brazil Epidemiology of immune thrombocytopenia: study of adult patients at a referral hematology service in Northeastern Bra
https://www.scielo.br/j/htct/a/jyvVdsc8Zttd4kPdkmcQ3yn/?lang=en
The epidemiology of ITP has been investigated in some countries, such as in the UK, France, the US, Japan and Korea, but no epidemiological studies have, to our knowledge, been conducted in Brazil. […] The predominance of females observed in this study (154/187; 82.35 %) in all age brackets was expected with similar findings being reported by studies on ITP incidence in a range of other countries. […] In this study, secondary ITP accounted for 9.6 % of the 187 adult cases. […] The frequency of adult secondary ITP displayed a bimodal pattern: one peak for young adults (18-27 years) and another peak for older adults (68 years). […] This study of the epidemiology of ITP in Brazil is intended as a contribution to public health policy development, health care cost modeling and the updating of curricula used in health education. Based on a sample of 187 adult patients, the demographic profile drawn in this study shares similarities with profiles from other countries, especially France, with regard to the prevalence of the female sex and age distribution. These similarities between the profiles of Cear and France may be related to genetic inheritance. Secondary ITP displayed a bimodal distribution and a linear increase between 38 and 68 years of age.
#30 Immune Thrombocytopenia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK562282/
The chronic form more often affects adults, and the inciting factor is usually unclear. […] However, aging-related immune decline, comorbidities, and drugs are thought to contribute to the condition’s development in adults. […] Approximately 25% of children in the United States develop persistent or chronic ITP, where thrombocytopenia-associated bleeding can be life-threatening. […] Seasonal fluctuations have been noted among children with ITP, with the conditions incidence rising in the spring and early summer when viral infections are common. […] ITP’s annual incidence in adults is estimated to be 1 to 6 cases per 100,000 people. […] However, the condition is more of a chronic disease in adults, so the prevalence is approximately 12 per 100,000 cases. […] Peak incidence in adults occurs around 60 years old. […] However, incidence increases with age. […] ITP’s incidence beyond age 60 is nearly similar between male and female adults.
#31 Immune Thrombocytopenia | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/23385
However, aging-related immune decline, comorbidities, and drugs are thought to contribute to the condition’s development in adults. […] Approximately 25% of children in the United States develop persistent or chronic ITP, where thrombocytopenia-associated bleeding can be life-threatening. […] Seasonal fluctuations have been noted among children with ITP, with the conditions incidence rising in the spring and early summer when viral infections are common. […] ITP’s annual incidence in adults is estimated to be 1 to 6 cases per 100,000 people. […] However, the condition is more of a chronic disease in adults, so the prevalence is approximately 12 per 100,000 cases. […] Peak incidence in adults occurs around 60 years old. […] However, incidence increases with age. […] ITP’s incidence beyond age 60 is nearly similar between male and female adults.
#32 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/779545-overview
The annual incidence of immune thrombocytopenia (ITP) is estimated to be five cases per 100,000 children and two cases per 100,000 adults, but those data are not from large population-based studies. […] Most cases of acute ITP, particularly in children, are mild and self-limited and may not receive medical attention. Therefore, estimated incidences of ITP are difficult to determine and are likely to understate the full extent of the disease. The age-adjusted prevalence of ITP in Maryland was reported as 9.5 per 100,000 persons by Segal and Powe. […] A French study reported an incidence of ITP of 2.9 cases per 100,000 person-years, with peaks in children and in those older than 60 years of age and a higher frequency of ITP in males in these subgroups. ITP showed seasonal variation, with a peak in winter and a nadir in summer.
#33 Immune Thrombocytopenia epidemiology and demographics – wikidoc
https://www.wikidoc.org/index.php/Immune_Thrombocytopenia_epidemiology_and_demographics
Immune thrombocytopenia commonly affects individuals younger than 5 years of age. […] Black and non-hispanic individuals are less likely to develop ITP, thereafter, the providers should suspect alternative diagnosis or secondary ITP in these races. […] The majority of Immune thrombocytopenia cases are reported in January and the minority in summer in all age group probably due to viral infection.
#34 Immune Thrombocytopenia (ITP) | 5-Minute Clinical Consult
https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688304/all/Immune_Thrombocytopenia__ITP_?q=Hematuria
Immune thrombocytopenia (ITP) is a relatively common disease of childhood that typically follows a viral infection. Onset is within 1 week, and spontaneous resolution occurs within 2 months in 80% of patients. […] In adults, ITP is usually a chronic disease and spontaneous remission is rare. […] Peak age: pediatric ITP: 2 to 4 years; chronic ITP: 50 years with incidence 2 times higher in persons aged 60 years than those 60 years of age. […] Pediatric acute ITP: 1.9 to 6.4/100,000 children per year; adult ITP: 1.6/100,000 per year. […] Peak incidence of ITP in the spring and early summer in temperate climates. This observation supports the notion that viral triggers are an important cause of ITP. […] Limited data; in one population (in Oklahoma): Overall prevalence of 11.2/100,000 persons.
#35
http://waocp.com/journal/index.php/apjcb/article/view/1290
Globally, immune thrombocytopenia (ITP) affects more women than men with a higher incidence in older patients. However, data on the epidemiology and treatment regimen for ITP is limited and varies across different countries. In this non-interventional, longitudinal, nationwide estimation study, we present incidence (by age, sex, and diagnosis stage), prevalence, characteristics, and treatment regimens of ITP in Algeria. […] The national incidence was 0.85 (0.75-0.96) and prevalence was 5.65 (5.39-5.93) per 100,000 population. The incidence of ITP in women (1.18 [1.02-1.37]/100,000 population) was higher versus men (0.54 [0.43-0.67]/100,000 population). The incidence of ITP was four times higher in the 75 years cohort (2.37 [1.60-3.51]/100,000 population) versus that observed in the 15-35 years age cohort (0.54 [0.43-0.68]/100,000 population).
#36 Epidemiology of immune thrombocytopenia: study of adult patients at a referral hematology service in Northeastern Brazil | Hematology, Transfusion and Cell Therapy
https://www.htct.com.br/en-epidemiology-immune-thrombocytopenia-study-adult-avance-S2531137923025853
This study of the epidemiology of ITP in Brazil is intended as a contribution to public health policy development, health care cost modeling and the updating of curricula used in health education. Based on a sample of 187 adult patients, the demographic profile drawn in this study shares similarities with profiles from other countries, especially France, with regard to the prevalence of the female sex and age distribution. These similarities between the profiles of Cear and France may be related to genetic inheritance. Secondary ITP displayed a bimodal distribution and a linear increase between 38 and 68 years of age.
#37 Immune Thrombocytopenia epidemiology and demographics – wikidoc
https://www.wikidoc.org/index.php/Immune_Thrombocytopenia_epidemiology_and_demographics
Immune thrombocytopenia commonly affects individuals younger than 5 years of age. […] Black and non-hispanic individuals are less likely to develop ITP, thereafter, the providers should suspect alternative diagnosis or secondary ITP in these races. […] The majority of Immune thrombocytopenia cases are reported in January and the minority in summer in all age group probably due to viral infection.
#38 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/779545-overview
The primary cause of long-term morbidity and mortality in patients with immune thrombocytopenia (ITP) is hemorrhage. […] Spontaneous or accidental trauma-induced intracranial hemorrhage is the most frequent cause of death in association with ITP. […] Most cases of intracranial hemorrhage occur in patients whose platelet counts are less than 10 109/L ( 10 103/L). […] In one study, 17% of children experienced a major hemorrhage. […] The estimated frequency of intracranial hemorrhage in adults with ITP is 1.5%. […] In children, ITP is more common in boys than in girls. […] In middle-aged adults, women are affected more frequently than men. […] Children may develop ITP at any age, but the incidence peaks in children aged 1-6 years. […] Adults may be affected at any age, but most cases are diagnosed in women aged 30-40 years.
#39 Current Understanding of Immune Thrombocytopenia: A Review of Pathogenesis and Treatment Options
https://www.mdpi.com/1422-0067/25/4/2163
Based on findings from ITP registries and administrative databases, as well as clinical studies, the frequency of severe bleeding, manifested as intracranial hemorrhage (ICH), is ~0.5% in children and 1.5% in adults. […] Predictors of severe bleeding, as evaluated in clinical trials, include the presence of severe thrombocytopenia (platelet count <10,000â20,000/Î¼L), previous minor bleeding, older age (older than 60 years), concomitant medication use that predisposes patients to bleeding, and male sex. [...] There are several tools to assess bleeding that are specific to patients with ITP, of which the Buchanan tool for children and the Page score for adults have been most widely used.
#40 Immune thrombocytopenia – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/138
Immune thrombocytopenia (ITP) in children typically presents with a preceding viral illness and an abrupt onset. There is a female preponderance among adults, who may present with thrombocytopenia with or without bleeding. […] Intracranial bleeding is reported in approximately 0.5% of children and 1.5% of adults. […] Prognosis is good in children, with up to 80% achieving a spontaneous remission. Mortality is higher in older patients and in those unresponsive to several lines of treatment. […] The distinction between primary and secondary ITP is clinically relevant because of their different natural histories and distinct treatments, including the need to treat the underlying condition in secondary ITP.
#41 Immune Thrombocytopenia (ITP): Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/779545-overview
The primary cause of long-term morbidity and mortality in patients with immune thrombocytopenia (ITP) is hemorrhage. […] Spontaneous or accidental trauma-induced intracranial hemorrhage is the most frequent cause of death in association with ITP. […] Most cases of intracranial hemorrhage occur in patients whose platelet counts are less than 10 109/L ( 10 103/L). […] In one study, 17% of children experienced a major hemorrhage. […] The estimated frequency of intracranial hemorrhage in adults with ITP is 1.5%. […] In children, ITP is more common in boys than in girls. […] In middle-aged adults, women are affected more frequently than men. […] Children may develop ITP at any age, but the incidence peaks in children aged 1-6 years. […] Adults may be affected at any age, but most cases are diagnosed in women aged 30-40 years.
#42 Immune Thrombocytopenia | Disease Education | Amgen Oncology
https://www.amgenoncology.com/immune-thrombocytopenia.html
ITP affects all ages and genders, with the highest incidence in children (18 years old) and older adults (60 years)2,3 […] Severe bleeding occurs in ~10% of adults and 20% of children with newly diagnosed or chronic ITP7 […] Intracranial hemorrhage is a rare but serious complication in ITP with incidence of 11.8% in adults and 0.6% in children8 […] The primary goal of treatment is to sustain platelet counts that are associated with adequate hemostasis, and reduce bleeding risk with minimal side effects. Treatments should be tailored to individual patients, taking into account the patients age, severity of illness, bleeding risk, comorbidities, lifestyle considerations, and careful evaluation of benefit/risk profile of each therapy.1,17 […] Epidemiology of immune thrombocytopenic purpura in the General Practice Research Database.
#43 Current Understanding of Immune Thrombocytopenia: A Review of Pathogenesis and Treatment Options
https://www.mdpi.com/1422-0067/25/4/2163
Based on findings from ITP registries and administrative databases, as well as clinical studies, the frequency of severe bleeding, manifested as intracranial hemorrhage (ICH), is ~0.5% in children and 1.5% in adults. […] Predictors of severe bleeding, as evaluated in clinical trials, include the presence of severe thrombocytopenia (platelet count <10,000â20,000/Î¼L), previous minor bleeding, older age (older than 60 years), concomitant medication use that predisposes patients to bleeding, and male sex. [...] There are several tools to assess bleeding that are specific to patients with ITP, of which the Buchanan tool for children and the Page score for adults have been most widely used.
#44 Epidemiology and Clinical Manifestations of Immune Thrombocytopenia – PubMed
https://pubmed.ncbi.nlm.nih.gov/30868551/
Immune thrombocytopenia (ITP) occurs with an incidence rate of 1.6 to 3.9 per 100,000 patient-years, which increases with age and has a slight female preponderance. […] Over long-term follow-up, ITP is also associated with an increased risk of venous and arterial thromboembolism, haematologic malignancy and overall mortality than the general population.
#45 Epidemiology | SpringerLink
https://link.springer.com/chapter/10.1007/978-981-10-4142-6_4
ITP is estimated to have incidence between 2.16 and 3.9 per 100,000 person-years. […] There is a 1.1 to 1.5:1 female to male predominance in the entire ITP patients although ITP was more frequent among males in the age groups less than 5 years and over 75 years old. […] Intracranial hemorrhage (ICH) is the most devastating bleeding event, and its incidence is 0.370.6%. […] In contrast, recent studies suggest that ITP may have paradoxically an increased risk for thromboembolism. […] The epidemiology of immune thrombocytopenic purpura in children and adults: a critical review of published reports. […] Epidemiology of immune thrombocytopenic purpura in the General Practice Research Database. […] Epidemiology of primary immune thrombocytopenia in children and adults in Japan: a population-based study and literature review.
#46 How we treat primary immune thrombocytopenia in adults | Journal of Hematology & Oncology | Full Text
https://jhoonline.biomedcentral.com/articles/10.1186/s13045-023-01401-z
Primary immune thrombocytopenia (ITP) is an acquired autoimmune bleeding disorder characterized by isolated thrombocytopenia (platelet countâ<â100âÃâ10^9/L) in the absence of other etiologies. The incidence of the disease is approximately 2â10 per 100,000 adults each year, with a prevalence of 9â20 per 100,000 adults. [...] A population-based study revealed a 1.3â2.2-fold increase in the mortality rate for adult ITP patients compared with the general population due to bleeding episodes, infection, and cardiovascular events. [...] Although the reported incidence of thrombosis was inconsistent, most studies demonstrated a slightly increased risk of thromboembolism in ITP patients. [...] The international working group (IWG) on ITP and the American Society of Hematology (ASH) both updated their guidelines for the diagnosis and management of ITP in 2019.
#47 Immune thrombocytopenic purpura – Wikipedia
https://en.wikipedia.org/wiki/Immune_thrombocytopenic_purpura
Epidemiology: The incidence of ITP is estimated at 50100 new cases per million per year, with children accounting for half of that number. […] At least 70 percent of childhood cases will end up in remission within six months, even without treatment. […] ITP is usually chronic in adults and the probability of durable remission is 2040 percent. […] The male to female ratio in the adult group varies from 1:1.2 to 1.7 in most age ranges (childhood cases are roughly equal for both sexes) and the median age of adults at the diagnosis is 5660. […] In the United States, the adult chronic population is thought to be approximately 60,000 with women outnumbering men approximately 2 to 1, which has resulted in ITP being designated an orphan disease. […] The mortality rate due to chronic ITP varies but tends to be higher relative to the general population for any age range. […] In a study conducted in Great Britain, it was noted that ITP causes an approximately 60 percent higher rate of mortality compared to sex- and age-matched subjects without ITP.
#48 Immune thrombocytopenia (ITP) in adults: Clinical manifestations and diagnosis – UpToDate
https://www.uptodate.com/contents/immune-thrombocytopenia-itp-in-adults-clinical-manifestations-and-diagnosis
Immune thrombocytopenia (ITP) is one of the more common causes of thrombocytopenia in otherwise asymptomatic adults. […] The lack of a sensitive or specific diagnostic test for ITP and the large number of other potential causes of thrombocytopenia, some of which may be overlooked (eg, drug-induced thrombocytopenia, hereditary thrombocytopenia), also contribute to challenges in diagnosing ITP. […] Incidence of immune thrombocytopenia (ITP) by age and sex.
#49
https://haematologica.org/article/view/7816
Immune thrombocytopenia (ITP) is an autoimmune disorder mediated by platelet antibodies thought to accelerate platelet destruction while inhibiting also their production, resulting in low platelet counts with potentially spontaneous bruising, petechial rash, mucosal bleeding or even life-threatening hemorrhage. ITP affects children and adults, with an incidence rate for the latter estimated between 2.8 and 3.9 per 100,000 person-years in Europe, and namely 2.9/100,000 in France. […] A recent retrospective study based on administrative registers reported that about two-thirds of adult ITP patients are likely to develop a chronic form of the disease. […] In France, a nationwide prospective cohort of adult patients presenting with a newly diagnosed episode of ITP was constituted primarily to explore the association between exposure to common vaccines and risk of developing ITP.
#50 Surveillance of Severe Primary Immune Thrombocytopenia (ITP) in pregnancy | NPEU
https://www.npeu.ox.ac.uk/research/projects/133-ukoss-itp
Primary Immune Thrombocytopenia (ITP) describes an acquired immunological disorder characterized by an isolated low platelet count (thrombocytopenia) necessary for normal clotting function. […] This study aimed to estimate the current incidence and describe management and treatment of severe ITP in pregnancy in the UK.
#51 Current Understanding of Immune Thrombocytopenia: A Review of Pathogenesis and Treatment Options
https://www.mdpi.com/1422-0067/25/4/2163
Based on findings from ITP registries and administrative databases, as well as clinical studies, the frequency of severe bleeding, manifested as intracranial hemorrhage (ICH), is ~0.5% in children and 1.5% in adults. […] Predictors of severe bleeding, as evaluated in clinical trials, include the presence of severe thrombocytopenia (platelet count <10,000â20,000/Î¼L), previous minor bleeding, older age (older than 60 years), concomitant medication use that predisposes patients to bleeding, and male sex. [...] There are several tools to assess bleeding that are specific to patients with ITP, of which the Buchanan tool for children and the Page score for adults have been most widely used.
#52 How we treat primary immune thrombocytopenia in adults | Journal of Hematology & Oncology | Full Text
https://jhoonline.biomedcentral.com/articles/10.1186/s13045-023-01401-z
Data from the CARMEN-France registry indicated that anticoagulant exposure was the major risk factor for severe bleeding in very elderly ITP patients agedââ¥â80 years, and thus for whom more close monitoring was needed. […] Bleeding severity in ITP patients may be graded using the well-established ITP-specific bleeding assessment tool (ITP-BAT), as it is one of the basic determinants of treatment initiation and response evaluation.
#53 How we treat primary immune thrombocytopenia in adults | Journal of Hematology & Oncology | Full Text
https://jhoonline.biomedcentral.com/articles/10.1186/s13045-023-01401-z
Data from the CARMEN-France registry indicated that anticoagulant exposure was the major risk factor for severe bleeding in very elderly ITP patients agedââ¥â80 years, and thus for whom more close monitoring was needed. […] Bleeding severity in ITP patients may be graded using the well-established ITP-specific bleeding assessment tool (ITP-BAT), as it is one of the basic determinants of treatment initiation and response evaluation.
#54
http://waocp.com/journal/index.php/apjcb/article/view/1290
Globally, immune thrombocytopenia (ITP) affects more women than men with a higher incidence in older patients. However, data on the epidemiology and treatment regimen for ITP is limited and varies across different countries. In this non-interventional, longitudinal, nationwide estimation study, we present incidence (by age, sex, and diagnosis stage), prevalence, characteristics, and treatment regimens of ITP in Algeria. […] The national incidence was 0.85 (0.75-0.96) and prevalence was 5.65 (5.39-5.93) per 100,000 population. The incidence of ITP in women (1.18 [1.02-1.37]/100,000 population) was higher versus men (0.54 [0.43-0.67]/100,000 population). The incidence of ITP was four times higher in the 75 years cohort (2.37 [1.60-3.51]/100,000 population) versus that observed in the 15-35 years age cohort (0.54 [0.43-0.68]/100,000 population).
#55 Global Immune Thrombocytopenia (ITP) Market Insights, Epidemiology, and Forecasts, 2017-2028: Focus on United States, Germany, Spain, Italy, France, and the United Kingdom, and Japan
https://www.prnewswire.com/news-releases/global-immune-thrombocytopenia-itp-market-insights-epidemiology-and-forecasts-2017-2028-focus-on-united-states-germany-spain-italy-france-and-the-united-kingdom-and-japan-300967265.html
Immune thrombocytopenia (ITP) Epidemiology […] The disease epidemiology covered in the report provides historical as well as forecasted epidemiology (Total Prevalent Cases of Immune thrombocytopenia (ITP) in 7MM, Total Diagnosed Prevalent Cases of Immune thrombocytopenia (ITP) in 7MM, and Gender-specific Diagnosed Prevalent Cases of Immune thrombocytopenia (ITP) in 7MM) scenario of Immune thrombocytopenia (ITP) in the 7MM covering United States, EU5 countries (Germany, Spain, Italy, France and United Kingdom) and Japan from 2017-2028. The total diagnosed cases of Immune thrombocytopenia (ITP) were found out to be approximately 147,174 in 2017, in the 7MM. The number of Immune thrombocytopenia (ITP) cases in the 7MM is expected to increase during the study period of 2017-2028.
#56 Immune thrombocytopenic purpura – Wikipedia
https://en.wikipedia.org/wiki/Immune_thrombocytopenic_purpura
Epidemiology: The incidence of ITP is estimated at 50100 new cases per million per year, with children accounting for half of that number. […] At least 70 percent of childhood cases will end up in remission within six months, even without treatment. […] ITP is usually chronic in adults and the probability of durable remission is 2040 percent. […] The male to female ratio in the adult group varies from 1:1.2 to 1.7 in most age ranges (childhood cases are roughly equal for both sexes) and the median age of adults at the diagnosis is 5660. […] In the United States, the adult chronic population is thought to be approximately 60,000 with women outnumbering men approximately 2 to 1, which has resulted in ITP being designated an orphan disease. […] The mortality rate due to chronic ITP varies but tends to be higher relative to the general population for any age range. […] In a study conducted in Great Britain, it was noted that ITP causes an approximately 60 percent higher rate of mortality compared to sex- and age-matched subjects without ITP.
#57 Thieme E-Journals – TH Open / Abstract
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2336-1062
BackgroundImmune thrombocytopenia (ITP) is characterised by low platelet counts and often leads to bleeding, fatigue, and reduced health-related quality of life. […] Epidemiology, baseline/clinical characteristics, treatment trends, healthcare resources and costs were analysed. […] ITP prevalence and annual incidence per 100,000 were estimated in 10.8 (2.8 in chronic ITP [cITP] patients) and 1.5 (0.3 in cITP patients), respectively. […] This is the first study to provide an overall perspective on the situation of the Spanish ITP population in terms of epidemiology, treatment trends, health care resources and costs, highlighting unmet patient needs, and direct and indirect costs/resource use between 2014 and 2020.
#58 Epidemiology of immune thrombocytopenia: study of adult patients at a referral hematology service in Northeastern Brazil | Hematology, Transfusion and Cell Therapy
https://www.htct.com.br/en-epidemiology-immune-thrombocytopenia-study-adult-avance-S2531137923025853
This study of the epidemiology of ITP in Brazil is intended as a contribution to public health policy development, health care cost modeling and the updating of curricula used in health education. Based on a sample of 187 adult patients, the demographic profile drawn in this study shares similarities with profiles from other countries, especially France, with regard to the prevalence of the female sex and age distribution. These similarities between the profiles of Cear and France may be related to genetic inheritance. Secondary ITP displayed a bimodal distribution and a linear increase between 38 and 68 years of age.