Abstract

Nazir A. A., Dr. Zaki N. E.*, Mansour A. R., Farrag N. A., Agamy E.

ABSTRACT

Background: This study aimed to assess the plasma interleukin-21 and CXCL-13 levels in adult patients with newly diagnosed immune thrombocytopenic purpura (ITP) as predictors of response to corticosteroids as first line therapy. Methods: 30 newly diagnosed adult ITP patients and 30 age and sex-matched controls were enrolled. Both groups were tested for IL-21 and CXCL-13 plasma levels by ELISA at diagnosis and after receiving 2-4 weeks of prednisolone 1-2 mg/kg/day. Results: Patients' age ranged from18 to 49 years with a mean of 33.70 ± 8.563 years; 76.67% were females. Clinically, 66.67% of patients complained of fatigue, 43.33% presented with menorrhagia, 36.67% of patients had ecchymosis, 20% complained of epistaxis, 10% presented with melena, 6.67% with gingival bleeding, 3.33% manifested by subconjunctival hemorrhage and 3.33% presented with intracranial hemorrhage. In addition, 10% of patients were accidentally diagnosed during routine laboratory work up. The platelet count of ITP patients at diagnosis (mean: 16.79±11.085X109/L) was significantly lower than the controls (mean: 239.80±43.245X109/L)), and it significantly increased after treatment (mean: 109.83 ±47.015 X109/L) compared to pre- treatment value [Z=4.783, p=0.000*]. Regarding response to treatment; 60% of patients showed a complete response (CR= platelet count ?100 x 109/L and absence of bleeding), 33.33% showed a response (R= platelet count ?30 x 109/L and at least 2-fold increase in the baseline count and absence of bleeding), and 6.66% of patients showed no response to treatment {NR= platelet count