PMID- 22817814
OWN - NLM
STAT- MEDLINE
DCOM- 20121207
LR  - 20161013
IS  - 0929-6646 (Print)
IS  - 0929-6646 (Linking)
VI  - 111
IP  - 7
DP  - 2012 Jul
TI  - Clinical features and major histocompatibility complex genes as potential 
      susceptibility factors in pediatric immune thrombocytopenia.
PG  - 370-9
LID - 10.1016/j.jfma.2011.06.025 [doi]
AB  - BACKGROUND/PURPOSE: Immune thrombocytopenia (ITP) is a heterogeneous autoimmune 
      disorder with diverse response rates to treatments that include corticosteroids, 
      intravenous immunoglobulins (IVIG), and splenectomy. The predisposing causes of 
      this autoimmune disorder, one of which is immunogenetic susceptibility, have not 
      been fully determined. We investigated whether clinical features and human 
      leukocyte antigen (HLA) genotypes influence the occurrence, treatment response, 
      and disease duration of childhood ITP in Taiwan. METHODS: We performed HLA 
      genotyping of 70 Taiwanese children with ITP and of 70 healthy controls and 
      compared the data. Demographic data were also collected and evaluated. RESULTS: 
      The frequencies of heterozygous HLA-A11 and the HLA-Cw1 allele were both 
      significantly decreased in the ITP group (p = 0.0160 and p = 0.0089, 
      respectively), whereas the frequency of heterozygous HLA-DQ5 was significantly 
      increased in the ITP group (p = 0.0057). Patients with HLA-DRB1*11 or -DRB1*15 
      were more likely to respond poorly to corticosteroids than IVIG (p = 0.0446 and p 
      = 0.0008, respectively). In addition, we observed a positive association between 
      HLA-A11 homozygosity and the development of persistent or chronic ITP [odds ratio 
      (OR) = 6.3165, p = 0.0479]. The presence of HLA-DRB1*08 was, however, negatively 
      correlated with the development of persistent or chronic ITP (OR = 0.1729, p = 
      0.0657). Children with antecedent of preceding illness (API) and with a younger 
      age of onset were more likely to experience a better treatment response and 
      shorter course of ITP. CONCLUSION: We suggest that API, age of onset, and 
      particular HLA class I and class II alleles, may be involved in and influence the 
      occurrence and disease duration of childhood ITP, as well as responses to 
      different therapeutic approaches.
CI  - Copyright (c) 2012. Published by Elsevier B.V.
FAU - Ho, Wan-Ling
AU  - Ho WL
AD  - Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
FAU - Lu, Meng-Yao
AU  - Lu MY
FAU - Hu, Fu-Chang
AU  - Hu FC
FAU - Lee, Chin-Cheng
AU  - Lee CC
FAU - Huang, Li-Min
AU  - Huang LM
FAU - Jou, Shiann-Tarng
AU  - Jou ST
FAU - Lin, Dong-Tsamn
AU  - Lin DT
FAU - Lin, Kai-Hsin
AU  - Lin KH
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120309
PL  - Singapore
TA  - J Formos Med Assoc
JT  - Journal of the Formosan Medical Association = Taiwan yi zhi
JID - 9214933
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Alleles
MH  - Case-Control Studies
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Gene Frequency/genetics
MH  - Genetic Predisposition to Disease/*genetics
MH  - Genotyping Techniques
MH  - HLA Antigens/genetics
MH  - Heterozygote
MH  - Homozygote
MH  - Humans
MH  - Major Histocompatibility Complex/*genetics
MH  - Male
MH  - Purpura, Thrombocytopenic, Idiopathic/*genetics
MH  - Taiwan/epidemiology
EDAT- 2012/07/24 06:00
MHDA- 2012/12/12 06:00
CRDT- 2012/07/24 06:00
PHST- 2011/03/08 00:00 [received]
PHST- 2011/06/13 00:00 [revised]
PHST- 2011/06/22 00:00 [accepted]
PHST- 2012/07/24 06:00 [entrez]
PHST- 2012/07/24 06:00 [pubmed]
PHST- 2012/12/12 06:00 [medline]
AID - S0929-6646(12)00075-7 [pii]
AID - 10.1016/j.jfma.2011.06.025 [doi]
PST - ppublish
SO  - J Formos Med Assoc. 2012 Jul;111(7):370-9. doi: 10.1016/j.jfma.2011.06.025. Epub 
      2012 Mar 9.