Ozan SALİM, Orhan Kemal YÜCEL, Mehmet Ali SUNGUR, Naci TİFTİK, Emel GÜRKAN, Güray SAYDAM, Anıl TOMBAK, Melda CÖMERT, Burcu BOZTEPE, Kaniye AYDIN

Seasonal Association of Immune Thrombocytopenia in Adults

Background: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is seen

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