Prevalence and impact of antithyroid antibodies in children with immune thrombocytopenic purpura

Background Immune thrombocytopenia (ITP) is a common autoimmune condition characterized by isolated thrombocytopenia. ITP can present either as a primary disorder or secondary to other diseases, such as infections or altered immune states. The aim of this work was to evaluate the prevalence of antithyroid autoantibodies found at the time of diagnosis of childhood ITP and their influence on treatment response, in addition to prevalence of antiplatelet antibodies and thyroid dysfunction in pediatric patients with ITP. Patients and methods This prospective controlled study was carried out on 50 children with newly diagnosed primary ITP, and 50 apparently healthy children served as a control group. Serum levels of thyroid-stimulating hormone, free thyroxin and free triiodothyronine), anti-thyroglobin, anti-peroxidase antibodies, and antiplatelet antibodies were evaluated at diagnosis. Results Anti-thyroglobin, anti-peroxidase antibodies, and antiplatelet were significantly positive in children with ITP than the control group. Patients with positive antiplatelet, anti-thyroglobin, and anti-peroxidase antibodies show more resistance to effective medications in comparison to ITP patients with negative antibodies (P<0.001). The relation of these antibody positivity and the clinical course of these groups was statistically significant. Conclusions Pediatric ITP patients are prone to develop autoantibodies such as antiplatelet antibodies. Also, anti-thyroglobin and anti-peroxidase antibodies were significantly higher in children with ITP with positive antiplatelet, and both show more resistance to effective medications with relatively good response to eltrombopag olamine in comparison to ITP patients with negative antiplatelet, anti-thyroglobin, and anti-peroxidase antibodies.