Annals of Hematology

, Volume 93, Issue 2, pp 309–315

Antiplatelet antibodies detected by the MAIPA assay in newly diagnosed immune thrombocytopenia are associated with chronic outcome and higher risk of bleeding

  • David Grimaldi
  • Florence Canouï-Poitrine
  • Laure Croisille
  • Ketty Lee
  • Françoise Roudot-Thoraval
  • Laetitia Languille
  • Medhi Khellaf
  • Marc Michel
  • Bertrand Godeau
  • Philippe Bierling
Original Article

DOI: 10.1007/s00277-013-1855-5

Cite this article as:
Grimaldi, D., Canouï-Poitrine, F., Croisille, L. et al. Ann Hematol (2014) 93: 309. doi:10.1007/s00277-013-1855-5
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Abstract

Immune thrombocytopenia (ITP) results in part from the presence of platelet antibodies, which can be demonstrated by the Monoclonal Antibody-Specific Immobilization of Platelet Antigens (MAIPA) assay. The aim of our study was to correlate the presence of antiplatelet autoantibodies and the natural history of ITP. We performed a retrospective, single-center study of 108 adults with newly diagnosed ITP who had indirect MAIPA assay performed at disease onset. Chronic ITP was defined by the presence of thrombocytopenia after 1 year. Bleeding diathesis was evaluated with a bleeding score. At baseline, patients with a positive indirect MAIPA have a greater bleeding score than patients with negative MAIPA assay [median (interquartile) = 8 (6–12) vs 2 (0–6), p = 0.002]. Patients with a positive indirect MAIPA also had a higher rate of chronic ITP (92.9 vs 68.7 %, p = 0.06). In multivariate analysis, a positive indirect MAIPA result and a platelet count at onset ≥10 × 109/L remained independently associated with chronic ITP [adjusted OR (aOR) = 8.01; 95 % confidence interval (CI), 0.98–66.6; p = 0.05 and aOR = 3.09; 95 % CI, 1.18–8.10; p = 0.02, respectively]. Furthermore, when we analyzed together the results of direct (n = 41) and indirect MAIPA, the same results were observed. Thus, indirect MAIPA positivity at disease onset is associated with more severe hemorrhage and predicts a chronic course in adult ITP patients. MAIPA assay could be useful in the management of ITP patients when it is performed at diagnosis.

Keywords

Immune thrombocytopeniaMAIPA assayChronic ITPPlatelet autoantibodies

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • David Grimaldi
    • 1
  • Florence Canouï-Poitrine
    • 2
    • 3
  • Laure Croisille
    • 1
    • 4
  • Ketty Lee
    • 1
    • 4
  • Françoise Roudot-Thoraval
    • 2
    • 3
  • Laetitia Languille
    • 1
  • Medhi Khellaf
    • 1
  • Marc Michel
    • 1
  • Bertrand Godeau
    • 1
  • Philippe Bierling
    • 1
    • 4
  1. 1.Service de Médecine interne, Centre de référence des cytopénies auto-immunes, hôpital Henri Mondor, AP-HPUniversité Paris EstCréteilFrance
  2. 2.Université Paris EstCréteilFrance
  3. 3.AP-HP, Service de santé publiqueHôpital Henri MondorCréteilFrance
  4. 4.Etablissement Francais du SangHopital Henri MondorCreteilFrance