الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
ITP is an autoimmune disease with a decreased number of platelets and an elevated risk of bleeding. The loss of self-tolerance that leads to the development of autoantibodies directed toward platelet antigens is a critical component in the pathogenesis of ITP.
Chronic ITP is identified as thrombocytopenia where (abnormal platelet count for 12 months, regular or increased bone marrow megakaryocytes, and no secondary immune or non-immune defects that may account for the thrombocytopenic condition). Upon presentation of ITP, ITP with extreme thrombocytopenia is known as thrombocytopenia (platelet count < 10x109/l).
The majority of these antibodies act against platelet membrane glycoprotein (GP) complexes, GPIIb/IIIa (CD41/CD61) or GPIbIX (CD42b and CD42a).
Interleukin 10 (IL-10) is defined as an anti-inflammatory cytokine, suppressing immune responses. IL-10 is naturally manufactured by macrophages, mast cells, and Th2 cells. The action of IL-10 is regulated by the IL-10 (IL-10R) receptor, a member of the family of Class II cytokine receptors. It has been stated that by modulating the activities of nature killer, T-cells and macrophages, IL-10 single nucleotide polymorphisms (SNPs) can impact immune function and thus change the progression of the disease. The aim of this study is to investigate the relationship between IL-10- 592 (C/A) gene polymorphism with the risk susceptibility and severity of adult chronic ITP.
The present study included forty adult patients diagnosed with chronic ITP and forty control subjects of matched age and sex, patients included 12(30%) males and 28(70%) females with a female to male ratio of 3:7 with mean age of of 36.93 ± 11.21 years with no statistical significant difference between cases and controls regarding sex and age.
Regarding the clinical presentation of the studied patients, mucocutaneous bleeding was present in 28 (70%), while most of the patients (92.5%) had no life-threatening complication.
For the total number of 25 chronic ITP cases who had platelet count < 30x109/L, bleeding score ranged from 0 to 12.0 with a mean of 5.04 ± 2.35. While 15 chronic ITP cases who had platelet count > 30x109/L, bleeding score ranged from 0 to 5.0 with a mean of 2.20 ± 1.21. There was moderate negative correlation with statistical significance between platelet count and bleeding score among the studied cases. (p=<0.001)
There was no statistically significant relation between H pylori infection in chronic ITP cases and platelet count
Studying the hematological profile There was a statistical significant difference between cases and controls regarding the hemoglobin concentration and the platelet count (p< 0.003) (p <0.001) respectively. While no statistical significant difference regards their white blood count.
Among the 40 ITP adult patients, 77.5% showed C/C genotype, 20% showed C/A genotype and 2.5% showed A/A genotype, while among controls, 72.5% showed C/C genotype, 25% showed C/A genotype and 2.5% showed A/A genotype. This relation was not statistically significant. (p=0.893).
Regarding Relation between IL10-592(C/A) polymorphism and different clinical parameters There was no statistically significant difference between different genotypes of cases regarding age and sex (p= 0.235 and 0.922respectively).
Also, there was no statistical significant difference between IL10 polymorphism and either the hematological profile or bleeding score and presence of purpura.
Regarding complications there were two (6.5%) cases with C/C genotypes developed intracranial hemorrhage up to death and one (3.2%) of them developed septic arthritis on top of steroid treatment up to death. While there were no complications among cases with C/A and A/A genotypes.
There was no statistically significant difference in complications and reactions to steroid therapy between carriers and non-carriers. (p=1.000)