STUDY OF GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR (GM-CSF) LEVEL IN CHILDREN WITH ACUTE IMMUNE THROMBOCYTOPENIC PURPUA

Rizk EA*, El-Gendy WM*, Hassab H** and El-Madboully L

Departments of Clinical Pathology* and Pediatrics**, Faculty of Medicine, Alexandria University, Alexandria, Egypt

 

Objectives: To assess the serum level of GM-CSF in children with acute ITP and its correlation with clinical parameters and with level of platelet associated immunoglobulins; thirty children with acute ITP who are selected from the inpatient department at Alexandria University Children&#8217;s Hospital at El Shatby. Ten apparently healthy children were included in the study as a control group. ITP Patients were divided according to the platelet count into cases with platelet count>20,000/ul and cases with platelet counts <20,000/ul.            

Methods: Flow-cytometric measurement of serum GM-CSF by ELISA technique, and measurement of total IgG by radial immunodiffusion plates.

Results: Total IgG showed a significant elevation in ITP patients as compared to the control group (t=2.748,P<0.05), may be due to previous URT infection, but no correlation between platelet antibodies and total IgG was detected (r=-0.140,P=0.460). Eighty-six percent of patients had an elevated platelet-associated immunoglobulin (PAIgG). No correlation between PAIgG and platelet count was detected (r=-0.072,P=0.72). Serum level of GM-CSF was significantly higher in ITP patients than controls (t=3.757,P<0.05). An inverse correlation was found between serum level of GM-CSF and platelet count (r=-0.4643, P=0.010). A positive correlation between serum level of GM-CSF and PAIgG was detected (r=0.4224,P=0.020).

Conclusion: Our results suggest that GM-CSF may have a role in the pathogenesis of ITP through activation of mononuclear phagocyte system resulting in acceleration of destruction and phagocytosis of antibody coated platelets and decrease platelet count.

 
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