Characteristics of bone marrow megakaryocytes in patients with idiopathic thrombocytopenic purpura complicated with positive antinuclear antibody
Objective To investigate the characteristics of bone marrow megakaryocytes in pa-tients with idiopathic thrombocytopenic purpura(ITP)complicated with positive for antinuclear anti-body(ANA)but cannot be diagnosed as rheumatic immune diseases.Methods Newly diagnosed ITP patients in the First Hospital Affiliated to Sun Yat-sen University were retrospectively selected and divided into ITP1 group(ITP patients with positive ANA)and ITP2 group(ITP patients with negative rheumatic indicators).Degree of thrombocytopenia,the total number of bone marrow megakaryo-cytes,and the ratios of various types of megakaryocytes at the initial diagnosis were compared between the two groups.Results A total of 42 newly diagnosed ITP patients were included,with 20 cases in the ITP1 group and 22 cases in the ITP2 group.There were no significant differences in general infor-mation such as gender and age between the two groups(P＞0.05).The platelet(PLT)count was(7.55±0.96)× 109/L in the ITP1 group,which was lower than(10.23±1.21)× 109/L in the ITP2 group,but there was no significant between-group difference(t=1.697,P=0.097).Com-pared with the ITP2 group,the total number of megakaryocytes in the ITP1 group was significantly de-creased(t=3.071,P＜0.01),and the ratio of granular megakaryocytes was significantly increased while the ratio of naked nuclear megakaryocytes was significantly decreased(P＜0.05);there were no significant differences in the ratios of immature and platelet-producing megakaryocytes between the two groups(P＞0.05).Conclusion Patients with ITP and positive ANA have a tendency of de-creased PLT,and a more significant maturation disorder of bone marrow megakaryocytes,with a low-er degree of megakaryocyte proliferation compared to patients without positive ANA.ANA may exacer-bate the severity of ITP by aggravating the developmental disorder of bone marrow megakaryocytes.
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