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. 2006 Mar;3(3):e24.
doi: 10.1371/journal.pmed.0030024.

Long-term outcome of otherwise healthy individuals with incidentally discovered borderline thrombocytopenia

Roberto Stasi  1 , Sergio Amadori, John Osborn, Adrian C Newland, Drew Provan
Affiliations

Long-term outcome of otherwise healthy individuals with incidentally discovered borderline thrombocytopenia

Roberto Stasi et al. PLoS Med. 2006 Mar.

Abstract

Background: The long-term outcome of individuals with mild degrees of thrombocytopenia is unknown.

Methods and findings: In a prospective study conducted between August 1992 and December 2002, 260 apparently healthy individuals with incidentally discovered platelet counts between 100 x 10(9)/l and 150 x 10(9)/l were monitored for 6 mo to determine whether their condition persisted. The monitoring period was completed in 217 cases, of whom 191 (88%) maintained stable platelet counts. These 191 individuals were included in a long-term follow-up study to gain knowledge of their natural history. With a median time of observation of 64 mo, the thrombocytopenia resolved spontaneously or persisted with no other disorders becoming apparent in 64% of cases. The most frequent event during the study period was the subsequent development of an autoimmune disease. The 10-y probability of developing idiopathic thrombocytopenic purpura (ITP), as defined by platelet counts persistently below 100 x 10(9)/l, was 6.9% (95% confidence interval [CI]: 4.0%-12.0%). The 10-y probability of developing autoimmune disorders other than ITP was 12.0% (95% CI: 6.9%-20.8%). Most of the cases (85%) of autoimmune disease occurred in women.

Conclusions: Healthy individuals with a sustained platelet count between 100 x 10(9)/l and 150 x 10(9)/l have a 10-y probability of developing autoimmune disorders of 12%. Further investigation is required to establish whether this risk is higher than in the general population and whether an intensive follow-up results in an improvement of prognosis.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Study Design and Results
Figure 2
Figure 2. Cumulative Incidence of ITP
The upper and lower lines indicate the 95% confidence limits.
Figure 3
Figure 3. Cumulative Incidence of an Autoimmune Disease Other Than ITP
The upper and lower lines indicate the 95% confidence limits.
See this image and copyright information in PMC

Comment in

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