Work

Antinuclear antibody positive in patients with primary immune thrombocytopenia: incidence and risk prediction of developing autoimmune diseases

Year: 2025

Type: article

Abstract: Objective Primary immune thrombocytopenia (ITP) is a heterogeneous disease. antinuclear antibody (ANA)-positive primary ITP may resemble the preclinical stage of autoimmune diseases (AIDs), but is still considered primary ITP due to a controversial AIDs risk assessment in this group. This study aimed to clarify the risk of AIDs in ANA-positive patients with primary ITP.Methods This is a retrospective cohort study. A total of 360 patients with newly diagnosed primary ITP were followed up, and Cox regression analysis was used to analyze the association of ANA positivity and other immune parameters with AIDs development.Results Among 360 primary ITP patients followed for a median of 14 months (IQR 12–18), 72.5% were ANA-positive. Compared with ANA-negative patients, ANA-positive patients experienced significantly higher incidences of SLE (22.6% vs 8.1%) and Sjögren’s syndrome (37.6% vs 19.2%), with a crude HR of 16.8 (95% CI 16.1–17.5; p = 0.001) for overall AID development. Nomograms integrating ANA/anti-SSB/C3 and ANA/anti-Ro52/C3 accurately predicted 1.5- and 2-year AIDs- and SJD-free survival, respectively.Conclusions These findings suggest that ANA-positive primary ITP is a clinical entity distinct from other primary ITP and is associated with an increased risk of developing AIDs, especially SJD.

Source: Hematology

DOI: 10.1080/16078454.2025.2551454