Comparative analysis of primary immune thrombocytopenia and immune thrombocytopenia secondary to connective tissue diseases.

Objectives: To explore the differences between primary immune thrombocytopenia (ITP) and ITP secondary to connective tissue disease (CTD-ITP).

Methods: A retrospective observational study was conducted on patients newly diagnosed with primary ITP and CTD-ITP hospitalized in the Hematology Department of Tianjin Medical University General Hospital from July 1, 2019 to December 31, 2023. Data, including demographic details, medical history records, and laboratory test results, were collected, followed by a comparative analysis to identify differences between the groups.

Results: Compared with patients in the primary ITP group, those in the CTD-ITP group exhibited a female predominance, along with lower platelet and hemoglobin levels. Total globulin and immunoglobulin G (IgG) concentrations were higher in the CTD-ITP group than in the primary ITP group, whereas albumin, complement C3, and C4 levels were lower. Antinuclear antibody titers were higher in the CTD-ITP group, and the percentages of regulatory B (Breg) cells and transitional B cells were lower. A greater percentage of abnormal megakaryocytes was observed in the CTD-ITP group. Furthermore, a larger proportion of patients in the CTD-ITP group met treatment criteria, necessitated more intensive therapy, and required a longer duration to achieve complete remission.

Conclusion: Compared with patients in the primary ITP group, those in the CTD-ITP group had more severe conditions, more intense immune disturbances, and greater treatment challenges. Individualized treatment is needed.