title: Gender-related analysis of the clinical presentation, treatment response and outcome in patients with immune thrombocytopenia.
abstract: BACKGROUND
  Immune thrombocytopenia (idiopathic thrombocytopenic purpura [ITP]) frequently occurs in young adults, particularly women in their third or fourth decade. The female predominance suggests that sex hormones may play a role in the different aspects of ITP. In this paper, we report a gender-related analysis of patients with ITP, specifically examining the clinical manifestations, responses to treatment and overall outcomes of the patients.
  
  
  METHODS
  We included patients with "ITP" attending the departments of onco-hematology or internal medicine B (university hospital of Strasbourg, France) between 1990 and December 2010 The gender-related analysis was retrospective.
  
  
  RESULTS
  We studied in 225 consecutive cases of established ITP with a follow-up period of 1.7 to 112 months The mean age of the patients was 44 years; 156 patients were female. The analysis revealed no significant statistical differences regarding patient characteristics between the female and male groups, with the exception of the following characteristics: the bleeding score, which altered in the presence of meno- and/or metrorrhagia and hematuria in female patients (P=0.03); the presence of anemia (P=0.04); and the detection of antinuclear and/or antiphospholipid antibodies (P=0.02). During the follow-up, no statistically significant difference was found regarding outcome or treatment response in relation to gender among these 225 patients (all P>0.05).
  
  
  CONCLUSIONS
  Gender does not appear to affect the manifestation of immune thrombocytopenia, the outcome or response to treatment. However, further large-scale randomized trials are needed to confirm these findings.
authors.affiliation: University hospital of Strasbourg, department of internal medicine B, 67091 Strasbourg cedex, France. emmanuel.andres@chru-strasbourg.fr
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Andrès
authors.forename: Mustapha
authors.initials: M
authors.lastname: Mecili
authors.forename: Helen
authors.initials: H
authors.lastname: Fothergill
authors.forename: Jacques
authors.initials: J
authors.lastname: Zimmer
authors.forename: Thomas
authors.initials: T
authors.lastname: Vogel
authors.forename: Frédéric
authors.initials: F
authors.lastname: Maloisel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology; D000974:Antibodies, Antinuclear / Q000097:blood; D017152:Antibodies, Antiphospholipid / Q000097:blood; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D003613:Danazol / Q000627:therapeutic use; D004844:Epistaxis / Q000453:epidemiology; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006417:Hematuria / Q000453:epidemiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000097:blood; D008297:Male; D008595:Menorrhagia / Q000453:epidemiology; D008796:Metrorrhagia / Q000453:epidemiology; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D000069283:Rituximab; D012737:Sex Factors; D013156:Splenectomy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear; D017152:Antibodies, Antiphospholipid; D058846:Antibodies, Monoclonal, Murine-Derived; D004965:Estrogen Antagonists; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D000069283:Rituximab; D003613:Danazol