title: Intrinsically impaired platelet production in some patients with persistent or chronic immune thrombocytopenia.
abstract: Persistent or chronic immune thrombocytopenias (P/C-ITP) are acquired blood disorders lasting more than 3 months or 1 year, respectively. The pathogenesis of these disorders is thought to be immunological. We hypothesized that some patients with P/C-ITP might have an intrinsic megakaryopoiesis defect. We identified a group of P/C-ITP patients with acquired isolated mild thrombocytopenia (30-100 × 10(9) /l), undetectable anti-platelet antibodies, negative autoimmune investigations and no need for treatment. We examined in vitro megakaryocyte differentiation and compared these patients' results with those of acute-ITP patients and healthy controls. No difference in proliferation, ploidy or expression of surface markers was found. In contrast, P/C-ITP patients had significantly fewer proplatelet-forming megakaryocytes. This novel observation demonstrated that some patients diagnosed with P/C-ITP have an intrinsic megakaryopoiesis defect independent of the bone-marrow environment. Further investigations are needed to dissect mechanisms underlying this impaired proplatelet formation in these patients.
authors: Internal Medicine Department, Bordeaux University Hospital Centre, Pessac, France.|Adaptation Cardiovasculaire à l'Ischémie, University of Bordeaux, Pessac, France.|Adaptation Cardiovasculaire à l'Ischémie, INSERM, Pessac, France.
authors: Étienne
authors: É
authors: Rivière
authors: Internal Medicine Department, Bordeaux University Hospital Centre, Pessac, France.|Adaptation Cardiovasculaire à l'Ischémie, University of Bordeaux, Pessac, France.|Adaptation Cardiovasculaire à l'Ischémie, INSERM, Pessac, France.
authors: Jean-François
authors: JF
authors: Viallard
authors: Internal Medicine Department, Bordeaux University Hospital Centre, Pessac, France.|Adaptation Cardiovasculaire à l'Ischémie, University of Bordeaux, Pessac, France.|Adaptation Cardiovasculaire à l'Ischémie, INSERM, Pessac, France.
authors: Alexandre
authors: A
authors: Guy
authors: Adaptation Cardiovasculaire à l'Ischémie, University of Bordeaux, Pessac, France.|Adaptation Cardiovasculaire à l'Ischémie, INSERM, Pessac, France.
authors: Badr
authors: B
authors: Kilani
authors: Adaptation Cardiovasculaire à l'Ischémie, University of Bordeaux, Pessac, France.|Adaptation Cardiovasculaire à l'Ischémie, INSERM, Pessac, France.
authors: Juliana
authors: J
authors: Vieira-Dias
authors: Laboratory of Haematology, Bordeaux University Hospital Centre, Pessac, France.
authors: Anne C
authors: AC
authors: Pons
authors: Adaptation Cardiovasculaire à l'Ischémie, University of Bordeaux, Pessac, France.|Adaptation Cardiovasculaire à l'Ischémie, INSERM, Pessac, France.
authors: Thierry
authors: T
authors: Couffinhal
authors: Internal Medicine Department, Bordeaux University Hospital Centre, Pessac, France.
authors: Jean-Luc
authors: JL
authors: Pellegrin
authors: Adaptation Cardiovasculaire à l'Ischémie, University of Bordeaux, Pessac, France.|Adaptation Cardiovasculaire à l'Ischémie, INSERM, Pessac, France.|Laboratory of Haematology, Bordeaux University Hospital Centre, Pessac, France.
authors: Chloé
authors: C
authors: James
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000276:immunology*; D001792:Blood Platelets / Q000276:immunology* / Q000473:pathology; D002454:Cell Differentiation / Q000276:immunology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008533:Megakaryocytes / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D038042:Myelopoiesis / Q000276:immunology*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology
chemical_list: D001323:Autoantibodies
keywords: immune thrombocytopenia; megakaryocyte; megakaryocytopoiesis; platelet; thrombocytopenia