J Clin Med. 2021 Apr 30;10(9):1940. doi: 10.3390/jcm10091940.

Angela Guarina ¹, Angelica Barone ², Assunta Tornesello ³, Maddalena Marinoni ⁴, Giuseppe Lassandro ⁵, Paola Giordano ⁵, Milena Motta ⁶, Marco Spinelli ⁷, Ilaria Fontanili ², Fiorina Giona ⁸, Francesco Menna ⁹, Elena Chiocca ¹⁰, Ilaria Fotzi ¹⁰, Angelamaria Petrone ¹¹, Francesco Graziano ¹², Paola Saracco ¹³, Giuseppe Puccio ¹, Michele Citrano ¹², Giovanna Russo ⁶, Piero Farruggia ¹

Author information

• ¹UOC Oncoematologia Pediatrica-ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy.
• ²UO Pediatria e Oncoematologia-AOU, 43126 Parma, Italy.
• ³UOC Di Oncoematologia Pediatrica-PO "Vito Fazzi", 73100 Lecce, Italy.
• ⁴SSD Oncoematologia Pediatrica-Ospedale Filippo Del Ponte, Varese ASST Settelaghi, 21100 Varese, Italy.
• ⁵Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", 70121 Bari, Italy.
• ⁶UOC Ematologia ed Oncologia Pediatrica-AOU Policlinico "Rodolico-San Marco", Università di Catania, 95131 Catania, Italy.
• ⁷Fondazione MBBM/AO San Gerardo Clinica Pediatrica Universitaria, 20900 Monza, Italy.
• ⁸Policlinico Umberto I, Università La Sapienza, 00185 Roma, Italy.
• ⁹Dipartimento di Oncoematologia-AORN Santobono-Pausilipon, 80122 Napoli, Italy.
• ¹⁰Oncologia, Ematologia e TCSE-Centro di Eccellenza di Oncologia ed Ematologia-AOU A. Meyer, 50139 Firenze, Italy.
• ¹¹UOM Pediatria Ospedale S. Chiara, 38122 Trento, Italy.
• ¹²UO di Pediatria-Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy.
• ¹³Dipartimento di Scienze Pediatriche e dell'Adolescenza, SC Pediatria Specialistica Universitaria, AOU Città della Salute e della Scienza, Presidio Ospedale Infantile Regina Margherita, 10126 Torino, Italy.

Abstract

Background: The association between inflammatory bowel disease (IBD) and immune thrombocytopenia (ITP) is still uncertain. In this multicenter retrospective study, the coexistence of both diseases was investigated in children diagnosed from 1 January 2000 to 31 December 2019.

Methods: Clinical characteristics of both IBD and ITP, onset of disorders, and patient's response to treatment were collected through a structured form sent to 55 Italian pediatric referring centers for hematological disorders.

Result: Centers responded to the survey and reported the coexistence of IBD and ITP in 14 children. The first diagnosis was ITP in 57.1% and IBD in 35.7% of patients: it was simultaneous in 7.1%. IBD was classified as ulcerative colitis (57.1%), Crohn disease (35.7%), and unclassified (7.1%). No therapy for IBD other than steroids had any effect on ITP course. Colectomy resulted in recovery from ITP in 1 of the 2 patients surgically treated. ITP was always mild but turned to be chronic in half of patients.

Conclusions: In all patients, ITP was mild without any evident impact on IBD severity, but the incidence of chronic ITP seems to be higher than what is usually observed in the pediatric age group. Colectomy had unpredictable effects on ITP.