STUDY OF
GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR (GM-CSF) LEVEL IN CHILDREN
WITH ACUTE IMMUNE THROMBOCYTOPENIC PURPUA
Rizk EA*, El-Gendy WM*, Hassab H** and El-Madboully L
Departments of
Clinical Pathology* and Pediatrics**, Faculty of Medicine, Alexandria
University, Alexandria, Egypt
Objectives: To assess the serum level of GM-CSF in
children with acute ITP and its correlation with clinical parameters and
with level of platelet associated immunoglobulins; thirty children with
acute ITP who are selected from the inpatient department at Alexandria
University Children’s Hospital at El Shatby. Ten apparently
healthy children were included in the study as a control group. ITP
Patients were divided according to the platelet count into cases with
platelet count>20,000/ul and cases with platelet counts
<20,000/ul.
Methods: Flow-cytometric measurement of serum GM-CSF by
ELISA technique, and measurement of total IgG by radial immunodiffusion
plates.
Results: Total IgG showed a significant elevation in ITP
patients as compared to the control group (t=2.748,P<0.05), may be due
to previous URT infection, but no correlation between platelet antibodies
and total IgG was detected (r=-0.140,P=0.460). Eighty-six percent of
patients had an elevated platelet-associated immunoglobulin (PAIgG). No
correlation between PAIgG and platelet count was detected
(r=-0.072,P=0.72). Serum level of GM-CSF was significantly higher in ITP
patients than controls (t=3.757,P<0.05). An inverse correlation was found
between serum level of GM-CSF and platelet count (r=-0.4643, P=0.010). A
positive correlation between serum level of GM-CSF and PAIgG was detected
(r=0.4224,P=0.020).
Conclusion: Our results suggest that GM-CSF may have
a role in the pathogenesis of ITP through activation of mononuclear
phagocyte system resulting in acceleration of destruction and phagocytosis
of antibody coated platelets and decrease platelet count.