Celiacs disease is not a major risk factor for the development of childhood idiopathic thrombocytopenic purpura

Association of Immune Thrombocytopenia and Celiac Disease in Children: A Retrospective Case Control Study

Objective:

The association between celiac disease (CD) and immune thrombocytopenia (ITP) is still uncertain. The aim of this study was to characterize the coexistence of these two diseases in Italian children.

Materials and Methods:

This is a retrospective multicenter study investigating the occurrence of CD in 28 children with ITP diagnosed from January 1, 2000, to December 31, 2019.

Results:

The first diagnosis was ITP in 57.1% and CD in 32.1% of patients. In 3 patients (10.7%), the two diagnoses were simultaneous. All the potential and silent cases of CD in our cohort were diagnosed in the groups of “ITP first” and “simultaneous diagnosis”. In all children ITP was mild, and in 2 out of 8 not recovered from ITP at the time of CD diagnosis a normalization of platelet counts (>100,000/μL) occurred 3 and 5 months after starting a gluten-free diet, respectively.

Conclusion:

We think that screening for CD should be considered in children with ITP regardless of the presence of gastrointestinal symptoms. Furthermore, some patients may recover from ITP after starting a gluten-free diet.

Increased Frequency of Immune Thrombocytopenic Purpura in Coeliac Disease and Vice Versa: A Prospective Observational Study

Introduction

Coeliac disease (CD) and immune thrombocytopenic purpura (ITP) are immune conditions, often associated with other immune disorders. In recent years, increasing attention has been directed towards the association between ITP and CD.

Aim

To investigate the frequency of ITP in CD patients and vice versa and to assess the risk of their association.

Patients and Methods

This was a prospective observational study. All consecutive patients with CD or ITP attending our department were enrolled between January 2016 and December 2017. All patients with CD were screened for ITP and patients with ITP for CD. Odds ratios (ORs) were calculated based on the prevalence in the general population.

Results

Two hundred sixty-one CD patients (212 female, mean age 47 ± 16.1 years) and 32 ITP patients (17 female, mean age 57.8 ± 17.4 years) were enrolled. In the CD cohort, two patients (2/261; 0.8%) reported a previous diagnosis of ITP, compared to the general population; OR was 15.3 (95% CI, 3.82–61.73; p < 0.0001). Similarly, in the ITP cohort, two patients (2/32; 6.3%) had a previous diagnosis of CD (OR: 9.89, 95% CI, 2.27–43.16; p = 0.0002).

Discussion

A greater frequency of ITP in coeliac patients and vice versa was observed in our study, suggesting an increased risk for patients of developing both disorders.

Celiac disease with Evans syndrome and isolated immune thrombocytopenia in monozygotic twins: a rare association

Celiac disease is a multisystem immune-mediated disorder caused by exposure to dietary gluten in genetically predisposed individuals. The clinical presentation is characterized by a multitude and diversity of symptoms and complications. The coexistence of celiac disease with other autoimmune disorders has been established, most frequently with type 1 diabetes mellitus and autoimmune thyroiditis. The association of celiac disease with immune-mediated hematologic conditions has been rarely reported. This case study describes a pair of identical twin sisters with celiac disease associated with Evans syndrome in one sibling, and with isolated immune thrombocytopenia in the other.