HYPERTENSION AND DIABETES-MELLITUS INCREASE THE RISK OF HEMORRHAGE INCHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA

The risk factors for haemorrhage in chronic idiopathic thrombocytopeni c purpura (ITP) remain poorly understood. We classified 49 patients wi th chronic ITP into two groups on the basis of the presence (n = 11) o r absence (n = 38) of hypertension and/or diabetes mellitus, and then analyzed their clinical and immunological characteristics. The patient s with hypertension and/or diabetes were older than those without thes e complications. There were no significant differences between the two groups with regard to platelet count or the levels of platelet-associ ated immunoglobulin G, platelet-associated immunoglobulin M, and plate let-associated C3. Positivity for anti-glycoprotein IIb/IIIa and anti- glycoprotein Ib autoantibodies was also similar. However, severe purpu ra and a poor response to prednisolone were far more common in the pat ients with hypertension and/or diabetes. We conclude that ITP complica ted by hypertension and/or diabetes may be resistant to prednisolone a nd thus require more careful treatment.