IMMUNE THROMBOCYTOPENIA. EGYPTIAN EXPERIENCE WITH STUDY OF IL-17, TGFB, CYTOKINES IN CHRONIC AND PERSISTENT IMMUNE THROMBOCYTOPENIA PATIENTS

Background: Autoimmune diseases are characterized by various factors that contribute to a breakdown in self tolerance. In this study we review the demographic features of 150 immune thrombocytopenic Egyptian patients and for cases who were chronic and persistent with negative both autoimmune screen and virology for hepatitis B and C, we measured IL-17 and TGF-β by ELISA. Results: Our results revealed Chronic and persistent cases who fulfilled the criteria for cytokine assay were 45 cases with a mean (? SD) age of 31.60 ? 8.78 years. Thirty two patients were presented by skin manifestations (71.1%).Eight patients presented with mucous bleeding (17.8%) and five patients presented by combined skin and mucous membrane bleeding (11.1%). Comparison between the cases studied and control groups revealed statistically significant lower platelet count in cases rather than the control. While the two measured cytokines were statistically significant higher in cases rather than the control. Correlation between platelet count and the level of cytokines was statistically insignificant. All cases were under treatment by low dose corticosteroid in addition to another immunesuppression medication. Conclusion: the higher expression of Treg cytokines (IL-17 and TGF-B) may be explained by effect of immune suppression use or up regulation of their receptors on Treg cells which have resistance to their activity.