Chronic vs acute

Immune thrombocytopenia (ITP) is an autoimmune disease where platelets are destroyed prematurely. In the majority of children the disease resolves but in some it becomes chronic. To investigate whether these two phases of the disease are molecularly similar or separate entities we performed DNA microarray analysis (GEO accession number: GSE46922) of T-cells from newly diagnosed children and children with chronic ITP. We found complete separation of the gene expression profiles between the two phases of the disease. Furthermore, the gene expression levels of several cytokines differed between the two phases of the disease. This was also reflected in plasma with increased levels of IL-16 and TWEAK and lower levels of IL-4 in newly diagnosed compared with chronic ITP. Thus, our data indicate that chronic ITP in childhood is a separate disease entity, dissimilar in many aspects to the newly diagnosed phase.

bloodjournal.hematologylibrary.org/content/early/2013/07/18/blood-2013-05-502807.abstract?ct

Thanks, any idea what that means? Would it be treated differently? Would it lead to worse outcomes?

So, does that mean chronic ITP in children is the same as ITP in an adult, but acute ITP in a child is different? Does that also mean that chronic ITP in a child is less likely to go into remission?

Basically, it means that there is a distinct difference between acute and chronic as far as cells go. If a child were tested, they could tell you whether or not it would be chronic. My guess is that those tests will not be available to the public on a general basis - research only for the time being.

I do not think that the treatments would be any different, at least not until they can distinguish that something works better for one or the other. The article doesn't say if that has yet been determined.

I do not think the outcome would be any worse, the only difference thus far is that one lasts longer.

I would think that chronic ITP for a child is probably the same as chronic ITP in an adult, because 'chronic' simply means longer than 6 to 12 months. A child with chronic ITP has a chance at remission and most do achieve that eventually. I would never give up that hope. I've seen it happen many, many times.

You mentioned something that caught my eye..."t-cells"...So, I have psoriases, and at some point over the years reading up on it, I learned that as an auto-immune disease, there's some "data' in the t-cells that cause it to be as it is (for lack of a better way to express it); also, I've often questioned if I have celiac disease--again, there's that t-cell relationship to celiac...I personally don't have ITP (that I'm aware of but my 3yo daughter does, and I've wondered if the t-cells were contributory to its development and if my (and daddy's) thyroid conditions, plus my other auto immune disorders could have contributedf to this. Not for purposes of pointing blame, but more for purposes of "if she has celiac, we'll eliminate gluten".

I'm curious to know what you have found the relationship to thyroid, celiac, psoriases, or t-cells in general?

T cells are involved in many autoimmune disorders, which is why treatments are designed to eliminate them to improve the disorder.

Autoimmune disorders tend to run in families. One person might have one disorder and others can have other disorders. My sister and I have both had ITP. Hers was acute, mine was chronic. My other sister has Discoid Lupus and I have Lupus. My daughter has asthma and Graves.

Personally, I do believe that gluten can play a role in autoimmune disorders. I've been tested for Celiac's and it was negative. However, I also believe that a person can have a sensitivity to gluten that does not show up on antibody tests. Both my daughter and I have gone gluten free and noticed a difference in symptoms.