{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T13:18:18Z","timestamp":1771852698082,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the cumulative prevalence of coeliac disease, systemic lupus erythematosus, autoimmune hyperthyroidism and primary immunodeficiencies in children with either newly diagnosed\/persistent or chronic immune thrombocytopenia (ITP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Monocentric retrospective analysis of the clinical and biochemical features of 330 consecutive patients with ITP referred to our Pediatric Hematology Unit between January 2009 and December 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of systemic lupus erythematosus (0.3%), coeliac disease (0.3%) and autoimmune hyperthyroidism (0.6%) was not increased compared to general paediatric population. Of note, the prevalence of underlying primary immunodeficiencies was 2.4%, remarkably higher than the general paediatric population (<jats:italic>P\u00a0=\u00a0<\/jats:italic>.005). All the patients diagnosed with immunodeficiency developed either bi\u2010\/trilinear cytopenia or splenomegaly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Whilst autoimmune and immunological screening is already recommended at the onset of immune thrombocytopenia, we recommend that primary immunodeficiencies be regularly screened during follow\u2010up, especially in case of additional cytopenia or lymphoproliferation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.15593","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T04:37:35Z","timestamp":1602045455000},"page":"643-651","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Primary immunodeficiencies, autoimmune hyperthyroidism, coeliac disease and systemic lupus erythematosus in childhood immune thrombocytopenia"],"prefix":"10.1111","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0767-3905","authenticated-orcid":false,"given":"Francesco","family":"Saettini","sequence":"first","affiliation":[{"name":"Department of Pediatric Onco\u2010Hematology San Gerardo Hospital Fondazione MBBM Universit\u00e0 degli Studi di Milano\u2010Bicocca Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Cattoni","sequence":"additional","affiliation":[{"name":"Department of Pediatrics San Gerardo Hospital Fondazione MBBM Universit\u00e0 degli Studi di Milano\u2010Bicocca Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Redaelli","sequence":"additional","affiliation":[{"name":"Department of Pediatric Onco\u2010Hematology San Gerardo Hospital Fondazione MBBM Universit\u00e0 degli Studi di Milano\u2010Bicocca Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Silvestri","sequence":"additional","affiliation":[{"name":"Department of Pediatrics San Gerardo Hospital Fondazione Tettamanti Universit\u00e0 degli Studi di Milano\u2010Bicocca Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia Maria","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Department of Pediatric Onco\u2010Hematology San Gerardo Hospital Fondazione MBBM Universit\u00e0 degli Studi di Milano\u2010Bicocca Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Biondi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Onco\u2010Hematology San Gerardo Hospital Fondazione MBBM Universit\u00e0 degli Studi di Milano\u2010Bicocca Monza Italy"},{"name":"Department of Pediatrics San Gerardo Hospital Fondazione MBBM Universit\u00e0 degli Studi di Milano\u2010Bicocca Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Momcilo","family":"Jankovic","sequence":"additional","affiliation":[{"name":"Department of Pediatric Onco\u2010Hematology San Gerardo Hospital Fondazione MBBM Universit\u00e0 degli Studi di Milano\u2010Bicocca Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Spinelli","sequence":"additional","affiliation":[{"name":"Department of Pediatric Onco\u2010Hematology San Gerardo Hospital Fondazione MBBM Universit\u00e0 degli Studi di Milano\u2010Bicocca Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000812"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2011.050799"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-015-0251-z"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.4274\/Tjh.2012.0049"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20970"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2007.0066"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199707000-00006"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/08880018.2012.756564"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2005.04.006"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000133624.65946.40"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1054\/blre.2001.0185"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.5114\/ceji.2015.50838"},{"issue":"3","key":"e_1_2_9_14_1","first-page":"169","article-title":"Presence of idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia in the patients with common variable immunodeficiency","volume":"7","author":"Asghar R","year":"2008","journal-title":"Iran J Allergy Asthma Immunol"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-06-225565"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2004.04.006"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-17-0430"},{"key":"e_1_2_9_18_1","first-page":"420","article-title":"Acute childhood idiopathic thrombocytopenic purpura: AIEOP consensus guidelines for diagnosis and treatment","volume":"85","author":"De Mattia D","year":"2000","journal-title":"Haematologica"},{"key":"e_1_2_9_19_1","unstructured":"Associazione Italiana Ematologia Oncologia Pediatrica.Raccomandazioni per la gestione della trombocitopenia immune (ITP) persistente\u2010cronica in et\u00e0 pediatrica.http:\/\/www.aieop.org\/web\/wp\u2010content\/uploads\/2018\/03\/LG\u2010ITP\u2010cronica\u201018.10.17\u20101.pdf. Accessed April 15 2020."},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-07-162503"},{"key":"e_1_2_9_21_1","first-page":"136","article-title":"European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease","volume":"54","author":"Husby \u00c3S","year":"2012","journal-title":"JPGN [Internet]"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40930"},{"key":"e_1_2_9_24_1","unstructured":"ESID Registry Working Party.ESID Registry \u2010 Working definitions for clinical diagnosis of IEI.2019;1\u201033.https:\/\/esid.org\/content\/download\/16792\/456144\/file\/ESIDRegistry_ClinicalCriteria.pdf. Accessed April 15 2020."},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-017-0465-8"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra071297"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60254-3"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0801880"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-014-0102-8"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-007-9103-1"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-04-570127"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871530319666190905161347"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.0486"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27452"},{"key":"e_1_2_9_35_1","first-page":"39","article-title":"Peculiarities of autoimmune thyroid diseases in children with Turner or Down syndrome: an overview. Ital","volume":"41","author":"Aversa T","year":"2015","journal-title":"J Pediatr"},{"key":"e_1_2_9_36_1","first-page":"160","article-title":"Investigation of celiac disease in patients followed by immun thrombocytopenic purpura diagnosis and comparison with literature","volume":"4","author":"Sarbay H","year":"2017","journal-title":"North Clin Istanbul"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/6341321"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/4138434"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2009.1.139"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-06-583260"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.15593","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apa.15593","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.15593","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T10:29:40Z","timestamp":1693736980000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.15593"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,13]]},"references-count":39,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1111\/apa.15593"],"URL":"https:\/\/doi.org\/10.1111\/apa.15593","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,13]]},"assertion":[{"value":"2020-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}