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We performed a retrospective single\u2010centre study of adult patients with primary ITP undergoing at least one Indium\u2010111 platelet scintigraphy (IPS) between 2009 and 2018. Thirty\u2010three patients had isolated hepatic platelet destruction (H\u2010group), and 97 isolated splenic destruction (S\u2010group). Median age at diagnosis (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), proportion of associated cardiovascular (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), organ\u2010specific autoimmune diseases (<jats:italic>p<\/jats:italic>\u2009=\u20090.02), dependence on steroids (<jats:italic>p<\/jats:italic>\u2009=\u20090.003) and failure to rituximab (<jats:italic>p<\/jats:italic>\u2009=\u20090.01) were higher and relapse more frequent (<jats:italic>p<\/jats:italic>\u2009=\u20090.03) in H\u2010group compared to non\u2010splenectomized patients in S\u2010group. Splenectomy was only performed in patients from S\u2010group (as patients with hepatic sequestration are not splenectomized in our centre): 79% were in relapse\u2010free remission at the end of a median 3.4\u2010year post\u2010IPS follow\u2010up, 16% relapsed. In multivariate analyses, only a history of organ\u2010specific autoimmune or inflammatory disease was significantly associated with hepatic sequestration (OR\u2009=\u20094.3, 95% CI\u2009=\u20091.2\u201315, <jats:italic>p<\/jats:italic>\u2009=\u20090.02). Patients with isolated hepatic sequestration were older, had more cardiovascular events and organ\u2010specific autoimmune diseases, greater dependence on steroids, more relapses and a decreased response rate to rituximab suggesting an increased refractoriness to immunomodulatory therapies. Patients with isolated splenic sequestration responded well to splenectomy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bjh.19833","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T04:35:49Z","timestamp":1729053349000},"page":"279-289","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Course of immune thrombocytopenia according to the site of platelet destruction identified by indium\u2010111 platelet scintigraphy"],"prefix":"10.1111","volume":"206","author":[{"given":"Pauline","family":"Durand","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases University Hospital Centre of Bordeaux  Pessac France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Val\u00e9rie","family":"Pottier","sequence":"additional","affiliation":[{"name":"Department of Radiopharmacy University Hospital Centre of Bordeaux  Pessac France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Debordeaux","sequence":"additional","affiliation":[{"name":"Department of Radiopharmacy University Hospital Centre of Bordeaux  Pessac France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3889-755X","authenticated-orcid":false,"given":"Charles","family":"Mesguich","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine University Hospital Centre of Bordeaux  Pessac France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Duffau","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital Centre of Bordeaux  Bordeaux France"},{"name":"UMR CNRS 5164, ImmunoconcEpT &amp; FHU ACRONIM Bordeaux University  Bordeaux France"},{"name":"Faculty of Medicine Bordeaux University  Bordeaux France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estibaliz","family":"Lazaro","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases University Hospital Centre of Bordeaux  Pessac France"},{"name":"UMR CNRS 5164, ImmunoconcEpT &amp; FHU ACRONIM Bordeaux University  Bordeaux France"},{"name":"Faculty of Medicine Bordeaux University  Bordeaux France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Fran\u00e7ois","family":"Viallard","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases University Hospital Centre of Bordeaux  Pessac France"},{"name":"Faculty of Medicine Bordeaux University  Bordeaux France"},{"name":"INSERM U1034 Bordeaux University  Pessac Cedex France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0254-3394","authenticated-orcid":false,"given":"Etienne","family":"Rivi\u00e8re","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases University Hospital Centre of Bordeaux  Pessac France"},{"name":"Faculty of Medicine Bordeaux University  Bordeaux France"},{"name":"INSERM U1034 Bordeaux University  Pessac Cedex France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2017.04.012"},{"key":"e_1_2_11_3_1","first-page":"629","article-title":"Platelet destruction in autoimmune thrombocytopenic purpura: kinetics and clearance of indium\u2010111\u2010labeled autologous platelets","volume":"30","author":"Stratton JR","year":"1989","journal-title":"J Nucl Med off Publ Soc Nucl Med"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI106077"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI113060"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1991.tb04532.x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2010.08377.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-07-162503"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000812"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1981.tb01682.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1042\/cs0580243"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0883-2897(86)90231-X"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V50.6.1137.1137"},{"key":"e_1_2_11_14_1","first-page":"564","article-title":"Recommended method for indium\u2010111 platelet survival studies. 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