Characteristics of Corticosteroid‐Resistant Secondary Immune Thrombocytopenia Associated With Connective Tissue Diseases in China: A Retrospective Comparative Study

ABSTRACT Objective Corticosteroid‐resistant secondary immune thrombocytopenia (ITP) is a challenging condition in clinical practice. This study aimed to explore the clinical and immunological characteristics of corticosteroid‐resistant secondary ITP associated with connective tissue diseases (CTD‐IT...

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Main Authors: Yangchun Chen, Yingying Shi, Yuechi Sun, Yun Peng, Guixiu Shi, Yuan Liu, Shiju Chen
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Immunity, Inflammation and Disease
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Online Access:https://doi.org/10.1002/iid3.70236
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author Yangchun Chen
Yingying Shi
Yuechi Sun
Yun Peng
Guixiu Shi
Yuan Liu
Shiju Chen
author_facet Yangchun Chen
Yingying Shi
Yuechi Sun
Yun Peng
Guixiu Shi
Yuan Liu
Shiju Chen
author_sort Yangchun Chen
collection DOAJ
description ABSTRACT Objective Corticosteroid‐resistant secondary immune thrombocytopenia (ITP) is a challenging condition in clinical practice. This study aimed to explore the clinical and immunological characteristics of corticosteroid‐resistant secondary ITP associated with connective tissue diseases (CTD‐ITP). Methods We conducted a retrospective analysis of 201 CTD‐ITP hospitalized patients between 2014 and 2022. Patients were categorized as corticosteroid‐resistant or corticosteroid‐sensitive, and their demographic, clinical, and immunological data were compared. Logistic regression analysis was employed to identify independent predictors of corticosteroid resistance. Results Corticosteroid resistance was observed in 27.4% of patients. Compared with the corticosteroid‐sensitive group, the corticosteroid‐resistant group exhibited a higher percentage of CD3+ T cell (71.38% vs. 64.70%, p = 0.004) and CD3+CD8+ T cell (38.55% vs. 28.95%, p = 0.003), but a lower percentage of CD19+ B cell (13.70% vs. 22.45%, p = 0.001) in peripheral blood. No significant differences were found in other demographics, clinical features, or autoantibody profiles. The multivariable logistic regression analysis showed that higher percentage of CD3+CD8+ T cells (OR = 1.170, 95% CI: 1.014–1.350, p = 0.031) was an independent risk factor for corticosteroid resistance in CTD‐ITP patients. Conclusion This study revealed the potential role of higher CD3+CD8+ T cells in corticosteroid resistance among CTD‐ITP patients, and provided the potential biomarker for predicting corticosteroid therapy response.
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spelling doaj-art-1a991ccd63da452abb345d834d4e58b02025-08-20T02:46:35ZengWileyImmunity, Inflammation and Disease2050-45272025-07-01137n/an/a10.1002/iid3.70236Characteristics of Corticosteroid‐Resistant Secondary Immune Thrombocytopenia Associated With Connective Tissue Diseases in China: A Retrospective Comparative StudyYangchun Chen0Yingying Shi1Yuechi Sun2Yun Peng3Guixiu Shi4Yuan Liu5Shiju Chen6Department of Rheumatology and Clinical Immunology School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University Xiamen ChinaDepartment of Rheumatology and Clinical Immunology School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University Xiamen ChinaDepartment of Rheumatology and Clinical Immunology School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University Xiamen ChinaDepartment of Rheumatology and Clinical Immunology School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University Xiamen ChinaDepartment of Rheumatology and Clinical Immunology School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University Xiamen ChinaDepartment of Rheumatology and Clinical Immunology School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University Xiamen ChinaDepartment of Rheumatology and Clinical Immunology School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University Xiamen ChinaABSTRACT Objective Corticosteroid‐resistant secondary immune thrombocytopenia (ITP) is a challenging condition in clinical practice. This study aimed to explore the clinical and immunological characteristics of corticosteroid‐resistant secondary ITP associated with connective tissue diseases (CTD‐ITP). Methods We conducted a retrospective analysis of 201 CTD‐ITP hospitalized patients between 2014 and 2022. Patients were categorized as corticosteroid‐resistant or corticosteroid‐sensitive, and their demographic, clinical, and immunological data were compared. Logistic regression analysis was employed to identify independent predictors of corticosteroid resistance. Results Corticosteroid resistance was observed in 27.4% of patients. Compared with the corticosteroid‐sensitive group, the corticosteroid‐resistant group exhibited a higher percentage of CD3+ T cell (71.38% vs. 64.70%, p = 0.004) and CD3+CD8+ T cell (38.55% vs. 28.95%, p = 0.003), but a lower percentage of CD19+ B cell (13.70% vs. 22.45%, p = 0.001) in peripheral blood. No significant differences were found in other demographics, clinical features, or autoantibody profiles. The multivariable logistic regression analysis showed that higher percentage of CD3+CD8+ T cells (OR = 1.170, 95% CI: 1.014–1.350, p = 0.031) was an independent risk factor for corticosteroid resistance in CTD‐ITP patients. Conclusion This study revealed the potential role of higher CD3+CD8+ T cells in corticosteroid resistance among CTD‐ITP patients, and provided the potential biomarker for predicting corticosteroid therapy response.https://doi.org/10.1002/iid3.70236CD8+ T cell percentageconnective tissue diseasecorticosteroid‐resistantsecondary immune thrombocytopenia
spellingShingle Yangchun Chen
Yingying Shi
Yuechi Sun
Yun Peng
Guixiu Shi
Yuan Liu
Shiju Chen
Characteristics of Corticosteroid‐Resistant Secondary Immune Thrombocytopenia Associated With Connective Tissue Diseases in China: A Retrospective Comparative Study
Immunity, Inflammation and Disease
CD8+ T cell percentage
connective tissue disease
corticosteroid‐resistant
secondary immune thrombocytopenia
title Characteristics of Corticosteroid‐Resistant Secondary Immune Thrombocytopenia Associated With Connective Tissue Diseases in China: A Retrospective Comparative Study
title_full Characteristics of Corticosteroid‐Resistant Secondary Immune Thrombocytopenia Associated With Connective Tissue Diseases in China: A Retrospective Comparative Study
title_fullStr Characteristics of Corticosteroid‐Resistant Secondary Immune Thrombocytopenia Associated With Connective Tissue Diseases in China: A Retrospective Comparative Study
title_full_unstemmed Characteristics of Corticosteroid‐Resistant Secondary Immune Thrombocytopenia Associated With Connective Tissue Diseases in China: A Retrospective Comparative Study
title_short Characteristics of Corticosteroid‐Resistant Secondary Immune Thrombocytopenia Associated With Connective Tissue Diseases in China: A Retrospective Comparative Study
title_sort characteristics of corticosteroid resistant secondary immune thrombocytopenia associated with connective tissue diseases in china a retrospective comparative study
topic CD8+ T cell percentage
connective tissue disease
corticosteroid‐resistant
secondary immune thrombocytopenia
url https://doi.org/10.1002/iid3.70236
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