Do the antiplatelets antibodies and ANA antibodies decrease after steroid treatment of the immune thrombocytopenia even if there is no clinical improvement?
ANA are usually IgG1 antibodies. IgG class of antibodies as a rule respond to steroids, while IgM does not. I have seen with ITP patients having concomitant Anti-Neutrophil Antibodies. Are you refering to Lupus Anti-Nuclear Antibodies or Anti-Neutrophil Antibodies?
IgG class antibodies respond to steroids. So, this is a broad answer to a specific problem. For IgM, there is little that can be done, except for plasmapheresis, which is very efficient for IgM, since 75% of IgM is intravascular. I can send you an entire presentation on this topic if you you so wish. Also, in the lab we use Dithio-Trietol (DTT) for breaking down IgM molecules. So if we want to know if it is an IgG or IgM, treatment with DTT will break the IgM ring. If any reactions persist it is due to IgG. I understand there use to be an IV preparation of DTT but the side effects were terrible. As far as I know this is no longer available.
Sergio
Medical Director
Blood Bank, Transfusion Medicine
Stem Cell Laboratory and Apheresis
MD Anderson Cancer Center, Phoenix - Arizon
Banner-MD Anderson Cancer Center
Thank you for your response. I wish if you can sen me this presentation.
My 2nd question if there is no response to the steroid clinically, the anti-platelets antibodies will decrease or not
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