Incidence and clinico-laboratory profile of adult primary immune thrombocytopenia: A retrospective study from 2000 to 2022 in a single teaching hospital

BACKGROUND: Limited availability of prevalence and clinical epidemiological data on adult primary immune thrombocytopenia (pITP) and the inaccessibility of a gold standard test restricts the veracity of the pITP representation in ASEAN countries, more so in Malaysia. OBJECTIVE: This study aims to ascertain the incidence rate and the relationship between the clinico-laboratory characteristics of adult pITP. MATERIALS AND METHODS: A retrospective study involving a total of 141 adult patients diagnosed with pITP at Hospital Pakar Universiti Sains Malaysia between 2000 and 2022. Incidence rates and clinico-laboratory profiles were established based on findings collected from hospital databases. RESULTS: The annual incidence rate of pITP was 1.2 per 100,000 person-years (95% confidence interval [CI]: 1.0–1.5). A higher incidence was observed in females compared to males (1.8 per 100,000 person-years, 95% CI: 1.4–2.0 vs. 0.7 per 100,000 person-years, 95% CI: 0.5–0.9), with a male-to-female ratio of 1:2.5. The most presented symptoms in pITP patients were cutaneous bleeding (53.2%), gingival bleeding (29.8%) and menorrhagia (19.1%) and they typically occurred in pITP patients with a mean platelet count less than 50 × 10 9 /L. The majority of the patients received first-line therapy (68.8%), whereas 17.7% received no treatment. First-line therapy nonresponders were given second-line therapy (4.2%). CONCLUSION: Our findings highlight the distinctive epidemiological patterns and clinical presentations of pITP in the northeast region of Malaysia, particularly highlighting gender, race, and age-specific variations. Despite comprehensive treatment guidelines, diagnostic challenges remain. Improved diagnostic tools are needed to enhance timely identification and effective management, ultimately improving patient outcomes for pITP.