Study of CD4+, CD8+, and natural killer cells (CD16+, CD56+) in children with immune thrombocytopenic purpura

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Objective/background: To assess the percentage of CD4 + , CD8 + , and natural killer cells (CD16 + , CD56 + ) in children with immune thrombocytopenic purpura (ITP) at presentation and study their impact on disease chronicity. Methods: This case-control study was conducted at the Pediatric Hematology and Oncology Unit, Menoufia University Hospital (tertiary care center in Egypt). The study was held on 30 children presenting with ITP; they were followed-up and classified into two groups: 15 children with acute ITP; and 15 children with chronic ITP. Patients were compared to a group of 15 healthy children of matched age and sex. Measurements of CD4 + , CD8 + , and natural killer cells (CD16 + , CD56 + ) by flow cytometry were assessed and compared in these groups. Results: CD4 + and CD4 + /CD8 + were significantly lower in acute and chronic patients than the control group ( p <0.05 and p <0.001, respectively), with no significant difference between acute and chronic patients ( p > 0.05). However, CD8 + was significantly higher in acute and chronic patients than the control group ( p < 0.05), with no significant difference between acute and chronic patients ( p > 0.05). Natural killer cell percent was significantly lower in acute patients than the control group ( p < 0.001), with no significant difference between chronic and control groups ( p > 0.05). Conclusion: ITP is associated with immunity dysfunction denoted by the increase in cytotoxic T lymphocytes and the decrease in natural killer cells.