The seasonal distribution of immune thrombotic thrombocytopenic purpura is influenced by geography: Epidemiologic findings from a multi-center analysis of 719 disease episodes.
Publication Date: 2024 Nov
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Authors
Jeremy W Jacobs; Caroline G Stanek; Garrett S Booth; Argiris Symeonidis; Andrew W Shih; Elizabeth S Allen; Eleni Gavriilaki; Brenda J Grossman; Katerina Pavenski; Amy Moorehead; Flora Peyvandi; Pasquale Agosti; Ilaria Mancini; Laura D Stephens; Jay S Raval; Maria Eva Mingot-Castellano; Elizabeth P Crowe; Laetitia Daou; Menaka Pai; Donald M Arnold; Marisa B Marques; Ryan Henrie; Tyler W Smith; Gayatri Sreenivasan; Rance C Siniard; Lisa R Wallace; Chisa Yamada; Miriam Andrea Duque; Yanyun Wu; Thomas J Harrington; Diana M Byrnes; Aikaterini Bitsani; Amanda K Davis; Danielle H Robinson; Quentin Eichbaum; Cristina A Figueroa Villalba; Justin E Juskewitch; Georgia Kaiafa; Eleni Kapsali; Ellen Klapper; Ingrid Perez-Alvarez; Monica S Klein; Nikolaos Kotsiou; Chrysavgi Lalayanni; Evdokia Mandala; Fatima Aldarweesh; Rahaf Alkhateb; Lisandro Fortuny; Zois Mellios; Apostolia Papalexandri; Meredith G Parsons; Annette J Schlueter; Christopher A Tormey; Cameron Wellard; Erica M Wood; Shiyang Jia; Allison P Wheeler; Amy A Powers; Christopher B Webb; Sean G Yates; Raïda Bouzid; Paul Coppo; Evan M Bloch; Brian D AdkinsAbstract
OBJECTIVE
Prior studies have suggested that immune thrombotic thrombocytopenic purpura (iTTP) may display seasonal variation; however, methodologic limitations and sample sizes have diminished the ability to perform a rigorous assessment. This 5-year retrospective study assessed the epidemiology of iTTP and determined whether it displays a seasonal pattern. Patients with both initial and relapsed iTTP (defined as a disintegrin and metalloprotease with thrombospondin type motifs 13 activity <10%) from 24 tertiary centers in Australia, Canada, France, Greece, Italy, Spain, and the US were included. Seasons were defined as: Northern Hemisphere-winter (December-February); spring (March-May); summer (June-August); autumn (September-November) and Southern Hemisphere-winter (June-August); spring (September-November); summer (December-February); autumn (March-May). Additional outcomes included the mean temperature in months with and without an iTTP episode at each site. A total of 583 patients experienced 719 iTTP episodes. The observed proportion of iTTP episodes during the winter was significantly greater than expected if equally distributed across seasons (28.5%, 205/719, 25.3%-31.9%; p = .03). Distance from the equator and mean temperature deviation both positively correlated with the proportion of iTTP episodes during winter. Acute iTTP episodes were associated with the winter season and colder temperatures, with a second peak during summer. Occurrence during winter was most pronounced at sites further from the equator and/or with greater annual temperature deviations. Understanding the etiologies underlying seasonal patterns of disease may assist in discovery and development of future preventative therapies and inform models for resource utilization.
Source
American journal of hematology
Pub Types(s)
Journal Article
Language
English
PubMed ID
39136282