1. The seasonal distribution of immune thrombotic thrombocytopenic purpura is influenced by geography: Epidemiologic findings from a multi-center analysis of 719 disease episodes.
- Author
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Jacobs JW, Stanek CG, Booth GS, Symeonidis A, Shih AW, Allen ES, Gavriilaki E, Grossman BJ, Pavenski K, Moorehead A, Peyvandi F, Agosti P, Mancini I, Stephens LD, Raval JS, Mingot-Castellano ME, Crowe EP, Daou L, Pai M, Arnold DM, Marques MB, Henrie R, Smith TW, Sreenivasan G, Siniard RC, Wallace LR, Yamada C, Duque MA, Wu Y, Harrington TJ, Byrnes DM, Bitsani A, Davis AK, Robinson DH, Eichbaum Q, Figueroa Villalba CA, Juskewitch JE, Kaiafa G, Kapsali E, Klapper E, Perez-Alvarez I, Klein MS, Kotsiou N, Lalayanni C, Mandala E, Aldarweesh F, Alkhateb R, Fortuny L, Mellios Z, Papalexandri A, Parsons MG, Schlueter AJ, Tormey CA, Wellard C, Wood EM, Jia S, Wheeler AP, Powers AA, Webb CB, Yates SG, Bouzid R, Coppo P, Bloch EM, and Adkins BD
- Subjects
- Humans, Female, Male, Retrospective Studies, Adult, Middle Aged, Purpura, Thrombotic Thrombocytopenic epidemiology, Aged, Adolescent, Young Adult, Canada epidemiology, Seasons
- Abstract
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%; pā=ā.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., (© 2024 The Author(s). American Journal of Hematology published by Wiley Periodicals LLC.)
- Published
- 2024
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