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    Poster Networking

    Pediatrics

    Poster Networking Session

    PB0252 - The role of hydroxychloroquine in the management of children with ITP and positive antinuclear antibodies

    Sunday, June 25, 2023
    18:30 – 19:30 ET
    Room: Exhibition

      Co-Author(s)

    • DB

      Dafna Brik - Simon

      Pediatric hematologist
      Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
      Petach Tikva, HaMerkaz, Israel

    • YL

      Yoel Levinsky

      Pediatric Rheumatologist
      Pediatric Rheumatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
      Petach Tikva, HaMerkaz, Israel

    • Orly Efros, MD, MHA (she/her/hers)

      Physician, thrombosis and hemostasis specialist
      National Hemophilia Center and Thrombosis & Hemostasis Institute, Sheba Medical Center, Israel. Sackler Faculty of Medicine, Tel Aviv University, Israel.
      Rishon Letzion, HaMerkaz, Israel

    • GA

      Gil Amarilyo

      Pediatric Rheumatologist
      Pediatric Rheumatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
      Petach tikva, HaMerkaz, Israel

    • RR

      Ron Rabinowicz

      Pediatric hematologist
      Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
      Petach tikva, HaMerkaz, Israel

    • OS

      Orna Steinberg - shemer

      Pediatric hematologist
      Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
      Petach tikva, HaMerkaz, Israel

    • IT

      Irit Tirosh

      Pediatric Rheumatologist
      Pediatric Rheumatology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel. Affiliated toSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
      Petach tikva, HaMerkaz, Israel

    • SI

      Shai Izraeli

      Pediatric hematologist
      Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
      Petach tikva, HaMerkaz, Israel

    • JY

      Joanne Yacobovich

      Pediatric hematologist
      Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
      Petach tikva, HaMerkaz, Israel

      • Presenting Author(s)

    • Oded Gilad

      Pediatric hematologist
      Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
      Mazor, HaMerkaz, Israel

    Background: Pediatric Immune thrombocytopenia (ITP) is usually primary, viral induced, but secondary ITP can occur.
    Adolescents with ITP are routinely screened for systemic lupus erythematosus (SLE) using antinuclear antibody (ANA) titer and if elevated, additional testing for SLE is warranted.
    Hydroxychloroquine (HCQ) is a safe, effective immunomodulatory drug used in the treatment of SLE and is also used rarely in secondary ITP.
    Past studies suggested a role for HCQ in achieving a long-term response in adults with SLE-associated ITP.

    Aims: We analyzed the efficacy and safety of HCQ in treatment of pediatric ITP patients with positive ANA.

    Methods: A retrospective, single center study, including all children with ITP who repeatedly tested positive for ANA (>1:80), and were treated with HCQ, between 2010-2021.
    Inclusion criteria were children fulfilling accepted diagnostic criteria of SLE or with incomplete SLE score who required immunomodulatory therapy with HCQ. The platelet response to HCQ was documented at several time points. "Complete response” (CR) defined as platelet count of at least 100 *109/L and “Response” (R), platelet count between 30-100 * 109/L and at least doubling of the baseline count.

    Results: 16 patients (14 female) were included, 12 with definite SLE and four with incomplete SLE, median age was 15 years (10-17.3) [table].
    HCQ was started at median of 5.5 months (0-120) post ITP diagnosis, mean platelet count at initiation was 41.8+20.3*109/L (13/16 on ITP therapy). At 8 weeks 7/16 (43%) responded, 5 achieved CR. At one-year, overall response was 81.2% (13/16), the remaining patients had stable platelet counts, needing no additional ITP therapy. The response was significant and maintained at a median follow-up of 42 months (range 6-120), [figure].
    No adverse effects to HCQ were documented.

    Conclusion(s): Pediatric ITP patients with high ANA titer who fulfill, fully or partially, criteria for SLE may benefit from early initiation of HCQ.