Immune thrombocytopenia in Kabuki syndrome, a comparison with non-Kabuki cases in the UK paediatric ITP registry

TL;DR

This study compares immune thrombocytopenia in children with Kabuki syndrome to those without it, finding similar clinical features despite a higher risk in Kabuki syndrome.

Contribution

The study identifies the relative prevalence and clinical features of ITP in Kabuki syndrome using a large pediatric registry.

Findings

Children with Kabuki syndrome had a 79-fold higher risk of ITP compared to the general population.

Clinical presentations of ITP in Kabuki syndrome and non-Kabuki syndrome children were similar.

Only one Kabuki syndrome patient had chronic ITP, and another had atypical symptoms.

Abstract

This study aims to compare the clinical presentation of Immune Thrombocytopenia (ITP) in children with Kabuki syndrome (KS) to those with sporadic ITP in the UK Paediatric ITP Registry. The Margot et al. analysis of a Kabuki database identified that children with KS had higher rates of chronic ITP and of other haematological abnormalities. This study aims to identify if children with KS do exhibit these features compared to the sporadic ITP population using data from the UK Paediatric ITP Registry between January 2006 and February 2020.

Of 2013 ITP patients, five had a confirmed diagnosis of KS, representing a 0.25% prevalence (95% CI = 0.031 – 0.47%). The relative prevalence of ITP in KS was estimated at 79 (95% CI = 10–149, p < 0.0001). Clinical presentations were similar between KS and non-KS children, with non-significant differences in severity of bleeding and platelet counts. One KS patient exhibited chronic ITP and another presented with symptoms not exclusively attributable to thrombocytopenia.

Our findings suggest that the clinical presentation and course of ITP in children with KS are comparable to those of general ITP patients. Despite the elevated risk of ITP in KS, the manifestations of the condition do not differ significantly.

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