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MedLine Citation:
PMID:  21323737     Owner:  NLM     Status:  Publisher    
Background:  Patients with primary immune thrombocytopenia (ITP) commonly describe symptoms of fatigue. However haematologists rarely consider fatigue as a manifestation of ITP. Objectives:  To document the prevalence of fatigue among ITP patients and to determine the patient characteristics that are associated with fatigue. Methods:  Using a cross sectional design, we surveyed 1871 members of the UK ITP Support Association (585 [31%] responded) and 93 patients enrolled in the Oklahoma (US) ITP Registry (68 [73%] responded) with questions about their ITP and with validated symptom assessment scales for fatigue, daytime sleepiness and orthostatic symptoms. Results:  The prevalence of fatigue among both UK (39%) and US (22%) patients was significantly greater than expected compared to normal subjects (p<0.0001 and p<0.0001 respectively). In univariate analysis of the combined cohorts, fatigue was associated with a platelet count <100,000/μL, treatment with steroids, bleeding symptoms, presence of other medical conditions, daytime sleepiness, and orthostatic symptoms. Fatigue was not associated with age, gender, duration of ITP, or splenectomy status. Multivariate analysis of the combined cohorts was stratified for the presence or absence of bleeding symptoms. Among 107 patients with bleeding symptoms, fatigue was independently associated with a platelet count <100,000/μL and female gender. Among 491 patients without bleeding symptoms, fatigue was independently associated with a platelet count <30,000/μL, presence of other medical conditions, daytime sleepiness, and orthostatic symptoms. Conclusions:  Fatigue is a common symptom among patients with ITP. These data provide the basis for future studies to define the clinical importance of fatigue in ITP.
Julia L Newton; Jessica A Reese; Shirley I Watson; Sara K Vesely; Paula H B Bolton-Maggs; James N George; Deirdra R Terrell
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-15
Journal Detail:
Title:  European journal of haematology     Volume:  -     ISSN:  1600-0609     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703985     Medline TA:  Eur J Haematol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 John Wiley & Sons A/S.
Institute for Ageing and Health and UK NIHR Biomedical Research Centre in Ageing, Newcastle University, Newcastle upon Tyne, UK Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma, USA ITP Support Association, Bolnhurst, UK Manchester Haemophilia Comprehensive Care Centre, Department of Clinical Haematology Manchester Royal Infirmary, Manchester, UK.
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