Clinical characteristics and risk factors for the bidirectional association between immune thrombocytopenia and Sjögren's syndrome.

OBJECTIVE

This study investigated the clinical characteristics and risk factors for bidirectional association between immune thrombocytopenia and Sjögren's disease (ITP/SjD).

METHODS

Patients with ITP/SjD in the First People's Hospital of Yunnan Province from July 2024 to December 2024 were retrospectively analyzed and compared to those of sex- and age-matched ITP or SjD controls. Logistic regression analysis was used to identify risk factors.

RESULTS

A total of 110 consecutive patients with ITP/SjD were enrolled. One hundred and five (95.45%) patients were female. The mean age at onset of ITP/SjD, ITP preceding SjD, SjD preceding ITP, and simultaneous ITP/SjD was 50.34 ± 16.46 years, 53.37 ± 12.38 years, 44.78 ± 18.50 years, and 57.73 ± 13.80 years, respectively. Compared to SjD controls, ITP/SjD patients were less likely to have dry mouth (p < 0.001) and more likely to have epistaxis (p = 0.012). Compared to ITP controls, the ITP/SjD patients presented with fewer petechiae, purpura, and ecchymosis, gingival bleeding, and epistaxis (p < 0.001). Fewer patients with ITP/SjD received corticosteroids (p = 0.010) and immunosuppressants (p = 0.002) than ITP controls. For SjD progressing to ITP/SjD, multivariate logistic analysis indicated that dry mouth (OR = 4.828), dry eyes (OR = 5.204), and anti-ENA (OR = 4.621) were independent risk factors. For ITP progressing to ITP/SjD, multivariate analysis confirmed only platelet counts (p = 0.041) as an independent predictor.

CONCLUSIONS

Our findings highlight the roles of platelet counts, dry mouth, dry eyes, and anti-ENA in the development of this bidirectional association disease. Key Points • There are few documents on the pathogenesis and risk factors of SjD/ITP at home and abroad, and most of them are case reports. • This study aims to investigate the clinical characteristics and risk factors of SjD/ITP, so as to improve the cognition of SjD/ITP, reduce the risk of bleeding and death in SjD patients to the greatest extent, and improve the prognosis of patients. • Based on the comparative results of ITP/SjD with ITP or SjD controls, risk factors for ITP developing SjD and SjD developing ITP were further identified. Patients with SjD preceding ITP, ITP preceding SjD, and simultaneous ITP and SjD were analyzed and compared. • We found the roles of platelet count, dry mouth, dry eye, and anti ENA in the development of this bidirectional association disease, providing guidance for clinical doctors in diagnosing the condition and predicting outcomes.