Pediatrics international : official journal of the Japan Pediatric Society · 2026
Risk Interval of Immune Thrombocytopenia in Children After Influenza Infection.
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Ibi Kyosuke, Miyamoto Yoshihisa, Kato Motohiro, Yasunaga Hideo
Аннотация
BACKGROUND: The temporal association between influenza and immune thrombocytopenia (ITP) is poorly characterized. This study examined the risk interval between influenza infection and newly diagnosed ITP in children.
METHODS: We enrolled individuals aged 1-15 years newly diagnosed with ITP between 2005 and 2024, using the Japanese large-scale administrative JMDC Database. We conducted a nested case-control study and self-controlled case series to evaluate the risk of ITP within 28 days (categorized into 7-day intervals) of influenza diagnosis. We estimated the risk interval from influenza diagnosis to ITP onset using conditional logistic and Poisson regressions.
RESULTS: We identified 2255 individuals diagnosed with ITP, of whom 1324 met the eligibility criteria. In the nested case-control analysis, the adjusted odds ratio of preceding influenza diagnosis was the highest within 1-7 days before ITP onset (3.13; 95% confidence interval 1.38-7.12) compared with the matched controls. In the self-controlled case series, the incidence rate ratio for ITP was the highest within 1-7 days after influenza diagnosis compared to the baseline period (2.44; 95% confidence interval 1.16-5.14). In the sensitivity and post hoc analyses for different definitions of influenza diagnosis and ITP onset dates, ITP onset peaked within 1-14 days of influenza diagnosis.
CONCLUSIONS: The risk of ITP appeared to be highest during the first 1-2 weeks after influenza diagnosis, particularly around the first week.
METHODS: We enrolled individuals aged 1-15 years newly diagnosed with ITP between 2005 and 2024, using the Japanese large-scale administrative JMDC Database. We conducted a nested case-control study and self-controlled case series to evaluate the risk of ITP within 28 days (categorized into 7-day intervals) of influenza diagnosis. We estimated the risk interval from influenza diagnosis to ITP onset using conditional logistic and Poisson regressions.
RESULTS: We identified 2255 individuals diagnosed with ITP, of whom 1324 met the eligibility criteria. In the nested case-control analysis, the adjusted odds ratio of preceding influenza diagnosis was the highest within 1-7 days before ITP onset (3.13; 95% confidence interval 1.38-7.12) compared with the matched controls. In the self-controlled case series, the incidence rate ratio for ITP was the highest within 1-7 days after influenza diagnosis compared to the baseline period (2.44; 95% confidence interval 1.16-5.14). In the sensitivity and post hoc analyses for different definitions of influenza diagnosis and ITP onset dates, ITP onset peaked within 1-14 days of influenza diagnosis.
CONCLUSIONS: The risk of ITP appeared to be highest during the first 1-2 weeks after influenza diagnosis, particularly around the first week.