الفهرس 
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Abstract
I
mmune thrombocytopenic purpra (ITP) is a common immune-mediated bleeding disorder in which platelets are opsonized by autoantibodies and prematurely destroyed by RES.
Impaired platelet production and T cell–mediated effects also play a role in the pathogenesis of the disease. Dysfunctional cellular immunity is evaluated by the level of the cytokines at the site of immune activation.
IL10 is an important immunoregulatory cytokine that is associated with many autoimmune diseases because of its anti-inflammatory functions and therefore gained much attention in ITP.
Reticulated platelets are the youngest circulating platelets recently released from marrow megakaryocytes and contain abundant mRNA amounts. RP level gives a simple and non-invasive measurement of the rate of thrombopoiesis.
The aim of the study was to evaluate the serum level of IL0 as an immunological marker and RP% as a thrombopoietic marker in children with ITP and correlate their levels with different disease stages. We applied measuring serum level of IL10 by ELISA technique and RP% by Flowcytometry technique. The study was conducted on 45 patients (15 acute ITP, 15 in persistent phase and 15 chronic ITP) and 30 age and sex matched apparently healthy control subjects.
Our study revealed that, there were no statistically significant differences between patients and control regarding age and gender. Patients with chronic and persistent ITP showed a higher prevalence of asymptomatic-paucisymptomatic forms of the disease compared to children with newly diagnosed ITP, who showed symptoms commonly between moderate to severe, and that was consistent with the highly significant decrease in Hb concentration and platelet counts in patients than control.
There was a statistically significant increase in serum IL10 level in acute ITP patients than persistent and chronic groups. Inspite of the differences between the three studied groups regarding IL10, its level in all patients was still higher than the control.
This study also revealed that, RP% was significantly increased in ITP patients than healthy control with no statistically significant differences among the studied groups of patients.
In addition, there was no correlation between symptoms and IL10 level. However, there was a significant correlation between symptoms and RP%.
IL10 and RP% could have a diagnostic utility in acute ITP with cut off value > 8 pg/ml, 93.3% sensitivity, 96.6% specificity for IL10 and cut off value > 6.8%, 71.11% sensitivity and 100% specificity for RP%.
In conclusion, IL10 can be used as a diagnostic marker for acute ITP. However, its role as a prognostic marker for the progression of the disease needs further investigations.
RP% is a useful, non invasive technique to assess thrombopoiesis in ITP patients, but it couldn’t be used as a prognostic marker for the disease progression.