The platelet counts of patients with cyclic thrombocytopenia (CT) are occasionally associated with menstruation, yet its mechanism is unknown. Leptin has been shown to stimulate the production of Th1 cytokines (

Nature 1998;27:897
), which dominate in idiopathic thrombocytopenic purpura (ITP) (
Blood 2004;103:2645
), and a recent study showed that the serum levels of leptin, whose secretion is menstruation-related, are high in ITP (
Eur J Haemataol 2004;72:348
). Here we examined the serial serum levels of leptin in 3 patients with CT by radioimmunoassay. Case 1 is a 29-year-old woman with ITP who had repeated spontaneous abortion at an early phase of pregnancy accompanied by transient severe thrombocytopenia. Case 2 is a 37-year-old woman diagnosed as having ITP and autoimmune neutropenia during her second pregnancy, whose platelet counts became cyclic after delivery. Case 3 is a 28-year-old woman, who developed CT after splenectomy performed for refractory ITP two years before. The serum leptin levels were inversely correlated with the platelet counts in case 1 (r = −0.573, P =0.047, n=13) and case 3 ( r = −0.771, P =0.029, n=9), and a similar inverse correlation was observed in case 2, although the correlation was statistically not significant (r = −0.524, P=0.116, n=10). These findings suggest that leptin might play an important role in the pathogenesis of menstruation-associated CT. Further interventional studies to give leptin and its antagonists to the patients with CT, as well as to ITP model mice, will be warranted.

Topics:
cyclic thrombocytopenia, menstruation, platelet count measurement, serum leptin measurement, purpura, thrombocytopenic, idiopathic, leptin, abortion, spontaneous, antagonists, autoimmune neutropenia, cytokine

Disclosure: No relevant conflicts of interest to declare.

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2006, The American Society of Hematology
2006
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