THE ASSOCIATION OF FCGRIIA AND FCGRIIIA POLYMORPHISMS AND ANTIPLATELETS AUTOANTIBODIES WITH PRIMARY IMMUNE THROMBOCYTOPENIA PATHOGENESIS AMONG PALESTINIAN CHILDREN
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Date
2026-01-25
Authors
Amer, Khitam
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An-Najah National University
Abstract
Background: Immune thrombocytopenia (ITP) is a common pediatric autoimmune disorder characterized by low platelet counts and bleeding risk. Fc gamma receptors (FcγRs), particularly FCGR2A (131H/R) and FCGR3A (158F/V), mediate immune responses and may influence ITP susceptibility. Gender-related genetic variation has been proposed but remains underexplored. In the current study, we aim to assess the prevalence and clinical relevance of FCGR2A and FCGR3A polymorphisms, including gender-based tendencies, in Palestinian children with ITP.
Methods: A multicenter case-control study included 40 proven pediatric ITP patients (20 males, 20 females; mean age (6.76 ± 4.13 years) and 80 age- and sex-matched healthy controls. Genotyping was performed using PCR-RFLP and nested PCR, the antinuclear antibody (ANA) and the anti-double stranded DNA (A- dsDNA) were tested in 32 patient sample using (ELISA).
Results: No statistically significant differences in genotype distributions were observed or FCGR3A (FF: 25.0%, FV: 55.0%, VV: 20.0%) (p > 0.05). However, gender specific trends yielded noteworthy observations: FCGR2A-HH was numerically more frequent in male ITP patients (57.4%) than in females (42.8%), while HR was lower in males (48% vs. 52%). Similarly, FCGR3A-VV occurred in 62.5% of males versus 37.5% in females. Furthermore, the combined HR/FV genotype (32.5%) showed a non-significant trend of association with chronic ITP (69.2%), while the VV/HH genotype, although rare (5%), was linked to 50% of refractory presentations. The ANA was positive in 53% of tested samples, and a 3% were positive to both ANA and the A-dsDNA. ANA positive cases (70%) were in patients having the FV and HR genotypes.
Conclusion: This exploratory study found no statistically significant association between FCGR2A and FCGR3A polymorphisms and overall ITP susceptibility in the full cohort. However, the observed trends, with gender-based distribution of specific genotypes and the association of combined genotypes with case severity, suggest that these genetic markers may play a role in disease progression. Further investigation in a larger study is warranted to validate these findings.