Serum copper and zinc status in children & adolescents with primary immune thrombocytopenia

Abstract Background Primary immune thrombocytopenia (ITP) is an autoimmune hematological disorder characterized by bleeding and thrombocytopenia. Deficiency of micronutrients, like copper and zinc, has been implicated in disease pathogenesis. Aim To evaluate serum copper and zinc levels in paediatric ITP patients and to investigate their potential effects on disease severity, chronicity, and response to treatment. Methods Seventy-four children and adolescents with ITP (aged 2–18 years) were enrolled, including 16% with persistent and 84% with chronic disease. Median disease duration was 2 years. Clinical history and physical examination were performed, and serum zinc and copper concentrations were measured using atomic absorption spectrophotometry. Results The frequency of zinc deficiency was 50% ( n = 37). No significant differences in demographic or clinical parameters were observed between zinc-deficient and zinc-normal groups ( p > 0.05). However, platelet counts tended to be lower in zinc-deficient patients. A higher proportion of zinc-normal patients were off treatment compared to zinc-deficient patients with marginal significance (25% vs. 5%; p = 0.06). Subnormal copper levels were more common in zinc-deficient patients (16.2% vs. 2.7%; p = 0.1). Overall, serum zinc levels showed no correlation with demographic or clinical variables. Copper deficiency was detected in 9.5% ( n = 7), with no significant differences between copper-deficient and copper-normal groups ( p > 0.05). Conclusion Zinc deficiency is more prevalent than copper deficiency among paediatric ITP patients. However, neither zinc nor copper levels demonstrated significant correlation with clinical or demographic parameters, suggesting that these deficiencies may represent non-specific findings rather than determinants of disease outcome.