الفهرس 
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Abstract
Summary and conclusion
This study aimed to detect the level of PD-1 expression on CD4+T-cells in primary immune thrombocytopenia, to determine its role in pathogenesis of the disease and relation to the Plt count. Also detect the level of expression of CD41and CD61 on Plt in primary immune thrombocytopenia and if this level affected by disease pathology.
In this study we performed CBC, bone marrow examination as routine investigation, PD-1+CD4+ T-cell, CD41and CD61 on Plt for 40 ITP patients attending the internal medicine department and pediatric department in Sohag University Hospital and 26 apparently healthy individuals, they have no history of hematologic or autoimmune diseases or history of blood transfusions, included as a control.
In this study we found that there are increased white blood cell counts, and lymphocytosis in ITP patients when compared with healthy individuals and this attributed to that some patients have a recent history of infection and to some extent the lymphocytosis with autoimmune process in ITP. Marked thrombocytopenia also detected in ITP patients when compared with healthy individuals.
Our study showed the high level of expression of PD-1+CD4+T- cells in ITP patients when compared with healthy individuals and this indicate the important role of PD-1 in the pathogenesis of ITP. There is decrease in level of expression of CD41and CD61 on Plt this due to coating of Plt by autoantibodies against these glycoproteins.
Recommendations
In view of the present study, we recommend the following:
Follow up the cases after recovery and compare the percentage of PD1 before and after the recovery
Compare acute and chronic ITP cases according PD1 percentage
Measure level of antibodies against CD41, CD61 and correlate between their level and CD41, CD61 percent of expression.