Prolonged Bleeding Time with Adequate Platelet Count in Hospital Patients

Abstract One hundred six patients with storage pool deficiency (SPD) were studied with respect to platelet count, bleeding time, total platelet ATP and ADP, platelet serotonin, and in vitro aggregation. The diagnosis of SPD was made on basis of a prolonged bleeding time, a decreased total platelet ADP, and a diminished level of serotonin. Fifty-one patients from 34 unrelated families had congenital SPD, and 55 patients had acquired SPD. Congenital SPD was a common disorder in patients with a lifelong bleeding tendency and a prolonged bleeding time. The frequency in this group of patients was 18%, about one-half the frequency of von Willebrand's disease (vWd). Twenty-three percent of all patients had normal aggregation responses to ADP, epinephrine, and collagen; 33% had aggregation tracings typical for a secretion defect; and 44% had miscellaneous aggregation abnormalities. These findings indicate that SPD is common, heterogeneous, and not necessarily associated with in vitro aggregation abnormalities.

Download Full-text

Prolonged Bleeding Time of Chediak-Higashi Cats Corrected by Platelet Transfusion

Thrombosis and Haemostasis ◽

10.1055/s-0038-1648527 ◽

1992 ◽

Vol 67 (06) ◽

pp. 708-712 ◽

Cited By ~ 14

Author(s):

B E Cowles ◽

K M Meyers ◽

K J Wardrop ◽

M Menard ◽

D Sylvester

Keyword(s):

Animal Model ◽

Platelet Count ◽

Platelet Transfusion ◽

Inverse Relationship ◽

Bleeding Time ◽

Normal Donor ◽

Prolonged Bleeding ◽

Prolonged Bleeding Time ◽

Platelet Storage ◽

Chediak Higashi Syndrome

SummaryCats with the Chediak-Higashi syndrome (CHS) have a platelet storage pool deficiency (SPD). Ten CHS cats were transfused with a concentrate of 51Cr-labeled platelets prepared from normal donor cats. Gne hour after transfusion, the donor platelet count in CHS recipient cats was 40,000-60,000/μl. Bleeding time before transfusion was 9.1 ± 3.0 min. When donor platelet count in CHS cats was 50,000/μl, bleeding time was 1.7 ± 0.2 min. Bleeding time of normal cats was 1.4 ± 0.3 min. Bleeding time increased to 3.3 ± 0.2 min and to 5.3 ± 0.2 min when the platelet count was 30,000/μl, and 15,000/μl, respectively. The close inverse relationship between bleeding time and number of donor platelets in CHS cats (r = —0.92), suggests that prolonged bleeding time is due to a platelet abnormality, that platelet transfusion can effectively correct prolonged bleeding time in an animal model of platelet SPD and that CHS cats may be an appropriate animal model to evaluate hemostatic capabilities of transfused platelets.

Download Full-text

Patients with a prolonged bleeding time and normal aggregation tests may have storage pool deficiency: studies on one hundred six patients

Blood ◽

10.1182/blood.v70.3.620.bloodjournal703620 ◽

1987 ◽

Vol 70 (3) ◽

pp. 620-623 ◽

Cited By ~ 3

Author(s):

HK Nieuwenhuis ◽

JW Akkerman ◽

JJ Sixma

Keyword(s):

Platelet Count ◽

Bleeding Time ◽

Bleeding Tendency ◽

Von Willebrand's Disease ◽

Common Disorder ◽

Storage Pool ◽

Prolonged Bleeding ◽

Prolonged Bleeding Time ◽

Platelet Serotonin

One hundred six patients with storage pool deficiency (SPD) were studied with respect to platelet count, bleeding time, total platelet ATP and ADP, platelet serotonin, and in vitro aggregation. The diagnosis of SPD was made on basis of a prolonged bleeding time, a decreased total platelet ADP, and a diminished level of serotonin. Fifty-one patients from 34 unrelated families had congenital SPD, and 55 patients had acquired SPD. Congenital SPD was a common disorder in patients with a lifelong bleeding tendency and a prolonged bleeding time. The frequency in this group of patients was 18%, about one-half the frequency of von Willebrand's disease (vWd). Twenty-three percent of all patients had normal aggregation responses to ADP, epinephrine, and collagen; 33% had aggregation tracings typical for a secretion defect; and 44% had miscellaneous aggregation abnormalities. These findings indicate that SPD is common, heterogeneous, and not necessarily associated with in vitro aggregation abnormalities.

Download Full-text

Some Considerations about the Purification and Standardization of Collagen from Patients with Prolonged Bleeding Time

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651342 ◽

1975 ◽

Vol 34 (01) ◽

pp. 304-305

Author(s):

Y Legrand ◽

J Caen

Keyword(s):

Bleeding Time ◽

Prolonged Bleeding ◽

Prolonged Bleeding Time

Download Full-text

Acquired Disorder of Platelet Function Associated with Autoantibodies against Membrane Glycoprotein IIb-IIIa Complex - 1. Glycoprotein Analysis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1648178 ◽

1991 ◽

Vol 65 (05) ◽

pp. 491-496 ◽

Cited By ~ 29

Author(s):

M Meyer ◽

C M Kirchmaier ◽

A Schirmer ◽

P Spangenberg ◽

Ch Ströhl ◽

...

Keyword(s):

Platelet Count ◽

Platelet Aggregation ◽

Platelet Adhesion ◽

Bleeding Time ◽

Membrane Glycoprotein ◽

Membrane Glycoproteins ◽

Abnormal Behaviour ◽

Thrombocytopenic Purpura ◽

Immunoelectrophoretic Analysis ◽

Prolonged Bleeding Time

SummaryA patient with idiopathic thrombocytopenic purpura developed after splenectomy a thrombasthenia-like severe haemor-rhagic diathesis characterized by a normal or subnormal platelet count, prolonged bleeding time, strongly reduced platelet adhesion to glass and defective platelet aggregation in response to ADP and collagen. In contrast to hereditary thrombasthenia membrane glycoproteins (GP) lib and Ilia were normally present in the patient’s platelets. Immunoelectrophoretic analysis revealed an abnormal behaviour of the patient’s GP IIb-IIIa complex. Autoantibodies against GP IIb-IIIa were detected in Triton-extracted washed platelets. Incubation of normal platelets with plasma from the patient resulted in a similar immunoelectrophoretic abnormality of the GP IIb-IIIa complex indicating that bound autoantibodies (IgG) are responsible for the abnormal immunoelectrophoretic behaviour of the patient’s GP IIb-IIIa complex. Platelet fibrinogen was severely reduced similar to classical thrombasthenia suggesting that the GP IIb-IIIa complex is involved in platelet fibrinogen storage.

Download Full-text

Factors which Influence the Bleeding Time

Thrombosis and Haemostasis ◽

10.1055/s-0038-1655447 ◽

1962 ◽

Vol 08 (03) ◽

pp. 511-523

Author(s):

G. J. H den Ottolander ◽

A Bleijenberg

Keyword(s):

Bleeding Time ◽

Prolonged Bleeding ◽

Prolonged Bleeding Time ◽

Normal Platelet

SummaryA prolonged bleeding time can be due to a vascular, plasmatic, or thrombocytic cause. On the basis of investigations in 8 patients with a prolonged bleeding time, these different forms are discussed.There appeared to be at least two plasmatic factors one of which is the bleeding factor of Nilsson. The demonstration of a thrombocytic cause is sometimes only possible with transfusions of normal platelet suspensions. A patient is described with a prolonged bleeding time due to an acquired thrombo-pathia, resulting from excessive haemorrhages and exchange transfusions.

Download Full-text

Congenital Vascular Defect Associated with Platelet Abnormality and Antihemophilic Factor Deficiency

Blood ◽

10.1182/blood.v15.6.807.807 ◽

1960 ◽

Vol 15 (6) ◽

pp. 807-829 ◽

Cited By ~ 15

Author(s):

GIOVANNI RACCUGLIA ◽

JAMES V. NEEL ◽

Ruth T. Davidson ◽

Mary Jane Ussery

Keyword(s):

Bleeding Time ◽

A Priori ◽

Dominant Gene ◽

Hemorrhagic Diathesis ◽

Prolonged Bleeding ◽

Prolonged Bleeding Time ◽

Factor Deficiency ◽

Hemorrhagic Tendency ◽

Vascular Defect ◽

Antihemophilic Factor

Abstract 1. A kindred of 311 individuals, many members of which are affected by a hemorrhagic diathesis, has been described. 2. The variability in the manifestations of this diathesis is extreme. In its fullest expression the disease is characterized by a prolonged bleeding time with evidence of a morphologic defect in the platelets, and a deficiency in antihemophilic globulin. Some possibly affected individuals exhibit only a prolonged bleeding time, while, on the other hand, the clinically most severely affected individual, with AHF levels on several occasions of 5 to 10 per cent, has not been observed by us to have a prolonged bleeding time, although his platelets are morphologically abnormal. 3. Genetic analysis suggests that the hemorrhagic tendency is determined by a single dominant gene of variable penetrance and expressivity. 4. No satisfactory explanation can be developed on the basis of these studies for the association between platelet abnormality and AHF deficiency. More specifically, it is impossible to conclude whether the platelet defect is precursor to the AHF deficiency, or whether—as on a priori grounds seems less likely—this is an example of true genetic pleiotropy. 5. The terminologic chaos which afflicts the literature on hemorrhagic diatheses characterized by a prolonged bleeding time is discussed in the light of the findings in this one large kindred, and suggestions are advanced for minimizing confusion based on terminology alone.

Download Full-text

Is a Prolonged Bleeding Time Associated with an Increased Risk of Hemorrhage after Liver Biopsy?

Thrombosis and Haemostasis ◽

10.1055/s-0037-1614481 ◽

1999 ◽

Vol 81 (03) ◽

pp. 378-381 ◽

Cited By ~ 41

Author(s):

Frank Brosstad ◽

Thore Egeland ◽

Tor Egge ◽

Erik Schrumpf ◽

Kirsten Boberg

Keyword(s):

Liver Biopsy ◽

Bleeding Time ◽

Hemoglobin Concentration ◽

Additional Information ◽

Risk Of Bleeding ◽

Prolonged Bleeding ◽

Prolonged Bleeding Time ◽

Increased Risk ◽

Patient Groups ◽

Risk Of Hemorrhage

SummaryBleeding time determination is not advised as a general preoperative hemostasis screening test, but it might be useful in some patient groups. Patients referred for liver biopsy frequently have coagulation disturbances and are at risk of hemorrhage. In this prospective study 219 liver biopsies were carried out regardless of a prolonged bleeding time, but with minimum requirements for hemoglobin concentration, platelet count, and tests of the internal and external coagulation pathways. The bleeding time was prolonged in the case of 48 (22%) of the biopsies. Significant bleeding as defined by a hemoglobin decrease of ≥2.0 g/dl occurred in nine patients. Three of these patients were bone marrow transplanted. Patients with a prolonged bleeding time carried a five times higher risk of bleeding (odds ratio = 5.0; confidence interval = 1.1-21.8; p = 0.019). We conclude that the bleeding time may give additional information on the risk of bleeding in some patient groups undergoing liver biopsy.

Download Full-text