Platelet volume analysis in thrombocytopenia in relation to bleeding tendency

2009 ◽  
Vol 37 (1) ◽  
pp. 25-28 ◽  
Author(s):  
J. Lelie ◽  
J. M. Kerst ◽  
E. Vorm ◽  
A. E. G. Kr. Borne
Keyword(s):  
Bleeding Tendency ◽  
Platelet Volume ◽  
Volume Analysis

Mean platelet volume analysis needs more standardization

Platelets ◽  
2010 ◽  
Vol 22 (3) ◽  
pp. 241-241 ◽  
Author(s):  
Marcus D. Lance ◽  
Yvonne M.C. Henskens ◽  
Marco A.E. Marcus
Keyword(s):  
Mean Platelet Volume ◽  
Platelet Volume ◽  
Volume Analysis

FACTORS AFFECTING PLATELET VOLUME ANALYSIS

1987 ◽  
Author(s):  
A Wehmeier ◽  
W Schneider
Keyword(s):  
Incubation Time ◽  
Whole Blood ◽  
Storage Temperature ◽  
Platelet Rich Plasma ◽  
Impedance Method ◽  
Blood Collection ◽  
Volume Distribution ◽  
Dependent Manner ◽  
Platelet Volume ◽  
Volume Analysis

Parameters of platelet volume have become widely available with the introduction of automated platelet counters. However, variant sample processing and in vitro platelet activation have prevented standardization of platelet volume analysis. We investigated the influence of anticoagulation, storage, temperature, and the presence or absence of RBC on platelet volume. Mean platelet volume (MPV) and the mode of the distribution were calculated from the platelet volume distribution curve recorded with the impedance method and plotted in 27 classes between 1.2 and 22 fl. The effects of EDTA (.335%), citrate (.38%), citrate (.38%)/glutaraldehyde (.125%) and a cocktail containing citrate, forskolin, indomethacin and theophyllin were determined 10, 30, 60, 120 and 240 min after blood collection. Tests were made at 4, 20° and 37°C in whole blood and platelet-rich plasma (PRP)from 6 healthy subjects. Platelet volume was strongly dependent on the anticoagulant in a time-dependent manner. MPV was lowest with citrate/glutaraldehyde and highest with EDTA. The maximum difference was 30% at 60 min both in whole blood and PRP. However, this was true only at 4 and 20°C. At 37°C, there was a constant rise in MPV using citrate/glutaraldehyde exceeding volume changes seen with the other anticoagulants. Platelet volume was higher in whole blood as compared to PRP. The difference was dependent on the anticoagulant used and the incubation time (1.8 fl for EDTA and 1.35 fl for citrate/glutaraldehyde, at 60 min). To determine the influence of platelet loss due to PRP preparation on this effect, we determined platelet volume in parallel from whole blood, PRP and the platelet population separated from whole blood by a linear Percoll gradient (n=5, recovery 94%). MPV was 7.6 fl in whole blood, 5.4 fl in PRP and 6.8 fl from the gradient (anticoagulant: citrate/glutaraldehyde). Platelet volume parameters highly depend on anticoagulation, incubation time and temperature. For clinical studies we recommend anticoagulation with citrate/glutaraldehyde and measurement within 2 hr at room temperature in whole blood.

scholarly journals Platelet volume analysis for differential diagnosis of thrombocytosis.

1986 ◽  
Vol 39 (2) ◽  
pp. 129-133 ◽  
Author(s):  
J Van der Lelie ◽  
A K Von dem Borne
Keyword(s):  
Differential Diagnosis ◽  
Platelet Volume ◽  
Volume Analysis

Inhibitor treatment by rituximabin congenital haemophilia A

2009 ◽  
Vol 29 (02) ◽  
pp. 151-154 ◽  
Author(s):  
Escuriola Ettingshausen ◽  
R. Linde ◽  
G. Kropshofer ◽  
L.-B. Zimmerhackl ◽  
W. Kreuz ◽  
...  
Keyword(s):  
B Cell ◽  
Immune Tolerance ◽  
High Titre ◽  
Clotting Factor ◽  
Severe Bleeding ◽  
High Morbidity ◽  
Haemophilia A ◽  
Concomitant Treatment ◽  
Bleeding Tendency ◽  
Severe Haemophilia

SummaryThe development of neutralizing alloanti-bodies (inhibitors) to factor VIII (FVIII) is one of the most serious complications in the treatment of haemophiliacs. Inhibitors occur in approximately 20 to 30% of previously untreated patients (PUPs), predominantly children, with severe haemophilia A within the first 50 exposure days (ED). Immune tolerance induction (ITI) leads to complete elimination of the inhibitor in up to 80% of the patients and offers the possibility to restore regular FVIII prophylaxis. However, patients with high titre inhibitors, in whom standard ITI fails, usually impose with high morbidity and mortality and therefore prompting physicians to alternate therapy regimens. Rituximab, an anti-CD 20 monoclonal antibody has been successfully used in children and adults for the management of B-cell mediated disorders. We report on the use of a new protocol including rituximab in two adolescents with severe haemophilia A and high titre inhibitors, severe bleeding tendency and high clotting factor consumption after failing standard ITI. Both patients received a concomitant treatment with FVIII according to the Bonn protocol, cyclosporine A and immunoglobulin. Treatment with rituximab resulted in a temporary B-cell depletion leading to the disappearance of the inhibitor. FVIII recovery and half-life turned towards normal ranges. In patient 1 the inhibitor reappeared 14 months after the last rituximab administration. In patient 2 complete immune tolerance could be achieved for 60 months. Bleeding frequency diminished significantly and clinical joint status improved in both patients. In patient 1 the treatment course was complicated by aspergillosis and hepatitis B infection. Conclusion: Rituximab may be favourable for patients with congenital haemophilia, high-titre inhibitors and a severe clinical course in whom standard ITI has failed. Prospective studies are required to determine safety, efficacy and predictors of success.

Von-Willebrand-Syndrom Typ 1 und Schwangerschaft

2011 ◽  
Vol 31 (S 01) ◽  
pp. S11-S13 ◽  
Author(s):  
J. Oppermann ◽  
A. Siegemund ◽  
R. Schobess ◽  
U. Scholz
Keyword(s):  
Clinical Presentation ◽  
Bleeding Disorder ◽  
Bleeding Tendency ◽  
Laboratory Findings ◽  
Mucous Membranes ◽  
Von Willebrand

SummaryThe von Willebrand-Jürgens syndrome (VWJS) type 1 is a common hereditary bleeding disorder with a bleeding tendency located especially in the mucous membranes. Women suffering from VWJS type 1 show menorrhagia and prolonged postoperative bleedings. During pregnancy the clinical presentation varies by the increase of the von Willebrand factors.In this article the laboratory findings and the clinical presentation of patients with VWJS during pregnancy was examined. The necessity of interventions during pregnancy and at the time of delivery was under consideration.

Klinische und labordiagnostische Parameter bei 21 Hunden mit primärer immunvermittelter Thrombozytopenie

2011 ◽  
Vol 39 (01) ◽  
pp. 17-24 ◽  
Author(s):  
H. J. Schuberth ◽  
R. Mischke ◽  
B. Dircks
Keyword(s):  
Mean Platelet Volume ◽  
Platelet Volume ◽  
Klinische Relevanz

Zusammenfassung Gegenstand und Ziel: Charakterisierung von klinischen und labordiagnostischen Parametern sowie Therapie und Krankheitsverlauf bei Hunden mit einer angenommenen primären immunvermittelten Thrombozytopenie (pIMT) und Identifizierung möglicher Besonderheiten im Vergleich zu Hunden mit einer sekundären immunvermittelten Thrombozytopenie (sIMT). Material und Methoden: Retrospektive Auswertung von Patientendaten thrombozytopenischer Hunde, bei denen plättchengebundene Antikörper mittels Durchflusszytometrie nachgewiesen wurden. Ergebnisse: Dreizehn der 21 Hunde (62%) mit einer pIMT waren männlich. Das mittlere Alter bei Erstvorstellung betrug 6,6 Jahre (1,6–13,5 Jahre [Median; Minimum–Maximum]). Blutungen, hauptsächlich in Form von Haut- und Schleimhautblutungen, lagen bei 18 Hunden (86%) vor. Neunzehn Hunde (91%) wiesen eine Thrombozytenzahl unter 20000/μl auf. Bei allen Hunden mit einer pIMT ergab sich ein mittleres Thrombozytenvolumen (mean platelet volume, MPV) im oder unter dem Referenzbereich. In nahezu allen Fällen bestand eine gesteigerte Megakaryopoeseaktivität. Der Vergleich zweier Therapieregime (Prednisolon versus Prednisolon und Azathioprin) zeigte keinen signifikanten Unterschied bezüglich der Zeit bis zum Erreichen einer Thrombozytenzahl im Referenzbereich. Zwischen Patienten mit pIMT oder sIMT ließ sich im Hinblick auf Alter und Geschlecht kein signifikanter Unterschied feststellen. Bei Hunden mit einer pIMT waren Thrombozytenzahl und MPV signifikant niedriger und die Megakaryopoeseaktivität signifikant häufiger erhöht. Schlussfolgerung und klinische Relevanz: Bei Hunden, die plättchengebundene Antikörper und zusätzlich eine schwere Thrombozytopenie, ein niedriges MPV und eine gesteigerte Megakaryopoeseaktivität aufweisen, ist eine pIMT naheliegend.

Azidothymidine (AZT) in the Treatment of Symptomatic HIV-1-Infected Hemophiliacs

1990 ◽  
Vol 64 (01) ◽  
pp. 108-112 ◽  
Author(s):  
S Eichinger ◽  
I Pabinger ◽  
H Hartl ◽  
C Stain ◽  
S Mayerhofer ◽  
...  
Keyword(s):  
Risk Groups ◽  
Clotting Factor ◽  
Bleeding Tendency ◽  
Probability Of Survival ◽  
Immunodeficiency Virus ◽  
Progression Of Disease ◽  
Bleeding Episodes ◽  
Clotting Factor Concentrates ◽  
Dose Dependent ◽  
Hiv 1

SummaryTwenty-one immunodeficiency virus 1 (HIV 1)-positive hemophilic patients were treated with Azidothymidine (AZT) for symptomatic HIV infection. The median observation period was 20.5 months.At 25 months the probability of survival was 82%, the probability of progression of disease from CDC III or IV C2 to IV C1 (AIDS) was 20% in patients on continuous AZT treatment and 50% in patients with intermption of treatment. Three patients developed severe leukopenia and 3 patients severe anemii during AZT treatment. In 1 patient a dose-dependent striking increase of transaminases during AZT treatment was observed. In 7 patients treatment was intermpted, in 1 patient because of anemia, in 1 because of pruritus and in 5 patients because of noncompliance.No signiticant changes in the consumption of clotting factor concentrates and number of bleeding episodes before and during AZT treatment were noted.We conclude, that both hematological and non-hematological side effects of AZT in HIV 1-infected hemophilic patientr ur. comparable to those seen in other risk groups . AzT does not increase the bleeding tendency in this patient group.

Essential Athrombia

1975 ◽  
Vol 33 (02) ◽  
pp. 278-285 ◽  
Author(s):  
Şeref Inceman ◽  
Yücel Tangün
Keyword(s):  
Platelet Aggregation ◽  
Bleeding Time ◽  
Bleeding Tendency ◽  
Clot Retraction ◽  
Platelet Factor ◽  
Prolonged Bleeding Time ◽  
Normal Platelet ◽  
Aggregation Response ◽  
Platelet Disorder ◽  
Fibrinogen Content

SummaryA constitutional platelet function disorder in a twelve-year-old girl characterized by a lifelong bleeding tendency, prolonged bleeding time, normal platelet count, normal clot retraction, normal platelet factor 3 activity and impaired platelet aggregation was reported.Platelet aggregation, studied turbidimetrically, was absent in the presence of usual doses of ADP (1–4 μM), although a small wave of primary aggregation was obtained by very large ADP concentrations (25–50 μM). The platelets were also unresponsive to epinephrine, thrombin and diluted collagen suspensions. But an almost normal aggregation response occurred with strong collagen suspensions. The platelets responded to Ristocetin. Pelease of platelet ADP was found to be normal by collagen and thrombin, but impaired by kaolin. Platelet fibrinogen content was normal.The present case, investigated with recent methods, confirms the existence of a type of primary functional platelet disorder characterized solely by an aggregation defect, described in 1955 and 1962 under the name of “essential athrombia.”

Gastric Fibrinolysis

1975 ◽  
Vol 34 (02) ◽  
pp. 409-418 ◽  
Author(s):  
I. M Nilsson ◽  
S.-E Bergentz ◽  
U Hedner ◽  
K Kullenberg
Keyword(s):  
Gastric Ulcer ◽  
Gastric Juice ◽  
High Activity ◽  
Fibrinolytic Activity ◽  
Duodenal Juice ◽  
Bleeding Tendency ◽  
Local Fibrinolysis ◽  
Heated Plates

SummaryGastric juice from 15 normals, 20 patients with gastric ulcer and 4 patients with erosive haemorrhagic gastroduodenitis was investigated in respect of its activity on unheated and heated fibrin plates and its content of FDP and plasminogen or plasmin with immunochemical methods. Gastric juice from normals showed no activity on unheated and heated fibrin plates, and no FDP or plasminogen could be demonstrated. In the patients with gastric ulcer the gastric juice showed little or no fibrinolytic activity on fibrin plates except in 2, who had regurgitation of duodenal juice and neutral pH of the juice. These patients had equally high activity on heated as on unheated plates and no plasmin could be demonstrated. It was shown that this activity was not due to fibrinolysis, but to non-specific proteolytic activity (probably trypsin). The patients with erosive haemorrhagic gastroduodenitis exhibited quite a different picture. The gastric juice from these patients showed extremely high activity on fibrin plates, the activity was higher on unheated than on heated plates. The activity was inhibited in vitro by addition of EACA and in vivo after administration of AMCA. The occurrence of plasmin could be demonstrated directly immunologically in the gastric juice. By comparison of plasmin and trypsin in various assays it could further be proved that the gastric juice in these cases contained plasminogen activator and plasmin. The patients with erosive haemorrhagic gastroduodenitis showed no increase in fibrinolysis in the blood, but low values for plasminogen and α2M, and the serum contained FDP. These findings in the blood and gastric juice were interpreted as signs of local fibrinolysis in the stomach and duodenum. There is reason to assume that this gastric fibrinolysis contributes substantially to the bleeding tendency. The effect of administration of AMCA on fibrinolytic activity and the haemorrhage lends support to the assumption of such a mechanism.

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