Low Platelet Counts: Diagnosis Using Flow Cytometry and Anti Platelet Antibody.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3966-3966
Author(s):  
Joao Carlos C. Guerra ◽  
Ruth H. Kanayama ◽  
Sonia S. Nozawa ◽  
Marcia R. Ioshida ◽  
Irina Y. Takihi ◽  
...  
Keyword(s):  
Platelet Count ◽  
Direct Method ◽  
Biochemical Tests ◽  
Platelet Counts ◽  
Normal Platelet ◽  
Laboratory Error ◽  
Unusual Phenomenon ◽  
Reference Service ◽  
Children And Young Adults ◽  
Platelet Antibody

Abstract In our service of hematology 9,1 % of all consults are related to low platelet number finding in the CBC. Pseudothormbocytopenia is a rather unusual phenomenon, induced by agglutination of platelets by auto-antibodies acting on EDTA collected blood. Objective: Classify, diagnose and analyze low platelet counts as obtained by automatic blood counters. Methods: From January 1997 to May 2005; 16761 patients were attended in our service. Among them, 1174 cases (7,0%), 429 males and 745 females (1 to 75 years), were there because of low platelet counts alone. Platelet counts were done by Coulter T-890, with blood collected in EDTA K3 and sodium citrate. Counts were repeated after letting blood at 4o C for 24 hours; also Fonio technique and Neubauer camera counts were done. Normal value was defined as platelet count between 150,000 to 450,000. Bone marrow was obtained when necessary and stained by conventional techniques. Serological and biochemical tests were done in a Cobas Core (Roche) machine. Immuno-phenotyping was done in 115 cases, to identify anti-platelet-antibody (CD41 PE Immunotech and anti human IgG FTIC conjugate Sigma)-direct method, by flow citometry (Coulter Epics XL-MCL). Results: Among the 1158 cases, platelets counts between 120 000 to 150 000, were found in 15.8 %; laboratory error in 6,3 % and spurious low platelet counts in 1.3 %. In addition, the follow up for four years of those patients with “lower normal” platelet count (120 000 to 150 000) did not show any morbid process. Immunologycal idiopatic purpura (ITP) was diagnosed in 49,1 % of the cases, being as expected, more frequent in females, children and young adults. Hepatitis C as cause of low platelet counts was responsible for 6,9 % and HIV infection for 1.3 % of the cases Anti-platelet antibodies were present in 76.9 % of ITP cases and was not found in 88.3 % of normal platelet values. Conclusions: In an hematological reference service should be considered a lower range for normal platelet values (120 000 to 450 000). Additionally, low platelet counts as diagnosed by automated machines should be confirmed by slide exam and anti platelet antibody is useful for asserting ITP diagnosis and to rule out spurious thrombocytopenia or normal values.

Use of the Megathrombocyte to Demonstrate Thrombopoietin

1972 ◽  
Vol 28 (01) ◽  
pp. 024-030
Author(s):  
Weiner Marc ◽  
Karpatkin Simon
Keyword(s):  
Platelet Count ◽  
Guinea Pig ◽  
Guinea Pigs ◽  
Platelet Counts ◽  
Normal Platelet ◽  
Large Platelet ◽  
Platelet Number ◽  
Lag Period ◽  
Platelet Antibody

SummaryQuantitation of megathrombocyte (large platelet) number was used as an assay for the detection of a humorally-transmitted thrombopoietic stimulus, thrombopoietin. Donor guinea pigs were depleted of circulating platelets by the injection of rabbit anti-guinea pig platelet antibody. Plasma from these donor guinea pigs, when injected into recipient guinea pigs raised their platelet count 1.5 fold and their megathrombocyte number 2.7 fold when compared to plasma injected from donor guinea pigs with normal platelet counts. A lag period of 4 to 5 days preceded the rise in platelet count and megathrombocyte number.

scholarly journals Quantitation of platelet-associated IgG by radial immunodiffusion

Blood ◽  
1981 ◽  
Vol 57 (4) ◽  
pp. 809-811 ◽  
Author(s):  
BS Morse ◽  
D Giuliani ◽  
M Nussbaum
Keyword(s):  
Platelet Count ◽  
Immune Thrombocytopenic Purpura ◽  
Radial Immunodiffusion ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Normal Platelet ◽  
Serum Igg ◽  
Acute Itp ◽  
Igg Level

Abstract Platelet-associated IgG (PAIgG) was measured by a simple radial immunodiffusion technique using washed solubilized platelets and commercially available immunoplates. Subjects with normal platelet counts had PAIgG levels of 1.5--7.0 fg/platelet. Subjects with idiopathic immune thrombocytopenic purpura (ITP) had levels ranging from 5.7 to 70.5 fg/platelet. All patients with recurrent ITP and 85% of patients with acute ITP had elevated PAIgg. Elevated PAIgG was also found in 17% of patients with recovered ITP, 40% of patients with SLE and thrombocytopenia, 57% of patients with thrombocytopenia occurring during the course of septicemia, and 100% of patients with IgG myeloma in whom the serum IgG level was clearly elevated, regardless of the platelet count. The results are similar to reports that used more complex techniques.

Preoperative thrombocytosis as a predictor of unfavorable survival in resectable non-small cell lung cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e18531-e18531
Author(s):  
Jiwen Wang ◽  
Min Luo ◽  
Hanmo Wu ◽  
Liming Sheng ◽  
Dan Su ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Platelet Count ◽  
Small Cell Lung Cancer ◽  
Disease Progression ◽  
Early Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Platelet Counts ◽  
Normal Platelet Count ◽  
Normal Platelet

e18531 Background: Activated platelet is thought to promote cancer cells growth and metastasis, playing an important role in progression of cancer. However, the association between platelet counts and prognosis of patient with non small cell lung cancer (NSCLC) had not been fully elucidated. The aim of this study is to investigate the prognostic value of platelet counts in resectable NSCLC. Methods: A total of 636 primary NSCLC patients who had curatively resected surgery in Zhejiang Cancer Hospital from November 2006 to January 2011 were retrospectively analyzed. Preoperative platelet counts and clinicopathological factors were collected from the medical record database. Patients were followed up for disease progression free survival (PDS) and overall survival (OS) until January 20, 2013. The association between platelet counts and patients’ outcome were evaluated. Results: In all patients, 13.8% (88/636) had increased platelet count (>300 × 109/L), referred to as thrombocytosis. The proportion of thrombocytosis was significantly higher in male, squamous-cell carcinoma and stage III than that in female, other histological types and early stage NSCLC. Moreover, thrombocytosis was associated with significantly shortened survival. Multivariate Cox analysis showed patient with thrombocytosis not only had a 1.66 time elevated risk for disease progression (95% CI, 1.14-2.41, p=0.009), but also had and a 1.47 time risk for death (95% CI, 1.04-2.08, P=0.029), compared with that in those having normal platelet count. More interestingly, the risk for replase was increased to 3.19 times (95% CI, 1.41-7.23, p=0.006) in stage I NSCLC with thrombocytosis than that in patients with normal platelet count after stratified analysis by stage. Conclusions: Preoperative platelet count is an independent prognostic predictor in operable NSCLC, especially in early stage I NSCLC. Platelet count may serve as a useful indicator and potential target for personalized treatment with antiplatelet reagent.

Effects of biological variations on platelet count in healthy subjects in China

2004 ◽  
Vol 91 (02) ◽  
pp. 367-372 ◽  
Author(s):  
Jing Yang ◽  
Xiaojun Lu ◽  
Tokuhiro Okada ◽  
Tamiaki Kondo ◽  
Changgeng Ruan ◽  
...  
Keyword(s):  
Platelet Count ◽  
Mean Platelet Volume ◽  
Healthy Subjects ◽  
Bleeding Time ◽  
Platelet Volume ◽  
Platelet Counts ◽  
Normal Platelet Count ◽  
Normal Platelet ◽  
Low Platelet Count ◽  
The Mean

SummaryThe effects of biological variations on platelet counts were investigated in 694 healthy subjects aged 18 to 60 years living in three cities including Chengdu (Sichuan Province), Suzhou (Jiangsu Province) and Harbin (Heilongjang Province) in China. Platelet counts in healthy subjects were significantly lower in Chengdu (52∼202 X 109/L) and Suzhou (60∼259 X 109/L) than in Harbin (154∼348 X 109/L)(p <0.0001), but the mean platelet volume (MPV) determined concurrently was negatively correlated with platelet count, the MPV values were significantly higher in Chengdu (11.8∼15.6 fl) and Suzhou (10.9∼15.8 fl) than in Harbin (9.5∼12.9 fl) (p < 0.0001). Platelet counts were significantly higher in summer (73∼289 X 109/L) than in winter (52∼202 X 109/L) (p <0.0001), but the MPV values were lower in summer (11.2∼14.7 fl) than in winter (11.8∼15.6 fl) (p <0.05) in Chengdu. Platelet associated immunoglobulin (PA-IgG) in Chengdu was revealed to be significantly higher in the low platelet count group (<150 X 109/L, 13.5 ± 7.1 ng/107 PLT) than in the normal platelet count group (≥150 X 109/L, 8.3 ± 2.7 ng/107 PLT)(p <0.0001). Similar results were observed in Suzhou for the reticulated platelet ratio, which was significantly higher in the low platelet count group (19.5 ± 7.1%) than in the normal platelet count group (11.6 ± 2.7%)(p <0.01). The bleeding time in Chengdu showed a significantly longer time in the low platelet count group (8.6 ± 2.3 min) than in the normal platelet count group (6.0 ± 1.2 min)(p <0.01). With regard to the effects of lipids on platelet counts, the HDL values were significantly higher in the normal platelet count group (1.60 ± 0.76 mmol/L) than the low platelet count group (1.23 ± 0.31 mmol/L) (p <0.01); but no significant differences in cholesterol and triglycerides values between the normal and low platelet count groups (p >0.05) were recorded. These findings suggest that the platelet counts could be greatly influenced in healthy subjects by biological variations such as geographical, seasonal, and lipid variations.

Thrombopoietin (TPO) Levels in Inflammatory Disorders with or without Reactive Thrombocytosis.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 1111-1111
Author(s):  
Patrizia Noris ◽  
Iride F. Ceresa ◽  
Chiara Ambaglio ◽  
Luca M. Dezzani ◽  
Carlo L. Balduini
Keyword(s):  
Platelet Count ◽  
Acute Phase ◽  
Acute Phase Protein ◽  
Strong Positive Correlation ◽  
Reactive Thrombocytosis ◽  
Inflammatory Disorders ◽  
Platelet Counts ◽  
Normal Platelet Count ◽  
Normal Platelet ◽  
Phase Protein

Abstract TPO, the primary regulator of megakaryopoiesis, is produced at a constant rate and is removed from the circulation by adsorption to specific receptors on platelet and megakaryocyte surfaces. An inverse relationship between platelet count and TPO therefore exists in healthy subjects. However, a few studies in patients with reactive thrombocytosis identified levels of the hormone higher than expected, and suggested that TPO behaves as an acute-phase protein and was responsible for increased platelet count. At the opposite, other studies did not find any significant rise of the hormone in patients who similarly developed reactive thrombocytosis. To gain further information on this topic, we compared TPO levels and platelet counts in two series of hospitalized patients: one (53 patients aged 73 ± 17 years) with strong elevation of both erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and the other (28 age-matched control patients) with normal values. All subjects had been admitted to hospital for acute illnesses: infections, cancer, heart failure or ischemia, stroke, deep vein thrombosis or pancreatitis. Within the group of subjects with high ESR and CRP, 38 had normal platelet counts, while 15 had thrombocytosis at the admittance (n=9) or developed it during their stay (n=6). No thrombocytosis was observed in control patients. Patients with high acute phase indexes had significantly higher TPO levels (R&D Systems, Minneapolis, USA) and platelet counts than control patients (TPO 189.55pg/ml ± 139 vs 62.04pg/ml ± 83, p<0.0001; platelets 310×109/L ± 98 vs 242×109/L ± 67, p=0.0016). Since similar TPO and platelet values were found in patients grouped according to their disorders, we assumed that the acute phase, but not the basic illness, was responsible for the increase of TPO and platelets. We identified strong, positive correlations between ESRc (ESR corrected for Hct) and CRP (r=0.809, p<0.0001), but only weak correlations between TPO and CRP (r=0.584, p<0.0001). Interestingly, no significant relationship between platelet counts and TPO levels (r=0.180, p=NS) was find. When we grouped patients with acute-phase reaction according to absence (platelets 280×109/L ± 61) or presence (platelets 516×109/L ± 105) of thrombocytosis, we found similar TPO values (184pg/ml ± 146 vs 203.4pg/ml ± 126, p=NS). By measuring plasma glycocalicin (GC, Takara Bio Inc. Shiga, Japan) and estimating the glycocalicin index (GCI, by normalizing GC levels for the individual platelet count), which reflects platelet turnover, we excluded that shortened platelet survival masked increased platelet production in subjects with inflammatory conditions and normal platelet count. In fact, identical values of GCI were found in patients with normal platelet count or thrombocytosis (2.434 ± 1.4 vs 2.496 ± 2.5). Finally, no correlation was detected between TPO and GCI (r=0.003, p=NS). Conversely, a strong positive correlation between IL-6 (R&D Systems) and CRP (r=0.692, p<0.0001), and a trend towards correlation between platelet count and IL-6 (r=0.493, p<0.0001) and between TPO and IL-6 (r=0.484, p<0.0001) have been identified. All together our results confirm that TPO acts as an acute phase protein but exclude the possibility that it is uniquely responsible for thrombocytosis of inflammatory disorders, which might recognize in IL-6 a credible candidate as a cooperating factor.

scholarly journals Rearrangements of chromosome 3 involving bands 3q21 and 3q26 are associated with normal or elevated platelet counts in acute nonlymphocytic leukemia

Blood ◽  
1985 ◽  
Vol 66 (6) ◽  
pp. 1362-1370 ◽  
Author(s):  
MA Bitter ◽  
ME Neilly ◽  
MM Le Beau ◽  
MG Pearson ◽  
JD Rowley
Keyword(s):  
Platelet Count ◽  
Chromosome 3 ◽  
Acute Nonlymphocytic Leukemia ◽  
Structural Rearrangements ◽  
Platelet Counts ◽  
Normal Platelet Count ◽  
Normal Platelet ◽  
British System ◽  
French American British

Abstract Fourteen patients with acute nonlymphocytic leukemia (ANLL) or dysmyelopoietic syndromes were found to have abnormalities involving the long arm of chromosome 3. In eight patients, the structural rearrangements involved both bands 3q21 and 3q26 and included t(3;3) (four patients), inv(3) (three patients), and ins(5;3) (one patient). Before treatment, seven of these eight patients had platelet counts above 100,000 per microliter, five had normal or elevated platelet counts, and four had significantly elevated platelet counts (600,000 to 1,731,000 per microliter). In each of the eight cases, normal or elevated platelet counts were associated with marked abnormalities of megakaryocytopoiesis, including increased numbers of megakaryocytes and numerous micromegakaryocytes. Classification within the French-American- British system was difficult in most of these cases; however, the leukemia in five of the eight patients with abnormalities of chromosome 3 that involved both bands 3q21 and 3q26 was classified as M4. The remaining six of the 14 patients had translocations between chromosome 3 and another chromosome. None involved both bands 3q21 and 3q26, and a break in either q21 or q26 was noted in only two patients. One of the six, who had ANLL (M4) with a normal platelet count, had a 3;5 translocation which involved band 3q25. These data suggest that in patients with ANLL, abnormalities of chromosome 3 which simultaneously involve bands 3q21 and 3q26 are associated with unusually high platelet counts.

scholarly journals Improvement of platelet counts in steroid-unresponsive idiopathic immune thrombocytopenic purpura after short-course therapy with recombinant alpha 2b interferon [see comments]

Blood ◽  
1989 ◽  
Vol 74 (6) ◽  
pp. 1894-1897 ◽  
Author(s):  
SJ Proctor ◽  
G Jackson ◽  
P Carey ◽  
A Stark ◽  
R Finney ◽  
...  
Keyword(s):  
Platelet Count ◽  
Partial Response ◽  
Immune Thrombocytopenia ◽  
Initial Response ◽  
Complete Responder ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Normal Platelet ◽  
Short Course ◽  
Steroid Refractory

Abstract In 13 patients with severe steroid-refractory idiopathic immune thrombocytopenia (ITP), a short course of recombinant alpha 2b interferon (IFN), given at a dose of 3 MU for 12 doses, caused a significant increase in platelet count in 11 patients. The rise in platelet count occurred following completion of the short course of IFN in 10 patients and occurred during therapy in one patient. Three patients showed an increase to normal platelet counts within 14 days of discontinuing the drug, eight showed a partial response, with a platelet count increase from 30 to 100 x 10(9)/L, and two patients showed minimal response. One complete responder relapsed at 5 months from initial response, and a further course of alpha 2b IFN caused a second prompt response with a rise of platelet count to supranormal levels. Short-course alpha 2b IFN can be recommended as a therapy for severe ITP. Responses are seen in splenectomized and nonsplenectomized subjects, and thrombocytopenia is not exacerbated during treatment.

scholarly journals P.038 Bilateral carotid thrombi and cerebral infarction as a manifestation of heparin-induced thrombocytopenia with normal platelet count: a case report

2019 ◽  
Vol 46 (s1) ◽  
pp. S24 ◽  
Author(s):  
P Malla
Keyword(s):  
Platelet Count ◽  
Sudden Onset ◽  
Serotonin Release ◽  
Heparin Induced Thrombocytopenia ◽  
Platelet Counts ◽  
Normal Platelet ◽  
Bilateral Carotid ◽  
Upper And Lower Extremities ◽  
Release Assay ◽  
Discharge From Hospital

Background: This is the first report of Heparin induced thrombocytopenia (HIT) presenting as bilateral carotid thrombi and multiple cerebral infarcts. Methods: 54 year old woman presented with sudden onset of right arm numbness and weakness two days after discharge from hospital. During her hospitalization 9 days prior, she underwent colovesicular fistula repair, received heparin subcutaneously for DVT prophylaxis and had normal platelet counts. Results: On this admission, MRI Brain showed scattered multiple acute infarcts within the cortex of bilateral cerebral hemispheres. CT angiography head /neck showed non-occlusive thrombi at the carotid bifurcations bilaterally. Platelet count on admission was 267 K/uL q which decreased to 125 K/uL the next day, after which heparin was started for the carotid thrombi. The platelet count rapidly decreased further to 79 K/uL leading to suspicion for HIT and switching to Argatroban. HIT and serotonin release assay were positive confirming the diagnosis of HIT. CT chest and tranthoracic echocardiogram was normal. Venous Duplex of bilateral upper and lower extremities were negative for DVTs.Hypercoaguable evaluation was negative. Conclusions: This case highlights the importance of identifying HIT as a cause of arterial thrombosis and stroke even with normal platelet counts in the clinical setting of recent heparin use.

scholarly journals Cancer incidence following a high-normal platelet count: cohort study using electronic healthcare records from English primary care

2020 ◽  
Vol 70 (698) ◽  
pp. e622-e628
Author(s):  
Luke TA Mounce ◽  
Willie Hamilton ◽  
Sarah ER Bailey
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Platelet Count ◽  
Cancer Incidence ◽  
Clinical Practice Research Datalink ◽  
Normal Range ◽  
Platelet Counts ◽  
Normal Platelet Count ◽  
Normal Platelet ◽  
One Year

BackgroundA raised platelet count (thrombocytosis) measuring >400 × 109/l is associated with high cancer incidence. It is uncertain whether platelet counts at the upper end of the normal range (high-normal: 326–400 × 109/l) are also associated with cancer.AimTo investigate cancer incidence following a normal platelet count in primary care.Design and settingA prospective cohort study was undertaken using data from the Clinical Practice Research Datalink and National Cancer Registration and Analysis Service, dating from 1 May 2005 to 30 April 2014.MethodOne-year cancer incidence was estimated for 295 312 patients with normal platelet counts (150–400 × 109/l). Patients with platelet counts >325 × 109/l were oversampled to maximise precision of estimates of cancer incidence. All patients were aged ≥40 years with no prior cancer diagnoses. The effects of age, sex, and smoking were explored. Non-melanoma skin cancers were omitted from exclusions and incidence.ResultsOne-year cancer incidence increased greatly with age, male sex, and higher platelet count. Males aged ≥60 years with a high-normal count had an incidence of 4.2% (95% confidence interval [CI] = 4.0 to 4.4). The highest incidence of 6.7% (95% CI = 5.3 to 8.4) was found in males aged ≥80 years, who had platelets in the range of 376–400 × 109/l; this was 3.1 percentage points higher than the incidence for patients in the same age group with lower-normal counts of 150–325 × 109/l. Risks for all female subgroups were <3%. Patients with high-normal platelet counts were most at risk of lung and colorectal cancers and, in general, had advanced-stage cancer at diagnosis.ConclusionPlatelet counts at the high-normal range in males aged ≥60 years may be indicative of an underlying malignancy, and referral for further investigation should be considered.

scholarly journals Prognostic significance of thrombocytosis in idiopathic sideroblastic anemia

Blood ◽  
1977 ◽  
Vol 50 (3) ◽  
pp. 427-432 ◽  
Author(s):  
RR Streeter ◽  
CA Presant ◽  
E Reinhard
Keyword(s):  
Platelet Count ◽  
Acute Leukemia ◽  
Case Reports ◽  
Prognostic Significance ◽  
Additional Case ◽  
Literature Analysis ◽  
Sideroblastic Anemia ◽  
Leukemic Transformation ◽  
Platelet Counts ◽  
Normal Platelet

Abstract In order to determine the prognostic significance of thrombocytosis in idiopathic sideroblastic anemia, the clinical courses of 17 patients were reviewed. Six patients (36%) had thrombocytosis, and none developed acute leukemia. Nine patients (53%) had normal platelet counts, and one developed acute leukemia. Two patients (12%) were thrombocytopenic, and one died of acute leukemia. There was little correlation between survival and platelet count. Sixty-three additional case reports of idiopathic sideroblastic anemia were collected from the literature. Analysis of those patients and the patients in the present study documented transformation to acute leukemia in 5 of 9 (56%) thrombocytopenic patients, 4 of 54 (7.4%) patients with normal platelet counts, and 0 of 17 patients with thrombocytosis (p less than 0.05). Therefore patients with idiopathic sideroblastic anemia and thrombocytosis appear to have a decreased likelihood of leukemic transformation.

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