scholarly journals Microscopic platelet size and morphology in various hematologic disorders

Blood ◽  
1978 ◽  
Vol 51 (3) ◽  
pp. 479-486
Author(s):  
Z Zeigler ◽  
S Murphy ◽  
FH Gardner
Keyword(s):  
Idiopathic Thrombocytopenic Purpura ◽  
Lupus Erythematosus ◽  
Thrombocytopenic Purpura ◽  
Hematologic Disorders ◽  
Platelet Counts ◽  
Normal Platelet ◽  
Large Size ◽  
Platelet Size ◽  
Microscopic Evaluation ◽  
Size And Morphology

Microscopic evaluation of apparent platelet size and morphology was examined in a variety of hematologic disorders. The time of preparation of the blood smear was important. An artifactual increase in platelet size was noted on blood films from 20 normal individuals that were prepared either immediately or 180 min after venipuncture. The clearest differentiation of patient categories was obtained with smears prepared 60 min after venipuncture using blood anticoagulated with K3EDTA. Under these conditions, normal size and morphology values were found in thrombocytopenic patients with aplasia or with increased splenic pooling. In contrast, large size values were a reliable finding in idiopathic thrombocytopenic purpura patients, whose platelet counts were less than 50,000/microleter. Large size values were also noted in patients with infiltrated bone marrows or myeloproliferative syndromes regardless of the platelet count. The last two groups usually showed abnormal platelet morphology with greater than 10% hypogranular platelets. Normal platelet size and morphology were observed in patients with iron-deficiency and megaloblastic anemias and in patients with idiopathic thrombocytopenic purpura and systemic lupus erythematosus who had normal platelet counts.

scholarly journals Microscopic platelet size and morphology in various hematologic disorders

Blood ◽  
1978 ◽  
Vol 51 (3) ◽  
pp. 479-486 ◽  
Author(s):  
Z Zeigler ◽  
S Murphy ◽  
FH Gardner
Keyword(s):  
Idiopathic Thrombocytopenic Purpura ◽  
Lupus Erythematosus ◽  
Thrombocytopenic Purpura ◽  
Hematologic Disorders ◽  
Platelet Counts ◽  
Normal Platelet ◽  
Large Size ◽  
Platelet Size ◽  
Microscopic Evaluation ◽  
Size And Morphology

Abstract Microscopic evaluation of apparent platelet size and morphology was examined in a variety of hematologic disorders. The time of preparation of the blood smear was important. An artifactual increase in platelet size was noted on blood films from 20 normal individuals that were prepared either immediately or 180 min after venipuncture. The clearest differentiation of patient categories was obtained with smears prepared 60 min after venipuncture using blood anticoagulated with K3EDTA. Under these conditions, normal size and morphology values were found in thrombocytopenic patients with aplasia or with increased splenic pooling. In contrast, large size values were a reliable finding in idiopathic thrombocytopenic purpura patients, whose platelet counts were less than 50,000/microleter. Large size values were also noted in patients with infiltrated bone marrows or myeloproliferative syndromes regardless of the platelet count. The last two groups usually showed abnormal platelet morphology with greater than 10% hypogranular platelets. Normal platelet size and morphology were observed in patients with iron-deficiency and megaloblastic anemias and in patients with idiopathic thrombocytopenic purpura and systemic lupus erythematosus who had normal platelet counts.

Platelet Counts Remain Elevated in Two Patients with Idiopathic Thrombocytopenic Purpura after Cessation of Oral Eltrombopag.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3927-3927 ◽  
Author(s):  
Gregory Cheng
Keyword(s):  
Idiopathic Thrombocytopenic Purpura ◽  
Platelet Destruction ◽  
Double Blind ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Normal Platelet ◽  
Baseline Levels ◽  
Platelet Growth Factor ◽  
Dose Dependent Increase ◽  
Dose Dependent

Abstract Idiopathic thrombocytopenic purpura (ITP) is a disease of inadequate platelet production and increased platelet destruction. Two randomized, double-blind, placebo-controlled trials (TRA100773 A/B) reported that eltrombopag, the first-in-class, oral, platelet growth factor, results in a dose-dependent increase in platelet counts in adult patients with chronic ITP. After treatment of eltrombopag was stopped, platelet counts returned to baseline levels in most patients within 2 weeks, reflecting the normal platelet lifespan (range, 10–14 days). This abstract presents data on two patients enrolled in TRA100773 A/B in whom a prolonged platelet count elevation was observed after cessation of eltrombopag treatment. A 79-year old Asian female (Patient 1) was diagnosed with ITP in September 2003. Prior ITP therapy included prednisolone and Danazol simultaneously in 1997. Prednisolone was stopped after 10 months. Danazol was continued until March 2005 (Day -50). The patient relapsed in March 2005 and received dexamethasone (5 days), IVIg (once), vincristine, and cyclosporin A without a significant response. Eltrombopag treatment was started in May 2005 leading to an increase in platelet counts that remained elevated above 100,000/uL after treatment with eltrombopag was discontinued (Table). Patient 2, a 49-year old Asian female, was diagnosed with ITP in 1997. She relapsed after two courses of dexmethasone 40 mg, QD × 4, administered in September 2003 with a 3-month response and in January 2006 with a 1-month response. Therapy with eltrombopag was initiated in March 2006. As was seen with Patient 1, platelet counts increased after administration of eltrombopag and remained elevated after cessation of eltrombopag (Table). To the best of our knowledge, this is the first report of an ongoing prolonged elevation of platelet counts after cessation of thrombopoietic medication, such as eltrombopag. Platelet Counts (/uL) Patient 1 Patient 2 *Eltrombpag withdrawn in both patients. Screening 26,000 69,000 Day 1 26,000 26,000 Day 8 193,000 136,000 Day 15* 591,000 283,000 Day 22 664,000 --- Day 50 --- 260,000 Day 57 330,000 116,000 Day 71 112,000 100,000 Day 85 116,000 111,000

scholarly journals Thrombocytopenia: diagnosis with flow cytometry and antiplatelet antibodies

2011 ◽  
Vol 9 (2) ◽  
pp. 130-134
Author(s):  
João Carlos de Campos Guerra ◽  
Ruth Hissae Kanayama ◽  
Sonia Tsukasa Nozawa ◽  
Márcia Regina Ioshida ◽  
Irina Yoko Takiri ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Hepatitis C ◽  
Hiv Infection ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Direct Method ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Antiplatelet Antibodies ◽  
Normal Platelet ◽  
Platelet Autoantibodies

Objective: To identify antiplatelet antibodies by flow cytometry (direct method) in patients with thrombocytopenia. Methods: Between January 1997 and March 2004 a total of 15100 patients were referred to the Centro de Hematologia de São Paulo for hematological investigation of several diagnoses (anemia, leukopenia, thrombocytopenia, coagulation abnormalities, adenomegaly, leukemia and others). Of those, 1057 were referred because of thrombocytopenia and were divided into two groups: Group Idiopathic thrombocytopenic purpura, with no identifiable cause; and Group Other thrombocytopenia, which included low normal platelet counts cause to be established, hepatitis C and HIV infection, hypersplenism, EDTA-induced artifacts, laboratory error, and other causes. Flow cytometry immunophenotyping was done in 115 cases to identify platelet autoantibodies (direct method). Results: Of the total number of patients, 1057 (7%) presented low platelet counts, 670 were females (63.4%) and age range of one to 75 years. Of the 115 cases (9.7%) submitted to immunophenotyping, the results were positive in 40% and the test was inconclusive in 5%. Idiopathic thrombocytopenic purpura was found in 52% of patients, more often in women. Hepatitis C virus infection was found in 7% and HIV infection in 1%. Low normal platelet counts were found in 17%, laboratory errors in 6%, and laboratory artifacts in 1% of cases. Platelet autoantibodies were found in 76.9% of all idiopathic thrombocytopenic purpura cases. It was negative in 83.3% of the low normal counts. Conclusion: antiplatelet autoantibodies when present help to diagnose idiopathic thrombocytopenic purpura. When absent, suggest other causes of thrombocytopenia.

scholarly journals Subarachnoid Haemorrhage Complicating Resistant Idiopathic Thrombocytopenic Purpura: A Case Report

2014 ◽  
Vol 4 (2) ◽  
pp. 105-107
Author(s):  
Farhana Afroz ◽  
Hasna Fahmima Haque ◽  
Samira Rahat Afroze ◽  
Muhammad Abdur Rahim ◽  
Aparna Rahman ◽  
...  
Keyword(s):  
Case Report ◽  
Autoimmune Disease ◽  
Subarachnoid Haemorrhage ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Conservative Management ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Chronic Itp

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease where low platelet counts predisposeto various bleeding tendencies; intracranial haemorrhageis one of them. It is a rare and devastating complication of ITP, mostly presenting as intracerebral (ICH) or subarachnoid haemorrhage (SAH). Here, we report a 32-year-old splenectomized chronic ITP patient on corticosteroid and azathioprine, in whom spontaneous SAH developed. In this case, conservative management resulted in clinicoradiological improvement and showed eventual favourable out-come.Birdem Med J 2014; 4(2): 105-107

Abnormalities In Platelet Arachidonic Acid Metabolism In Chronic Idiopathic Thrombocytopenic Purpura

1981 ◽  
Author(s):  
M J Stuart ◽  
J G Kelton ◽  
J B Allen
Keyword(s):  
Arachidonic Acid ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Inverse Correlation ◽  
Arachidonic Acid Metabolism ◽  
Thromboxane B2 ◽  
Bleeding Tendency ◽  
Chronic Idiopathic Thrombocytopenic Purpura ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts ◽  
Platelet Thromboxane

Patients with chronic idiopathic thrombocytopenic purpura (CITP) have been described to have bleeding times (B.Ts) that were shorter than would be predicted by their platelet counts. This phenomenon was explained by the presence in CITP of a young platelet population with increased hemostatic competence (NEJM 287:155, ’72). In contradistinction, we have observed patients with CITP to have a bleeding tendency at platelet counts >75,000/cu mm. We therefore evaluated B.Ts and platelet arachidonic acid (AA) metabolism in 7 patients with CITP who demonstrated increased amounts of platelet associated IgG (PAIgG >3fg per platelet) and compared them to 20 healthy controls. 3/7 patients with CITP and platelet counts of >75,000/cu mm demonstrated marked prolongations in their B.Ts. (10’, 12’ and 14’, normal <7’). Marked abnormalities in the metabolism of AA through the cyclo-oxygenase (Thromboxane B2 and HHT) and lipoxygenase (HETE) pathways were also observed in patients with CITP. Platelets in CITP synthesized less amounts (p <0.005) of Thromboxane B2 (10.3 ± 3.1%) in comparison to controls (22.9 ± 1.8). Values for HHT were decreased (23.7 ± 4.9 vs 39.7 ± 1.9; p<0.005), while HETE production was increased (59.5 ± 7.8 vs 30.7 ± 1.8; p<0.001). No correlation was observed between PAIgG and platelet Thromboxane B2 formation. However, an inverse correlation (r=0.81, p<0.05 was observed between the B.T. and platelet Thromboxane B2 formation in patients with chronic ITP. We have demonstrated platelet dysfunction and impaired Thromboxane B2 formation in CITP. This association should be investigated in the individual patient, since the bleeding tendency in these patients is exacerbated by the superimposed impairment in platelet function.

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