scholarly journals High Prevalence of Sticky Platelet Syndrome in Patients with Infertility and Pregnancy Loss

2019 ◽  
Vol 8 (9) ◽  
pp. 1328 ◽  
Author(s):  
Eray Yagmur ◽  
Eva Bast ◽  
Anja Susanne Mühlfeld ◽  
Alexander Koch ◽  
Ralf Weiskirchen ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Pregnancy Loss ◽  
Low Dose ◽  
Light Transmission ◽  
Previous History ◽  
Adenosine Diphosphate ◽  
Healthy Controls ◽  
Live Births ◽  
Aggregation Response ◽  
History Of

Platelet hyperaggregability, known as sticky platelet syndrome (SPS), is a prothrombotic disorder that has been increasingly associated with pregnancy loss. In this retrospective study, we aimed to investigate the clinical and diagnostic relevance of SPS in 208 patients with infertility and unexplained pregnancy loss history. We studied 208 patients that had been referred to undergo a dose-dependent platelet aggregation response to adenosine diphosphate and epinephrine using light transmission aggregometry modified by Mammen during an 11-year period. Patients’ platelet aggregation response was compared with platelet function in 29 female healthy controls of fertile age with no previous history of pregnancy loss. We found a prevalence of SPS type II (33.2%) in 208 female patients with infertility and pregnancy loss. ∆-epinephrine-induced platelet aggregation in patients with SPS was significantly decreased (median 7% and range −21 to 43%) compared to patients without SPS (median 59%, range 7–88% and p < 0.0001) and healthy controls (median 57%, range 8–106% and p < 0.0001). The optimum SPS-diagnostic cutoff value for ∆-epinephrine aggregation was ≤32% (sensitivity 95.7%, specificity 95.2%). SPS patients with low-dose acetylsalicylic acid (ASA) therapy (n = 56) showed improved pregnancy outcome (32 pregnancies; live births n = 18 (56%)) compared to SPS patients without low-dose ASA (n = 13) (3 pregnancies; live births n = 1 (33%)). Our study demonstrates the clinical and diagnostic relevance of platelet hyperaggregation in women with infertility and pregnancy loss history. Further studies should investigate the potential of SPS as a novel decisional tool with both diagnostic and clinical implications in infertility and pregnancy loss.

scholarly journals Role of low dose ecosprin and heparin in achieving live births in pregnancy with thrombophilia

2017 ◽  
Vol 6 (12) ◽  
pp. 5261
Author(s):  
Shilpa Asthana ◽  
Bandana Sodhi ◽  
Satish Kumar
Keyword(s):  
Low Dose ◽  
Previous History ◽  
Fetal Loss ◽  
Obstetric Outcomes ◽  
Obstetric Outcome ◽  
Live Births ◽  
History Of ◽  
Chi Square Analysis ◽  
In Pregnancy

Background: Thrombophilia is a disorder of haemostatic system that results in increased tendency of thrombus formation in both venous and arterial vascular system. The thrombotic events are not only restricted to venous thromboembolism but also can cause fetal loss (abortions or recurrent abortions and fetal demise), placental abruption, intrauterine growth restriction and severe pre-eclampsia. This study evaluates the role of administering thromboprophylaxis with heparin and ecosprin to patients with thrombophilia in pregnancy with previous history of adverse obstetric outcomes.Methods: This prospective study was conducted in 60 patients diagnosed with thrombophilia during pregnancy. The objective of the study was to determine the role of administering low dose ecosprin and heparin as thromboprophylaxis in achieving live births in these patients with thrombophilia. All patients included in this study were prophylactically administered low dose ecosprin with either unfractionated heparin (5000 IU s.c, BD) or low molecular weight heparin (40 mg s.c, OD) during pregnancy. Patients were followed up in the antenatal period and the obstetric outcome noted. Comparisons were made between the obstetric outcomes of these patients receiving the aforesaid thromboprophylaxis with those of previous untreated pregnancies during which no ecosprin or heparin had been administered. The data obtained were subjected to statistical analysis using Students ‘t’ test and Chi square analysis. P value <0.05 was considered statistically significant.Results: Fifty nine of the sixty patients with thrombophilia and previous adverse pregnancy outcome who received prophylaxis with ecosprin and heparin during the present pregnancy had live births (98.33%; p <0.0001). Fifty-eight (96.66%) of these patients progressed to term delivery and one (1.67%) pregnancy resulted in a pre-term birth.Conclusions: Present study reveals that prophylaxis with low dose ecosprin and heparin administered to patients with thrombophilia (acquired or inherited) with history of previous adverse obstetric outcome resulted in a positive outcome in terms of a significantly higher number of live births. However, larger studies are needed to further elaborate on the role of thromboprophylaxis in pregnancies with inherited thrombophilia.

First-trimester low-dose prednisolone in refractory antiphospholipid antibody–related pregnancy loss

Blood ◽  
2011 ◽  
Vol 117 (25) ◽  
pp. 6948-6951 ◽  
Author(s):  
Kate Bramham ◽  
Mari Thomas ◽  
Catherine Nelson-Piercy ◽  
Munther Khamashta ◽  
Beverley J. Hunt
Keyword(s):  
Antiphospholipid Antibodies ◽  
Maternal Morbidity ◽  
Pregnancy Loss ◽  
Conventional Treatment ◽  
Low Dose ◽  
First Trimester ◽  
Antiphospholipid Antibody ◽  
Live Births ◽  
Positive Pregnancy Test ◽  
History Of

Abstract The objective of this study was to assess pregnancy outcome in women with a history of refractory antiphospholipid antibody–associated pregnancy loss(es) who were treated with early low-dose prednisolone in addition to aspirin and heparin. Eighteen women with antiphospholipid antibodies who had refractory pregnancy loss(es) were given prednisolone (10 mg) from the time of their positive pregnancy test to 14 weeks' gestation. Before low-dose prednisolone was given as treatment, 4 (4%) of 97 pregnancies had resulted in live births. Among 23 pregnancies supplemented with prednisolone, 9 women had 14 live births (61%), including 8 uncomplicated pregnancies. The remainder were complicated by preterm delivery, preeclampsia, and/or small-for-gestational-age infants. There were 8 first-trimester miscarriages and 1 ectopic pregnancy. There were no fetal deaths after 10 weeks' gestation and no evidence of maternal morbidity. The addition of first-trimester low-dose prednisolone to conventional treatment is worthy of further assessment in the management of refractory antiphospholipid antibody–related pregnancy loss(es), although complications remain elevated.

Increased Response to Arachidonic Acid and U-46619 and Resistance to Inhibitory Prostaglandins in Patients with Chronic Myeloproliferative Disorders

1988 ◽  
Vol 59 (01) ◽  
pp. 073-076 ◽  
Author(s):  
Sergio Cortelazzo ◽  
Monica Galli ◽  
Donatella Castagna ◽  
Piera Viero ◽  
Giovanni de Gaetano ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Arachidonic Acid ◽  
Platelet Aggregation ◽  
Myeloproliferative Disorders ◽  
Bone Marrow Stem Cell ◽  
Healthy Controls ◽  
Aggregation Response ◽  
Thrombotic Complications ◽  
Cyclic Endoperoxide ◽  
Marrow Stem Cell

SummaryIn patients with myeloproliferative disorders (MPD) a group of related diseases of the bone marrow stem cell and recurrent haemorrhagic and/or thrombotic complications, the production of aggregating prostaglandins (PGs) may be normal or slightly reduced, while PGI2 production is normal. However, MPD platelet sensitivity to antiaggregatory PGs is still unknown.We studied the potency of PGD2, PGI2 and PGEi as inhibitors of platelet aggregation induced by threshold aggregating concentrations of arachidonic acid and U-46619-analogue of the cyclic endoperoxide PGH2 in 20 patients with MPD in comparison with healthy controls, with the aim of evaluating the sensitivity of MPD platelets to antiaggregatory PGs. In these patients platelet prostanoid metabolism was normal. However, the functional response of platelets to aggregating and antiaggregating prostanoids was shifted towards potentially increased platelet aggregation response. These findings could have a clinical relevance in view of the haemostatic and thrombotic complications so frequent in MPD.

scholarly journals "Impotent" Platelets in Albinos With Prolonged Bleeding Times

Blood ◽  
1972 ◽  
Vol 39 (4) ◽  
pp. 490-499 ◽  
Author(s):  
Harold M. Maurer ◽  
James A. Wolff ◽  
Sue Buckingham ◽  
Arthur R. Spielvogel
Keyword(s):  
Platelet Aggregation ◽  
Adenosine Diphosphate ◽  
Bleeding Tendency ◽  
Prolonged Bleeding ◽  
Prolonged Bleeding Time ◽  
Normal Platelet ◽  
Tryptophan Metabolites ◽  
History Of

Abstract Functional, biochemical, and morphologic platelet abnormalities are reported in four children with the syndrome of albinism, mild bleeding tendency, prolonged bleeding time, and normal platelet count. In these children, primary platelet aggregation with adenosine diphosphate occurred normally, but secondary aggregation was impaired. Collagen and norepinephrine produced almost no platelet aggregation. Platelet content of serotonin (5-HT) was markedly reduced, and uptake and retention of 5-HT by the platelets in vivo and in vitro was poor. In one child who was given a tryptophan load, urinary tryptophan metabolites were normal, suggesting that there was no evidence of a block in the 5-HT synthetic pathway in the gastrointestinal tract. Electron microscopy revealed an absence of densely osmophilic granules in 5-HT poor platelets. Platelets from other albinos with no history of bleeding contained normal amounts of 5-HT and densely osmophilic granules.

Interspecies Comparison of Platelet Aggregation, LIBS Expression and Clot Retraction: Observed Differences in GPIIb-IIIa Functional Activity

1995 ◽  
Vol 74 (06) ◽  
pp. 1551-1556 ◽  
Author(s):  
Lisa K Jennings ◽  
Melanie M White ◽  
Timothy D Mandrell
Keyword(s):  
Platelet Aggregation ◽  
Conformational Changes ◽  
Low Dose ◽  
Species Differences ◽  
Receptor Occupancy ◽  
Adenosine Diphosphate ◽  
Human Platelets ◽  
Clot Retraction ◽  
Fibrinogen Receptor ◽  
Functional Aspects

SummaryWe examined interspecies differences in the function of the platelet fibrinogen receptor, GPIIb-IIIa, by comparing platelet aggregation responses to adenosine diphosphate (ADP) added alone or in combination with a GPIIIa specific monoclonal antibody (mAb), D3. D3 can activate the GPIIb-IIIa receptor in the absence of platelet activation, and it preferentially binds to a region on the GPIIIa subunit after the GPIIb-IIIa complex is occupied by ligand. Using human, monkey, dog, rabbit and pig platelets, we examined whether all species’ platelets bound the D3 mAb similarly, and if the binding of Arg-Gly-Asp-Ser (RGDS) peptides induced the exposure of the anti-LIBS (D3) epitope as previously described for human platelets. We also evaluated how blocking of this neoantigenic region by the D3 mAb affected clot retraction, a process that requires linkage of GPIIb-IIIa with fibrin(ogen) and the platelet cytoskeleton. We found that all species tested bound the D3 mAb. Only in human and monkey platelets did D3 cause aggregation as well as inhibit clot retraction. However, in all species tested, except for pig, D3 prevented disaggregation of platelets typically observed when platelets are treated with low dose ADP. With the exception of pig platelets, there was increased D3 binding to platelets in the presence of RGDS peptides. We propose that this region of GPIIIa is important in the conformational changes that GPIIb-IIIa undergoes during the binding of ligand in most species tested. Our studies suggest 1) there are measurable inter-species differences in GPIIb-IIIa mediated platelet aggregation and clot retraction, 2) LIBS expression due to receptor occupancy is a common but not all-inclusive response and 3) interspecies comparisons may be useful in understanding structural and functional aspects of platelet GPIIb-IIIa.

C-reactive protein levels are related to suicidality in euthymic patients with bipolar disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S337-S337
Author(s):  
M. Pantovic Stefanovic ◽  
B. Dunjic-Kostic ◽  
M. Lackovic ◽  
A. Damjanovic ◽  
A. Jovanovic ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Previous History ◽  
Control Group ◽  
Healthy Controls ◽  
C Reactive Protein ◽  
Course Of Illness ◽  
Protein Levels ◽  
Reactive Protein ◽  
History Of ◽  
Competing Interest

IntroductionImmune alterations are believed to be an important part in etiopathogenesis of affective disorders. However, it is not clear if the altered immune mediators are related to distinct disorders or particular psychopathology.AimsThe aim of our study was to explore the differences in C-reactive protein levels (CRP) between euthymic BD patients and healthy controls, as well as to explore the relationship between CRP and lifetime presented psychopathology within BD.MethodsThe study group consisted of 83 patients diagnosed with BD, compared to the healthy control group (n = 73) and matched according to age, gender, and body mass index (BMI). Lifetime psychopathology has been assessed according to predominant polarity as well as previous history of suicide attempts and psychotic episodes.ResultsThe CRP levels were significantly higher in BD patients when compared to healthy controls. After covarying for confounders, we observed that CRP levels, in euthymic BD patients, were related to number of previous suicide attempts, but not other indicators of lifetime psychopathology.ConclusionsBD patients per se, and particularly those with more suicide attempts, are more likely to present with proinflammatory state, even when in remission. Previous history of suicide attempts could bear specifically vulnerable endophenotype within BD. Systemic, longitudinal monitoring of the course of illness, and potential inflammatory mediators that underlie its systemic nature is warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals LOW DOSE HCG IN PREVENTING OHSS IN HIGH-RISK WOMEN

2021 ◽  
pp. 7-8
Author(s):  
Dantam Hymavathi Devi
Keyword(s):  
Ovarian Hyperstimulation Syndrome ◽  
Low Dose ◽  
Previous History ◽  
High Serum ◽  
Fertility Treatment ◽  
Ovarian Hyperstimulation ◽  
High Concentration ◽  
High Risk Women ◽  
Increased Risk ◽  
History Of

Ovarian hyperstimulation syndrome(OHSS) is a complication of fertility treatment, which uses pharmacological ovarian stimulation to increase the number of oocytes and therefore embryos available during assisted reproductive technology (ART).Severe ovarian hyperstimulation syndrome (OHSS) is well known to be a rare but potentially fatal condition in anovulatory women with polycystic ovarian syndrome (PCOS) when undergoing IVF. Low-dose stimulation is thus recommended,but it can still lead to ovarian hyperstimulation associated with high serum oestradiol concentrations by the time leading follicles reach maturity. Several methods have, therefore, been applied to prevent OHSS. First, risk assessment is made on the basis of the previous history of OHSS and the identification of women with PCO. Second, in treatment cycles a high concentration of oestradiol and three ultrasound parameters (i.e. high number of follicles, large ovarian volume, and high stromal vascularity) on the day of human chorionic gonadotrophin (HCG) are all predictive of increased risk of developing OHSS.

scholarly journals Use of increased concentrations of adenosinediphosphate for high residual platelet reactivity in patients with coronary heart disease

2021 ◽  
Vol 70 (1) ◽  
pp. 129-132
Author(s):  
O.A. Trubacheva ◽  
S.N. Belyaeva ◽  
T.E. Suslova ◽  
I.V. Petrova
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Platelet Aggregation ◽  
Antiplatelet Therapy ◽  
Light Transmission ◽  
Platelet Reactivity ◽  
Platelet Rich Plasma ◽  
Adenosine Diphosphate ◽  
Transmission Curve ◽  
Platelet Suspension

Detection of a tendency to increased thrombosis in patients with coronary heart disease (CHD) is of important prognostic value in the selection of drugs aimed at achieving a persistent antithrombotic effect. The aim of the study was to evaluate the use of elevated ADP inducer concentrations to improve the accuracy of ADP-induced platelet aggregation in patients with coronary heart disease. Material and method. Material and method. We studied 48 patients with CHD who were on continuous double antiplatelet therapy for 6 months (aspirin 75mg and clopidogrel 75mg per day). The aggregation activity of the platelet suspension was studied using the Born method G. in the modification of Gabbasov Z. A. Platelet activity was evaluated by the degree of aggregation of platelet-rich plasma along the light transmission curve under the influence of the inducer adenosine diphosphate (ADP) at a concentration of 2 mmol/l and by its own patented method against the background of additional ADP application. Results. In patients, platelet aggregation decreased to 5-35% (p<0.005) compared to the standard values, which are 50-60%. The values of platelet aggregation with the additional introduction of the inducer of aggregation ADP in a ratio of 2:1 to 2 µmol/l for 1, 2, 3, and 4-minute registration of platelet aggregation, resulted in increased aggregation from 55% to 75% (p<0.001), indicating high residual platelet reactivity on the background of double antiplatelet therapy. Correlations of the degree of aggregation for elevated ADP concentrations with multivessel arterial lesion and dyslipidemia were also found, r=0.86 and r=0.92, respectively. Conclusion. The use of elevated concentrations of adenosine diphosphate in platelet aggregation in patients with ischemic heart disease increases the accuracy of assessing ADP-induced platelet aggregation against the background of dual antiplatelet therapy and contributes to the detection of high residual platelet reactivity.

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