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PubMed1968

Inherited thrombocytopenia with thrombasthenia.

A family with congenital thrombocytopenia is described through four generations where the mode of inheritance appears to be an autosomal dominant. Spontaneous bruising of varying severity, menorrhagia, and profuse bleeding at operation necessitating transfusion were predominant in the history. Platelet function tests were performed on the various patients. Platelet aggregation by adenosine diphosphate (ADP) was found to be defective, though liberation of platelet factor III and platelet thromboplastic function were found to be normal when corrected for deficient numbers.

Adult↗
PubMed2005

Platelet dysfunction-eosinophilia syndrome in parasitized Venezuelan children.

Platelet dysfunction was detected in six children with purpura and eosinophilia. We conducted clinical evaluations, hematologic and platelet function tests, clotting studies (bleeding time, prothrombin time, partial thromboplastin time, thrombin time, factor XIII, factor VIII, and von Willebrand factor), assays for IgG and IgM antibodies to platelets, and a search for stool parasites. Mild bleeding phenomena (ecchymoses, petechiae, epistaxis, and gingival) were transient. All children showed intestinal parasites and marked eosinophilia (mean count = 2,615.2 cells/muL, 95% confidence interval = 1,259.6-5,429.8). Main abnormalities included prolonged bleeding times (50%) and defective aggregation with collagen (100%) adrenaline (66%), or ADP (66%). Antibodies to platelets were not detected. Anti-parasite therapy reversed the hemorrhagic manifestations and normalized eosinophil counts and platelet alterations. No relationship could be established between excess eosinophils, intensity of bleeding, or type and degree of platelet abnormalities. Thrombocytopathic features mimicked the intrinsic defect of storage pool disease. The possible pathogenic roles of eosinophilia and parasitism are reviewed. This is the first report of this pathologic combination in Latin American children.

Blood Coagulation Tests↗
PubMed1997

Alterations of platelet, coagulation, and fibrinolysis markers in patients with acute ischemic stroke.

Alterations of platelet, coagulation, and fibrinolysis markers were investigated to determine the indications for antithrombotic therapy in patients with different clinical categories of acute cerebral infarction. Marked platelet activation was observed in platelet function tests, including measurements of platelet-specific proteins and platelet survival, platelet scintigraphy in the brain, and platelet fibrinogen binding assay, in patients with atherothrombotic stroke. Among patients with atherothrombotic stroke, increases of thrombin-antithrombin III complex (TAT) and D-dimer were frequent in addition to the findings of platelet activation in patients showing progressing stroke. Patients with cardioembolic stroke demonstrated marked elevation of coagulation markers, TAT and fibrinopeptide A, and fibrinolysis markers, D-dimer and plasmin-alpha2-plasmin inhibitor complex, as well as platelet activation. In contrast, neither activation was seen in patients with lacunar stroke. On the basis of these findings, antiplatelet therapy is indicated for stable or improving stroke, whereas anticoagulant therapy is indicated for progressing stroke among patients with atherothrombotic stroke. In patients with cardioembolic stroke, anticoagulant therapy should be started as soon as possible, or should be followed by thrombolytic therapy in the hyperacute phase. However, further investigation appears necessary for recommendations for patients with lacunar stroke.

Acute Disease↗
PubMed2006

Inhibitory effects of ticlopidine on platelet function as assessed by three different methods.

The inhibitory effects of ticlopidine on platelet function were evaluated in 18 healthy male volunteers using three different platelet function tests. Three methods include the recently developed small collagen-beads method, which evaluates the platelet response in whole blood samples under shear stress conditions, the conventional platelet aggregometry and a cone-plate viscometer which measures shear-induced platelet aggregation (SIPA). The latter two methods use platelet-rich plasma as measurement samples instead of whole blood. SIPA was significantly inhibited by the oral intake of ticlopidine. The conventional platelet aggregometry detected significant inhibition of ticlopidine on ADP-induced platelet aggregation. In contrast, ticlopidine moderately inhibited platelet aggregation induced by low concentrations of collagen, but not by high concentrations of collagen. With the collagen-bead column method, ticlopidine significantly inhibited platelet retention rates when the retention rates exceeded 30% prior to ticlopidine uptake. On the other hand, there was no significant inhibition when the original retention rates prior to ticlopidine uptake were below 30%. The three methods all proved useful to evaluate the effect of ticlopidine on platelet function. However, taking into consideration easy procedures, lower costs and use of whole blood samples under shear stress conditions, we suggest the collagen-bead column can serve as an appropriate method for monitoring ticlopidine therapy.

Blood Platelets↗
PubMed1987

Platelet functions, alpha 2-adrenergic receptors and cytoplasmic free calcium are normal in the myotonic dystrophy of Steinert.

Platelet function tests were performed on 11 patients with myotonic dystrophy of Steinert (MD) and on 21 healthy control subjects. Using citrated platelet-rich plasma or washed platelets, MD patients had normal aggregation and secretion responses after stimulation with adrenaline, ADP, collagen, PAF, arachidonic acid and thrombin. Using intact and functional washed platelets, MD patients responded normally to adrenaline and had a similar affinity and number of alpha 2-adrenergic receptors as control patients as measured by [3H]dihydroergocryptine and [3H]yohimbine binding. In addition platelets from MD patients had normal basal and stimulated levels of cytoplasmic free Ca2+ as measured with the fluorescent Ca2+ probe quin2. Thus platelet functions, alpha 2-adrenergic receptors and cytoplasmic free Ca2+ are normal in MD.

Adenosine Diphosphate↗
PubMed1993

Platelet, antithrombin, and fibrinolytic activities in taurine-deficient and taurine-replete cats.

Cats with cardiomyopathy, especially dilated cardiomyopathy associated with taurine deficiency, often develop systemic thrombi. To investigate the relation of taurine deficiency to formation and persistence of thrombi, cats were made taurine-deficient by consumption of a casein-based taurine-deficient diet, then were evaluated for anticoagulant and profibrinolytic activities and platelet function. The cats served as their own controls in the taurine-replete state; then, values were compared for the taurine-deficient state. Plasma (P < 0.01), blood (P < 0.05), and platelet (P < 0.05) taurine concentrations were decreased markedly after cats consumed the taurine-deficient diet for 6 weeks, compared with baseline concentrations before diet. Compared with the taurine-replete state, taurine deficiency induced significantly (P < 0.05) increased mean antithrombin III activity, no significant change in plasminogen and fibrinolytic activities, and similar clot retraction/lysis test results. Decreased (P < 0.01) adenosine diphosphate (ADP)-induced platelet aggregation and [14C]serotonin release, and slightly increased (P < 0.05) collagen-induced platelet [14C]serotonin release, but unchanged collagen-induced platelet aggregation were observed in taurine-deficient cats, compared with taurine-replete cats. Changes in antithrombin III activity most likely reflected hepatocellular acute-phase reaction, which indicates that taurine deficiency may induce a stress-responsive state. Results of platelet function testing indicate that taurine may modulate platelet responsiveness to physiologic agonists, but not in consistent manner. That platelets from the taurine-deficient cats had decreased responsiveness to ADP, but increased responsiveness to collagen is surprising, because irreversible aggregation is mediated by release of granule-associated ADP after sufficient initial stimulus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Diphosphate↗
PubMed1985

[Circulating platelet aggregates in patients with acute ischemic and so-called chronic cerebrovascular disorders].

A modified platelet function test was assessed as a routine method in 71 normal subjects and 96 patients. In patients with cerebral infarction (33) and those with transitory ischaemic attacks (30) definite changes in platelet function were demonstrated. In patients with cerebrovascular insufficiency (33) there was significantly increased platelet aggregation, but in only 46% of these patients were the values over 3 standard deviations above the mean of the control group (71).

Adult↗
PubMed1984

Assessment of platelet function in patients with Raynaud's syndrome.

Platelet function was studied in 11 patients with Raynaud's syndrome and 11 healthy controls. Platelets obtained from patients with Raynaud's syndrome were significantly more responsive to adrenaline, produced more thromboxane A2, and were resistant to prostaglandin inhibitors (prostacyclin and prostaglandin E1) of platelet aggregation. Platelets from control subjects and patients with Raynaud's syndrome were more resistant to prostaglandin inhibitors when reactions were carried out at 27 degrees C rather than at 37 degrees C. Patients with Raynaud's syndrome also had significantly increased plasma concentrations of beta-thromboglobulin, fibrinogen, and circulating platelet aggregates. In an attempt to elicit local platelet responses, the forearms of control subjects and patients with Raynaud's syndrome were cooled in water tanks and platelet function tests performed before and after cooling. No significant difference in the results was observed. The potential role of platelets in the pathogenesis of Raynaud's syndrome is discussed.

Adult↗
PubMed2003

Tomatoes have natural anti-thrombotic effects.

The prevention of arterial thrombotic diseases has a high priority in developed countries. An inappropriate diet may be an important risk factor for thrombotic events. The daily intake of an anti-thrombotic diet may offer a convenient and effective way of prevention. The aim of the present study was to test tomato extracts for anti-thrombotic effects and to identify those varieties that have such an effect. A shear-induced platelet-function test (haemostatometry) was used to test anti-thrombotic potential in vitro. Extracts from those tomato varieties that showed a significant anti-thrombotic activity in vitro were further assessed in vivo, using a laser-induced thrombosis test in mice. One tomato variety (KG99-4) showed significant anti-thrombotic activity both in vitro and in vivo. KG99-4 inhibited not only platelet-rich thrombus formation but also had a thrombolytic effect. It is concluded that haemostatometry can detect and classify the anti-thrombotic potential of fruits and vegetables and offers a simple way of screening for such effects.

Animals↗
PubMed1990

A study of 31 patients with easy bruising from University Hospital, Kuala Lumpur.

Thirty one patients were investigated for the main complaint of easy bruising. These patients had normal platelet count with no past history of immune thrombocytopenia or systemic disorders known to predispose to bruising and a negative drug history. The evaluation of these patients included clinical review (history and physical examination) plus coagulation tests consisting of bleeding time, prothrombin time, partial thromboplastin time, thrombin time, fibrinogen level, FXIII screen and platelet functions test. Seven of the paediatric patients had acquired platelet dysfunction with eosinophilia (APDE). In 17 (94.4%) of the 18 adult patients no abnormality was demonstrated. Hence APDE was the commonest cause of easy bruising in children while the haemostatic defect contributing to easy bruising in adults remained unknown.

Adolescent↗
PubMed2006

Platelet function of newborns as tested by cone and plate(let) analyzer correlates with gestational Age.

UNLABELLED: The issue of platelet function in infants and neonates is of interest, and current data are debatable. A new method for assessing platelet function involves using the cone and plate(let) analyzer (CPA), applicable for small (0.2 ml) whole blood volumes. We used polystyrene surface-coated plates to evaluate cord blood neonatal platelet function under flow. One hundred and sixty full-term and 29 preterm infants born at the Sheba Medical Center between March 2003 and January 2004 were evaluated for platelet adhesion measured as surface coverage (SC; the percentage of total area covered by platelets) and platelet aggregation, defined as the average size (AS) of the aggregates. Platelets from preterm infants displayed less platelet adhesion than did those from full-term infants. Platelet SC correlated with gestational age in all infants (p < 0.05), and both groups exhibited similar aggregation (AS). AS values, however, were significantly lower than the normal adult range in our laboratory. Infants born to mothers with pregnancy-induced hypertension displayed significantly lower SC. No association was found between CPA and postnatal complications. CONCLUSION: CPA provides a rapid, feasible option for testing platelet function in neonates. Its potential predictive value deserves further attention, and more extensive studies are warranted.

Adult↗
PubMed2006

Impact of platelet testing on presurgical screening and implications for cardiac and noncardiac surgical procedures.

Bleeding is a common complication of cardiac surgery, accounting for a significant portion of the total transfusions performed in the United States. This may be due in part to surgical factors and to the fibrinolysis and platelet activation induced by cardiopulmonary bypass. The increasing frequency with which antiplatelet medications are used to prevent thrombosis in cardiac surgical patients with cardiovascular disease also elevates the risk for postoperative bleeding. The resulting coagulopathy and need for transfusions may increase morbidity and mortality risk in cardiac surgical patients, depending on the specific antiplatelet agent used, as well as on patient factors. Empiric platelet transfusion, the frequency of which varies greatly among institutions, does not reliably prevent these complications and may even increase the risk for adverse outcomes. Platelet function testing, particularly with newer testing systems, may be a valuable tool for making decisions about stopping antiplatelet drug administration, surgical timing with respect to bleeding risk, and platelet transfusion in cardiac surgical patients.

Cardiac Surgical Procedures↗
PubMed2005

Platelet refractoriness to classical agonists in a child with essential thrombocythemia.

BACKGROUND: Essential thrombocythemia is a rare disease during childhood. Platelet morphological abnormalities are frequent and defects in platelet function tests, mainly hypoaggregation, occur. MATERIALS AND METHODS: An incidental diagnosis of essential thrombocythemia was established in a 9-year-old boy with a platelet count of 2050 x 10(9)/l. His platelets were studied for aggregation defects with four classical agonists employing optical aggregometry. RESULTS: Aggregation ranged from 5% for adrenaline, 8% for collagen, 12% for ristocetin, to 25% with adenosine diphosphate, followed by complete disaggregation. CONCLUSION: Platelet refractoriness to classical agonists, probably compounded by platelet GPIb deficiency, was documented. The differential diagnosis is discussed.

Adenosine Diphosphate↗
PubMed1989

Applications of ultraviolet light in the preparation of platelet concentrates.

Passenger lymphocytes in platelet concentrates (PCs) may induce the formation of lymphocytotoxic antibodies (LCTAbs) and subsequent refractoriness to platelet transfusions. Ultraviolet (UV) irradiation can prevent lymphocytes' acting as stimulator or responder cells in mixed-lymphocyte reactions (MLRs) and could theoretically prevent LCTAb formation in vivo. A system has been devised for the delivery of UV irradiation to PCs; platelet storage characteristics and MLRs were evaluated in UV-irradiated PCs harvested from healthy donors with the Haemonetics V50 and PCS cell separators. MLR and response to phytohemagglutinin stimulation were abolished by a dose of 3000 joules per m2 at a mean wavelength of 310 nm. Platelet aggregatory responses to adenosine diphosphate (ADP), ristocetin, collagen and epinephrine, hypotonic shock response, and pH showed no important differences when control PCs and PCs irradiated as above were compared during 5 days of storage in Fenwal PL-1240 packs. Lactate production during storage was significantly higher in UV-treated PCs (p less than 0.001), but values did not exceed 20 mmol per L. UV transmission at 310 nm in standard blood product containers, including the Fenwal PL-146, PL-1240, and PL-732, was low (less than 30%), but it was acceptable in the Delmed Cryostorage and DuPont SteriCell packs (greater than 50%). UV irradiation may provide a simple and inexpensive means of producing nonimmunogenic PCs.

Blood Platelets↗
PubMedDate not supplied

Platelets and coronary heart disease: potential psychophysiologic mechanisms.

Although there has been extensive research attempting to identify psychophysiologic mechanisms linking psychological events and behavior patterns with risk for coronary heart disease, these are important potential mechanisms that remain largely unexplored. One of these mechanisms is thrombosis, which is widely recognized as the precipitant of acute coronary events (myocardial infarction and sudden ischemic death). A major element in arterial thrombosis is the platelet, and platelet inhibition has been shown to be effective in preventing coronary events. In the present paper, platelet physiology and pathophysiology are reviewed. Platelet function testing and the clinical role of platelet activation in atherosclerosis and acute coronary events are also discussed. Because epinephrine and possibly shear stress are clinically important activators of platelets, it is proposed that platelet reactivity to psychological stress may be a major mechanism in coronary events. The literature to date supports the hypothesis that platelet activity is increased by emotional stress. Suggestions are made for future research in this area.

Animals↗
PubMed1995

A novel hereditary macrothrombocytopenia.

PURPOSE: A family is described in which macrothrombocytopenia and hearing loss are transmitted in an autosomal-dominant fashion. PATIENTS AND METHODS: Several members of the family were studied extensively. Review of blood smears, coagulation studies, platelet function testing, and electron microscopy were performed. Platelet membrane glycoproteins were examined using flourescein-conjugated antibodies and flow cytometry. RESULTS: Platelet counts ranged from 50,000 to 123,000/microliters. Both mean platelet diameter and volume were increased. No leukocyte inclusions were noted by light or electron microscopy. Platelet aggregation was normal with adenosine diphosphate (ADP), collagen, and ristocetin but diminished with epinephrine and arachidonic acid. Flow cytometry showed normal platelet membrane glycoproteins and the unusual expression of glycophorin A on 40-60% of the giant platelets. CONCLUSIONS: This family's syndrome of macrothrombocytopenia and late-onset hearing loss appears to represent a novel giant platelet disorder. The expression of glycophorin A suggests disordered megakaryocytopoiesis with the early release of immature platelets.

Adult↗
PubMed1994

Influence of calcium antagonists on platelet function and vascular prostacyclin production.

It is suggested that calcium antagonists can counteract the process of atherogenesis by influencing different cellular mechanisms, for example, inhibiting cellular migration and proliferation, as well as by having beneficial effects on lipid metabolism and platelet function. In an assessment of the activity of different calcium antagonists in various platelet function tests and prostacyclin (PGI2) synthesis, amlodipine, diltiazem, felodipine, isradipine, nicardipine, nifedipine, nitrendipine and verapamil were tested in vitro for their effects on adenosine diphosphate (ADP)- or collagen-induced platelet aggregation, malondialdehyde (MDA) formation and vascular PGI2 production. Nitrendipine, isradipine and nicardipine were shown to inhibit both ADP- and collagen-induced platelet aggregation at the lowest concentration (0.5 microgram/ml). The half-maximum inhibiting concentration (IC50) of isradipine (4.78 +/- 0.36 micrograms/ml for ADP-induced platelet aggregation) was significantly (p < 0.01) lower than the IC50 of all the other drugs. Nitrendipine, with an IC50 of 44.2 +/- 5.32 micrograms/ml, and nicardipine, with an IC50 of 46.74 +/- 3.83 micrograms/ml, were respectively the second and third most effective compounds. Formation of MDA was also inhibited the most by isradipine, which exerted its inhibitory properties at one-fifth the concentration needed with the other agents: the IC50 of isradipine was 0.98 +/- 0.16 microgram/ml, which was significantly different (p < 0.05) compared with the second most effective agent, verapamil, which had an IC50 of 14.92 +/- 3.78 micrograms/ml. In-vitro PGI2 production was stimulated the most by isradipine as well, producing a significant (p < 0.01) increase to 417.8 +/- 47.6 pg/mg tissue/h (control: 296.4 +/- 17.6 pg/mg tissue/h) at a concentration of 0.5 microgram/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Diphosphate↗
PubMed1991

Platelet activation by emotional stress in patients with coronary artery disease.

We studied the effects of experimentally induced emotional stress (mental arithmetic) on different hemodynamic parameters, catecholamine levels, and serum and platelet function tests in 25 postinfarction patients and in 10 apparently healthy, age-matched control subjects. Mental stress (10 minutes) induced significant increments in heart rate, systolic blood pressure, diastolic blood pressure, double product, and cardiac output, indicating a sympatho-adrenal stimulation that was confirmed by a significant increase in serum epinephrine and norepinephrine levels. All of the effects disappeared at minute 10 of recovery. Concomitantly, the test produced a significant increase in platelet aggregation (induced by 3 microM ADP or 1 microgram/ml collagen), the formation of circulating platelet aggregates, and an increase in thromboxane B2 levels in plasma and serum. These effects were also rapidly reversible. Similar activation of hemodynamic parameters and a similar but less evident increase in platelet function by emotional stress were observed in control subjects. A possible artifact due to factitious platelet activation by catheter sampling was excluded with experiments in which a 40-minute rest was introduced after the baseline period and before mental stress; platelet activation did not occur during baseline or rest periods, only after emotional stress. Furthermore, the antiplatelet drug dipyridamole reduced the stress-induced formation of platelet aggregates in postinfarction patients. These results demonstrate the existence of a direct link between emotional stress and platelet function and offer an explanation of one of the mechanisms through which mental stress may be involved in the development of coronary artery disease.

Coronary Disease↗