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[The functional properties of thrombocytes in patients with suppurative peritonitis].

An examination of 49 patients with local and diffuse purulent peritonitis at different stages of surgical treatment has shown that the pyodestructive process in the abdominal cavity develops against the background of thrombocytosis, thrombocyte destruction, their decreased energy resources and tendency to retarded and irreversible aggregation. To correct the disturbed aggregation properties of thrombocytes the HBO and intraaortal infusions of antiaggregants and vasoactive drugs may be used.

Adolescent↗

Elective splenectomy in haematological disorders.

We report on 106 elective splenectomies performed for haematological disorders between March 1979 and January 1986. The most common indications were immune thrombocytopenic purpura (30 patients) and Hodgkin's disease (19 patients). However, staging laparotomy is no longer performed routinely for patients with Hodgkin's disease and the reasons for this are discussed. Other indications for splenectomy included splenic pain (13 patients), autoimmune haemolytic anaemia (12 patients), hereditary spherocytosis (11 patients) and hypersplenism (9 patients). The overall morbidity and mortality was 48% and 5% respectively. The most common postoperative complication was thrombocytosis (defined as a platelet count greater than 800 X 10(9)/l) and occurred in 26 patients. This review confirms that splenectomy continues to have an important role in the management of certain haematological disorders.

Adolescent↗

Platelet immune complex interaction in the pathogenesis of Kawasaki disease.

We have shown that the thrombocytosis which occurs in the 3rd and 4th week of Kawasaki disease is associated with the appearance in the circulation of platelet aggregating factors detected by the PAT test. These factors induce aggregation and serotonin release from normal platelets. The aggregation can be blocked by EDTA and Prostacyclin. The aggregating factor appears to be of high molecular weight, and its activity was lost following fractionation at low pH. The platelet aggregating activity was significantly associated with the presence of IgG immune complexes, and these features suggest that IgG immune complexes are responsible for the platelet aggregating activity.

Antigen-Antibody Complex↗

Complications of free flap transfers.

Review of 72 cases of free flap transfer showed that flap failure was associated with thrombocytosis and open wounds and that complications were associated with open wounds. Specific biologic variables, therefore, may underlie flap failure and complications, and investigation of these variables could lead to reduced morbidity.

Adult↗

Effect of Haemaphysalis punctata infestation on growing lambs and rabbits.

Lambs infected with adult Haemaphysalis punctata and rabbits infected with nymphs developed a macrocytic normochromic anaemia during seven and six successive infestations, respectively. The anaemia was directly proportional to the degree of infestation but disappeared several days after the termination of infestation. A leucocytosis, due to neutrophilia, was seen in both lambs and rabbits. Rabbits developed a thrombocytosis and reticulocytosis. Infested lambs grew less rapidly than uninfested animals. Signs of tick toxicosis and several other clinical manifestations appeared in both infested sheep and rabbits. Circulating antibodies against salivary antigen of adult H punctata were demonstrated in the sera of infested lambs by the micro-ELISA test. Titres were first detected on day 3 after infestation and increased gradually as infestation progressed. No precipitating antibodies in either infested sheep or rabbits were detected.

Anemia, Macrocytic↗

Thromboelastographic assays of the clotting process in situations of obesity and caloric restriction.

A study on blood clotting has been carried out in a number of obese individuals and compared to a group of non-obese persons, in order to assess if the former can be considered to be in "high risk" regarding the onset of a thromboembolic process. The technique of thromboelastography was chosen. The results point out that in obese people a series of alterations take place, both in the time of clot formation, which is enlarged, as in the organization of its nets, which appear strongly structured, favoured by the hyperfibrinogenemia and thrombocytosis detected in these subjects. Likewise, the effect of a hypocaloric diet on clotting in obese persons has been evaluated and compared with the former groups. Clotting in treated obese individuals is modified in the same way as in the untreated group when compared to the non-obese population; nevertheless, when both groups of obese people are compared, no significant difference is observed in the different parameters studied, even though constants determined in citrated whole blood are closer to normality in the subjects undergoing caloric restriction.

Adolescent↗

[Leg ulcers in congenital dyserythropoietic anemia].

We report on an 18-year-old male patient suffering from leg ulcers due to congenital dyserythropoetic anemia and thrombocytosis. Based on this case, we discuss the importance of hematologic disorders for the development of leg ulcers as well as the pathogenetic mechanisms involved.

Adolescent↗

Evaluation of the in vitro detection of the hypercoagulable state using the thrombin generation test and plasma clot impedance test.

This study reports the correlation of the thrombin generation test and the plasma clot impedance test with clinical evidence of hypercoagulability. Thrombin generation is increased and the rate of change of plasma from a liquid to a gel (clot impedance) is increased in situations where the risk of thrombosis is increased. These situations include increasing clinical signs and/or symptoms of thromboembolism, positive lung scans, postoperative total hip replacement, patients over 40 years old, low serum antithrombin III, thrombocytosis, transient cerebral ischemia, and positive isotope venogram for thrombosis. The two tests failed to indicate a significant effect of antiplatelet drugs on the hypercoagulable state. This study shows that the thrombin generation and plasma clot impedance tests are practical, rapid and useful tests for the detection and monitoring of the hypercoagulable state.

Adult↗

Coeliac disease. Haematological features, and delay in diagnosis.

Seventy patients consecutively diagnosed as having coeliac disease were studied with regard to the clinical and laboratory features of related blood disorders and the delays that occurred in making the eventual correct diagnosis. Eighty-four percent of these patients had some readily demonstrable haematological abnormality. Thrombocytosis was present in 44% of the patients appropriately studied and hyposplenism was diagnosed in 21% of the total group. The importance of associating these conditions with coeliac disease has been stressed. The average delay from the time of initial presentation with relevant symptoms to correct diagnosis was 73 months.

Adolescent↗

[Blood and bone marrow abnormalities in primary lung cancers (author's transl)].

Blood and bone marrow abnormalities accompanying cancers have been known for a while, without yet being understood. The study of 89 patients having lung cancers leads to the following observations: thrombocytosis is frequent and should be considered as a diagnostic criterion; anemia is often associated and we have noticed a correlation between the two. The bone marrow abnormalities shown on biopsy are also frequent, presenting mainly (54/104) as irritative type. This histological pattern becomes a criterion of prognosis, since one should interpret it as a bone marrow reaction to the implantation of cancerous cells. Lastly, no relationship has been found between the blood count and the bone marrow pattern.

Anemia↗

Vindesine in bronchogenic carcinoma: a phase II trial.

Twenty-seven patients with advanced bronchogenic carcinoma were treated with vindesine, 3 mg/m2/week. Twenty-three patients were evaluable for response. Two of six patients with small-cell carcinoma and one of 17 patients with non-small-cell carcinoma had partial responses. Two other patients with non-small-cell carcinoma had minor responses. The duration of the responses was 2-4 months. Neurologic toxicity occurred in 14 patients and was mild except in two patients. There was a median hemoglobin fall of 2.2 g/dl and a median leukocyte nadir of 2800/microliter during vindesine therapy. Thrombocytopenia occurred in 2 patients and mild thrombocytosis occurred in 10 patients. Seven patients experienced phlebitis or cellulitis at the site of drug administration which could be prevented with small doses of intravenous methylprednisolone. These results suggest that vindesine is well tolerated and possesses some activity in patients with previously treated bronchogenic carcinoma.

Adenocarcinoma↗

Acne with acute systemic reaction (acne fulminans?). Report of a case.

A 17-year-old girl, hospitalized because of severe cystic acne of six weeks' duration, developed symptoms of systemic disease, with fever, accelerated erythrocyte sedimentation rate, leukocytosis, thrombocytosis, arthralgia and anemia. Extensive investigation ruled out other possible causes for the systemic involvement, and there was a prompt response to steroid therapy. This case had features similar to those associated with "acute, febrile, ulcerative conglobate acne with poly-arthralgia," except that there was an absence of ulcerative lesions: nonetheless, the dominant picture was that of cystic involvement. We believe that the use of the term "acne fulminans" for this and similar cases would be appropriate.

Acne Vulgaris↗

[Effect on hemostasis and thrombogenesis by septic processes especially in childhood].

In 284 children with sepsis coagulation analyses were carried out. In sepsis in the postnatal period number of thrombocytes, plasminogen, antithrombin III, alpha 2-macroglobulin and factor V were initially decreased on an average, but fibrinogen, alpha 2-antiplasmin, the factors II and X as well as the trypsin inhibitor capacity were increased. The initially on an average reduced parameters often still considerably decreased, in order to increase after this to the norm of age within one to two weeks. The thrombocytopenia longest persists, often to the third week. The components initially found increased on an average in most cases rapidly increase and beyond the norm of age. They behave as acute phase proteins. In sepsis beyond the neonatal period the quality of the acute phase protein is in numerous components still more distinct than in the postnatal period. Several parameters also showed a completely other dynamics: the thrombocytopenia is of lesser size and shorter duration and is very often changed by a thrombocytosis. Here alpha 2-macroglobulin also has the quality of an acute phase protein. From the dynamics observed is concluded that disseminated intravascular coagulation processes frequently accompany the initial phase of the sepsis. They cause an eminent over-production of coagulation components which is limited by their production capacity and partly compensates the defects. The diversity of the constellation is explained by different sizes of consumption and compensation. The parameters in their dynamics have diagnostic valency. As far as the difference from fibrinogen level and number of thrombocytes is concerned it could already proved by simple means.

Bacterial Infections↗

[Partial conservation of the splenic parenchyma in the prevention of hyposplenism after splenectomy. A note on modifications of blood platelet number from the 40th day until normalization (experimental research)].

The authors report the modifications of platelet rate in the blood in a succession of total and partial splenectomies (25%, 50%, 75%) from the 40th day after operation till normalization. The values of platelet rate got back to standard in the 50th day in the animals subjected to 25% splenectomy, and in the 60th, 70th and 80th day from operation in the rats with 50%, 75% and 100% splenectomy. The data remarked suggest the period of thrombocytosis is in direct relation with the entity of plastrinosis, whereas the modalities of decrease are similar in all groups of animals.

Animals↗

Megakaryopoiesis in chronic myeloproliferative diseases. A morphometric evaluation with special emphasis on primary thrombocythemia.

Morphometry was employed on different entities of chronic myeloproliferative diseases (CMPD) and reactive lesions in addition to normal control specimens. The entities studied included: (1) inflammatory reactions of the bone marrow (so-called myelitis in chronic rheumatoid arthritis), (2) chronic granulocytic leukemia (CGL), (3) agnogenic myeloid metaplasia in an early hypercellular stage (so-called chronic megakaryocytic-granulocytic myelosis, CMGM), (4) agnogenic myeloid metaplasia in an advanced fibrosclerotic stage or osteomyelofibrosis/sclerosis (MF/OMS), (5) polycythemia vera (P. vera), (6) reactive thrombocytosis (TH, as a sequel of miscellaneous conditions) and (7) primary (idiopathic, essential) thrombocythemia (PTH). Evaluation was done on plastic-embedded semithin sections with a constant thickness of 3 micron in approximately 20 cases of each group of CMPD. The following parameters were determined: (1) density distributions of the megakaryocyte and non-megakaryocyte compartments, (2) arrangement of megakaryopoiesis in the bone marrow space (i.e., inhomogeneity or clustering) and (3) the fine structure of megakaryocytes in PTH, with a quantitative analysis of the nuclear morphology by circular deviation and contour factors. The megakaryocyte morphology was closely related to a facultative or obligatory increase of the platelet count in these various entities of CMPD and was separable into two major categories: (1) controls, CGL and myelitis versus (2) CMGM, MF/OMS, P. vera, TH and PTH. These two categories were distinguishable by the prominence of megakaryopoiesis in the bone marrow as well as the elevated platelet counts in the periphery. Moreover, in comparison with CMGM and MF/OMS, PTH was characterized by an apparently normal maturation and a conspicuous polyploidization of megakaryocytes according to the nuclear morphology, which was similar to that of P. vera. Our results suggest that PTH presents a monolinear growth of the megakaryopoiesis in the same way as CGL exhibits a monolinear proliferation of the neutrophilic granulopoiesis. This is in contrast to the mixed cellularity of both the megakaryocyte and granulocyte lineage in CMGM and MF/OMS.

Biopsy↗

[Quantitative changes in peripheral blood thrombocytes in chronic alcoholics and experimental alcoholic intoxication in animals].

The time course of changes in peripheral-blood platelet count was examined in 129 alcoholics and 22 alcohol-intoxicated rats. The data obtained point to the existence of cause-and-effect relationships between the thrombocytopenia and thrombocytosis observed in various periods of abstinence on the one hand, and blood coagulation disturbances manifesting themselves in the forms of hemorrhages, thromboses and embolism, on the other.

Alcoholism↗

Connective tissue activation. XII. Platelet abnormalities in patients with rheumatoid arthritis.

Patients with rheumatoid arthritis frequently have an unexplained thrombocytosis which appears to be related to the severity of the disease process. This report shows that rheumatoid platelets have reduced saline soluble protein per 10(9) platelets, less of a lysosomal enzyme, acid phosphatase, and decreased connective tissue activating peptide (CTAP-III) activity. CTAP-III is a potent connective tissue mitogen, and promotes glycolysis and glycosaminoglycan synthesis, characteristics which make it an interesting candidate for a role as a mediator of inflammation.

Acid Phosphatase↗