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Journal of Veterinary Internal Medicine Jan 2022Carcinoma-associated thrombocytosis involves tumor production of mediators such as interleukin-6 (IL-6) and thrombopoietin (TPO) that increase thrombopoiesis and may...
BACKGROUND
Carcinoma-associated thrombocytosis involves tumor production of mediators such as interleukin-6 (IL-6) and thrombopoietin (TPO) that increase thrombopoiesis and may play a role in tumor evasion and metastasis. Carcinoma-associated thrombocytosis is described in people, but has not been described in dogs.
HYPOTHESIS/OBJECTIVES
Evaluate the concentrations of IL-6 and TPO in dogs diagnosed with carcinoma with or without thrombocytosis. We hypothesized that IL-6 and TPO concentrations would be higher in dogs with carcinoma compared to healthy dogs, and that IL-6 and TPO concentrations would be higher in dogs with carcinoma and thrombocytosis when compared to dogs with carcinoma and normal platelet counts.
ANIMALS
One-hundred sixteen dogs: 63 with carcinoma and 53 healthy control dogs.
METHODS
Complete blood count was performed in all dogs, and they were stratified for sub-group analysis based on the presence or absence of thrombocytosis (platelet count > 500 103/µL). Serum TPO and IL-6 concentrations were measured by ELISA. Results of selected numeric variables were compared using Wilcoxon rank sum tests for pairwise comparisons. A value of P < .05 was considered significant.
RESULTS
Twelve of the dogs with carcinoma (12/63, 19.0%) and none of the healthy control dogs (0%) had thrombocytosis. Thrombopoietin concentrations (median [range]) were significantly higher in dogs with carcinoma when compared to controls (87.42 pg/mL [0 to >600] vs 15.99 pg/mL [0 to >600], P < .001). Interleukin-6 concentrations (median [range]) were not different between dogs with carcinoma and healthy control dogs (9.70 pg/mL [0-181.53] vs 3.03 pg/mL [0-280.77], P = .15). In dogs with carcinoma, the TPO and IL-6 concentrations were not different between dogs with thrombocytosis and dogs with normal platelet count.
CONCLUSIONS AND CLINICAL IMPORTANCE
Thrombopoietin concentrations were significantly higher in dogs with carcinoma, regardless of platelet count. Thrombopoietin is likely to be 1 of multiple factors that can impact platelet number, production, and consumption in dogs with carcinoma.
Topics: Animals; Carcinoma; Case-Control Studies; Dog Diseases; Dogs; Interleukin-6; Platelet Count; Thrombocytosis; Thrombopoietin
PubMed: 34881459
DOI: 10.1111/jvim.16317 -
Deutsches Arzteblatt International Nov 2015Thrombocytopenia is, after anemia, the second most common abnormality of the complete blood count in pregnancy, with a reported frequency of 6.6% to 11.2%. It has many... (Review)
Review
BACKGROUND
Thrombocytopenia is, after anemia, the second most common abnormality of the complete blood count in pregnancy, with a reported frequency of 6.6% to 11.2%. It has many causes. Thrombocytopenia should be diagnostically evaluated as early as possible in pregnancy, so that the obstetrical management can be accordingly planned to minimize harm to the mother and child. As the various underlying diseases share clinical features and laboratory findings, the differential diagnosis is often a difficult interdisciplinary challenge.
METHODS
In this article, we review pertinent literature (2000-January 2015) retrieved by a selective search in PubMed.
RESULTS
Gestational thrombocytopenia is the most common type, accounting for 75% of cases, followed by severe pre-eclampsia/HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count) in 15-22% and autoimmune thrombocytopenia (ITP) in 1-4%. Gestational thrombocytopenia and ITP differ in the bleeding history, the severity of thrombocytopenia, the frequency of neo - natal thrombocytopenia, and the rate of normalization of the platelet count after delivery. The HELLP syndrome and rarer microangiopathic hemolytic anemias (e.g., thrombotic thrombocytopenic purpura) can be differentiated on the basis of their main clinical features, such as hypertension/proteinuria and upper abdominal pain, the severity of hemolysis and thrombocytopenia, the degree of transaminase elevation, and the rapidity of postpartum remission of the clinical and laboratory findings. A stepwise diagnostic procedure should be followed to distinguish further causes, e.g., to differentiate thrombocytopenia due to infection, autoimmune disease, or drugs from thrombocytopenia due to a rare hereditary disease.
CONCLUSION
The early interdisciplinary evaluation of thrombocytopenia in pregnancy is a prerequisite for the optimal care of the mother and child. The development of evidence-based recommendations for interdisciplinary management should be a goal for the near future.
Topics: Adolescent; Adult; Algorithms; Diagnosis, Differential; Evidence-Based Medicine; Female; Humans; Medical History Taking; Middle Aged; Platelet Count; Pregnancy; Pregnancy Complications, Hematologic; Prenatal Diagnosis; Reproducibility of Results; Sensitivity and Specificity; Symptom Assessment; Thrombocytopenia; Young Adult
PubMed: 26634939
DOI: 10.3238/arztebl.2015.0795 -
Revista Da Associacao Medica Brasileira... Aug 2020Easily accessible, inexpensive, and widely used laboratory tests that demonstrate the severity of COVID-19 are important. Therefore, in this study, we aimed to...
BACKGROUND
Easily accessible, inexpensive, and widely used laboratory tests that demonstrate the severity of COVID-19 are important. Therefore, in this study, we aimed to investigate the relationship between mortality in COVID-19 and platelet count, Mean Platelet Volume (MPV), and platelet distribution width.
METHODS
In total, 215 COVID-19 patients were included in this study. The patients were divided into two groups. Patients with room air oxygen saturation < 90% were considered as severe COVID-19, and patients with ≥90% were considered moderate COVID-19. Patient medical records and the electronic patient data monitoring system were examined retrospectively. Analyses were performed using the SPSS statistical software. A p-value <0.05 was considered significant.
RESULTS
The patients' mean age was 64,32 ± 16,07 years. According to oxygen saturation, 81 patients had moderate and 134 had severe COVID-19. Our findings revealed that oxygen saturation at admission and the MPV difference between the first and third days of hospitalization were significant parameters in COVID-19 patients for predicting mortality. While mortality was 8.4 times higher in patients who had oxygen saturation under 90 % at hospital admission, 1 unit increase in MPV increased mortality 1.76 times.
CONCLUSION
In addition to the lung capacity of patients, the mean platelet volume may be used as an auxiliary test in predicting the mortality in COVID-19 patients.
Topics: Aged; Aged, 80 and over; Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Mean Platelet Volume; Middle Aged; Pandemics; Platelet Count; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2
PubMed: 32935808
DOI: 10.1590/1806-9282.66.8.1122 -
Blood Advances Oct 2021Fluctuations in platelet count levels over time may help distinguish immune thrombocytopenia (ITP) from other causes of thrombocytopenia. We derived the platelet...
Fluctuations in platelet count levels over time may help distinguish immune thrombocytopenia (ITP) from other causes of thrombocytopenia. We derived the platelet variability index (PVI) to capture both the fluctuations in platelet count measurements and the severity of the thrombocytopenia over time. Raw PVI values, ranging from negative (less severe thrombocytopenia and/or low fluctuations) to positive (more severe thrombocytopenia and/or high fluctuations) were converted to an ordinal PVI score, from 0 to 6. We evaluated the performance characteristics of the PVI score for consecutive adults with thrombocytopenia from the McMaster ITP Registry. We defined patients with definite ITP as those who achieved a platelet count response after treatment with intravenous immune globulin or high-dose corticosteroids and possible ITP as those who never received ITP treatment or did not respond to treatment. Of 841 patients with thrombocytopenia, 104 had definite ITP, 398 had possible ITP, and 339 had non-ITP thrombocytopenia. For patients with definite ITP, the median PVI score was 5 [interquartile range (IQR) 5, 6] for patients with possible ITP, the median PVI score was 3 (1, 5); and for patients with non-ITP thrombocytopenia, the median PVI score was 0 (0, 2). A high PVI score correlated with the diagnosis of definite ITP even when calculated at the patient's initial assessment, before any treatment had been administered. Platelet count fluctuations alone contributed to the specificity of the overall PVI score. The PVI score may help clinicians diagnose ITP among patients who present with thrombocytopenia for evaluation.
Topics: Adult; Blood Platelets; Humans; Immunoglobulins, Intravenous; Platelet Count; Purpura, Thrombocytopenic, Idiopathic; Thrombocytopenia
PubMed: 34516622
DOI: 10.1182/bloodadvances.2020004162 -
Journal of Veterinary Internal Medicine Nov 2017Thrombocytosis is a hematologic abnormality in dogs that has been associated with various neoplastic, metabolic, and inflammatory conditions.
BACKGROUND
Thrombocytosis is a hematologic abnormality in dogs that has been associated with various neoplastic, metabolic, and inflammatory conditions.
OBJECTIVE
To classify thrombocytosis in dogs based on severity and evaluate whether there are associations between severity and underlying disease processes.
ANIMALS
Seven hundred and fifteen dogs with thrombocytosis and 1,430 dogs with normal numbers of platelets.
METHODS
Retrospective study. Medical records of dogs with increased (>500 × 10 /μL; thrombocytosis group) and normal (300-500 × 10 /μL; control group) platelet counts between 2011 and 2015 were reviewed. Dogs were characterized by severity of platelet increase and diagnosis. Diagnostic categories included neoplasia, endocrine disease, inflammatory disease, or miscellaneous.
RESULTS
A total of 1,254 complete blood counts with thrombocytosis from 715 dogs were included in the study. Median platelet count in this population was 582 × 10 /μL (500-1,810 × 10 /μL). No correlation between severity of thrombocytosis and diagnosis was identified. Causes of secondary thrombocytosis included neoplasia (55.7%), endocrine disease (12.0%), and inflammatory disease (46.6%). Immune-mediated disease was common (22.2%), associated with frequent glucocorticoid administration, and had a significantly higher median platelet count (636 × 10 /μL [500-1,262 × 10 /μL] versus 565 × 10 /μL [500-1,810 × 10 /μL]) when compared to the other inflammatory processes (P < 0.001). The diagnoses in the thrombocytosis dogs differed significantly from the control population (P < 0.001).
CONCLUSIONS AND CLINICAL IMPORTANCE
Thrombocytosis is commonly associated with carcinoma and immune-mediated disease in dogs.
Topics: Animals; Autoimmune Diseases; Dog Diseases; Dogs; Endocrine System Diseases; Female; Glucocorticoids; Inflammation; Male; Neoplasms; Platelet Count; Retrospective Studies; Risk Factors; Thrombocytosis
PubMed: 28895208
DOI: 10.1111/jvim.14831 -
Current Oncology (Toronto, Ont.) Feb 2022The prognostic role of platelet count in hepatocellular carcinoma (HCC) remains unclear, and in fact both thrombocytopenia and thrombocytosis are reported as predictors...
The prognostic role of platelet count in hepatocellular carcinoma (HCC) remains unclear, and in fact both thrombocytopenia and thrombocytosis are reported as predictors of unfavourable outcomes. This study aimed to clarify the prognostic value of preoperative platelet count in potentially resectable HCC. We retrospectively reviewed 128 patients who underwent hepatic resection for HCC at a tertiary academic centre (2007−2019). Patient data were modelled by regression analysis, and platelet count was treated as a continuous variable. 89 patients had BCLC 0/A tumours and 39 had BCLC B tumours. Platelet count was higher in patients with larger tumours and lower in patients with higher MELD scores, advanced fibrosis, and portal hypertension (p < 0.001 for all listed variables). After adjusting for BCLC stage and tumour diameter, low platelet count associated with reduced overall survival (hazard ratio 1.25 per 50/nL decrease in platelet count, 95% confidence interval (CI) 1.02−1.53, p = 0.034) and increased perioperative mortality (odds ratio 1.96 per 50/nL decrease in platelet count, 95% CI 1.19−3.53, p = 0.014). Overall, low platelet count correlates with increased liver disease severity, inferior survival, and excess perioperative mortality in resectable HCC. These insights might be applied in clinical practice to better select patients for resection.
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Platelet Count; Retrospective Studies
PubMed: 35323324
DOI: 10.3390/curroncol29030124 -
Shock (Augusta, Ga.) Apr 2022Platelet distribution width (PDW) and PDW-to-platelet ratio (PPR) have been proven to be good prognostic indicators for many diseases. However, their prognostic values...
BACKGROUND
Platelet distribution width (PDW) and PDW-to-platelet ratio (PPR) have been proven to be good prognostic indicators for many diseases. However, their prognostic values in severe burns have not been reported.
OBJECTIVE
To investigate the early time course of PDW and PPR in severe burn patients and investigate their prognostic values.
METHODS
This is a 16-year, single-center retrospective study of 590 severe burn patients. The complete blood count parameters on day 1, day 3, and day 7 postburn, including PDW and PPR, were collected. Receiver operating characteristic curves (ROC) analysis, multiple logistic regression analysis and Kaplan-Meier survival analysis were performed to evaluate the prognostic values of PDW and PPR in severe burn patients.
RESULTS
According to 120-day follow-up records, 96 patients were nonsurvivors and 494 patients were survivors. ROC and area under the curve (AUC) analysis showed that, for predicting 120-day prognosis, the AUC of PDW (0.782) and PPR (0.816) on day 3 was the highest, followed by the AUC of PDW (0.764) and PPR (0.750) on day 7. The ROC-AUC of PPR (0.816) on day 3 was very close to that of the ABSI score (0.818). Multiple logistic regression analysis showed that the PDW (P = 0.033 and P = 0.009) and PPR (P = 0.052 and P = 0.046) on day 3 and day 7 were all significantly independently positively associated with 120-day mortality. Kaplan-Meier survival analysis showed that high PDW and PPR were both significantly associated with a high 120-day mortality rate on day 3 and day 7.
CONCLUSION
PDW and PPR on day 3 and day 7 were independent risk factors for 120-day mortality in severe burn patients. These objective and readily available prognostic indicators may be more clinically favored.
Topics: Blood Platelets; Burns; Humans; Platelet Count; Prognosis; ROC Curve; Retrospective Studies
PubMed: 34812187
DOI: 10.1097/SHK.0000000000001890 -
Neonatology 2015Five percent of newborn infants admitted to UK neonatal units during a recent study developed a platelet count <60 × 10(9)/l, and 60% of these were transfused... (Review)
Review
Five percent of newborn infants admitted to UK neonatal units during a recent study developed a platelet count <60 × 10(9)/l, and 60% of these were transfused platelets. This review summarises the common causes and mechanisms of thrombocytopenia in the newborn. Relevant evidence relating the platelet count to the risk of haemorrhage is reviewed, and current UK guidance on transfusion thresholds outlined. The UK policy for the provision of platelets for transfusion to neonates is described, including the particular requirements for neonatal allo-immune thrombocytopenia. Finally, we look towards the future and prospects for reducing the need to expose newborns to donor-derived platelets.
Topics: Hemorrhage; Humans; Infant, Newborn; Needs Assessment; Platelet Count; Platelet Transfusion; Practice Guidelines as Topic; Thrombocytopenia, Neonatal Alloimmune; United Kingdom
PubMed: 25301082
DOI: 10.1159/000365163 -
BMC Neurology Aug 2022Platelets play an important role in homeostasis however, they have also been associated with increased mortality after myocardial infarction. In the present study, we...
BACKGROUND AND AIMS
Platelets play an important role in homeostasis however, they have also been associated with increased mortality after myocardial infarction. In the present study, we investigated whether platelet count is associated with differences in the short-term prognosis at the time of hospital discharge and early neurological deterioration in ischemic stroke patients.
METHODS
Patients with ischemic stroke were enrolled from among 661 cerebrovascular disease patients admitted between January 2018 and December 2020. Patients who received hyperacute treatment, had a pre-onset modified Rankin scale (mRS) ≥ 3, transient ischemic attack, or active malignant disease were excluded. The platelet count was divided into quartiles (Q1-4) according to the number of patients, and the relationship between platelet count and prognosis was assessed using multivariable analysis.
RESULTS
In total, 385 patients were included in the study. Regarding the functional outcome by platelet count, there was a significant increase in mRS ≥ 3 at discharge in the Q4 (range: 243-1327 × 10/L, p = 0.013, ORs: 1.674, 95%CI: 1.253-6.681) group compared to the Q3 (range: 205-242 × 10/L) group even after adjusting for factors with P < 0.2 in univariate analysis. Furthermore, the frequency of neurological deterioration (NIHSS ≥ 4) within 1 week was significantly lower in the Q3 group than in the Q1 (range; 19-173 × 10/L) and Q4 groups even after adjustment (Q1; p = 0.020 ORs: 6.634, 95%CI: 1.352-32.557, Q4; p = 0.007 ORs: 8.765, 95%CI: 1.827-42.035).
CONCLUSION
Platelet count at onset may affect the prognosis of cerebral infarction and early neurological deterioration. This study may help clarify the pathogenesis of cerebral infarction to improve prognosis.
Topics: Brain Ischemia; Cerebral Infarction; Humans; Ischemic Stroke; Platelet Count; Prognosis; Retrospective Studies; Stroke
PubMed: 36008789
DOI: 10.1186/s12883-022-02845-5 -
Journal of Clinical Laboratory Analysis Apr 2022Impedance technology has been shown to overestimate platelet (PLT) count in samples with microcytes, while the optical-fluorescence PLT count (PLT-F) by Sysmex has been...
BACKGROUND
Impedance technology has been shown to overestimate platelet (PLT) count in samples with microcytes, while the optical-fluorescence PLT count (PLT-F) by Sysmex has been suggested to be unaffected by microcytosis. The Abbott Alinity hq analyzer employs multi-dimensional optical PLT counting. Our goal was to assess the accuracy of this technology in microcytic samples.
METHODS
Platelet measurements were performed by Alinity hq and the impedance (PLT-I) and PLT-F methods on a Sysmex XN-3000 analyzer on 464 samples. PLT concentration range was 6.56-947 × 10 /L and mean cell volume (MCV) 40.9-123.0 fL. Samples were categorized into normocytic (MCV > 80 fL), microcytic (MCV 65-80 fL), and severely microcytic (MCV < 65 fL) groups.
RESULTS
Alinity hq PLT count showed excellent agreement with PLT-F (r = 1.00). Sysmex PLT-I data showed somewhat weaker correlation with both PLT-F and Alinity hq (r = 0.98). Increasing bias between Sysmex PLT-I and PLT-F was seen with decreasing MCV values, with mean bias of 35.2 × 10 /L in severe microcytosis. An inverse relationship was demonstrated between the PLT-I versus PLT-F bias and MCV (p < 0.0001). Consistent mean bias was observed between Alinity hq and PLT-F across all MCV ranges. Mean platelet volume was suppressed or flagged by Sysmex XN in 50% of the samples in the severely microcytic group, and markedly higher red cell distribution width (RDW) was reported compared to Alinity hq (18.1% vs 13.7%, p < 0.0001).
CONCLUSION
The Sysmex PLT-I method overestimated the PLT count in samples with severe microcytosis. Alinity hq provided PLT counts and PLT and RBC indices that were not impacted by microcytosis.
Topics: Blood Platelets; Erythrocyte Count; Erythrocyte Indices; Humans; Platelet Count; Reproducibility of Results
PubMed: 35274768
DOI: 10.1002/jcla.24218