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Blood Jan 2021Cyclic thrombocytopenia (CTP) is a rare disease, which is characterized by periodic fluctuation of the platelet count. The pathogenesis of CTP is unknown and most likely...
Cyclic thrombocytopenia (CTP) is a rare disease, which is characterized by periodic fluctuation of the platelet count. The pathogenesis of CTP is unknown and most likely heterogeneous. Patients with CTP are almost always misdiagnosed as having primary immune thrombocytopenia (ITP). The interval between ITP and CTP diagnosis can be many years. CTP patients often receive ITP-specific therapies including corticosteroids, thrombopoietin receptor agonists, rituximab, and splenectomy, which are followed by a transient increase in platelet count that is wrongly attributed to treatment effect with inevitable "relapse." CTP can be diagnosed by frequent platelet count monitoring, which reveals a typical pattern of periodic platelet cycling. An early diagnosis of CTP will prevent these patients from being exposed to possibly harmful therapies. The bleeding phenotype is usually mild and consists of mucocutaneous bleeding at the time when the platelet count is at its nadir. Severe bleeding from other sites can occur but is rare. Some patients respond to cyclosporine A or to danazol, but most patients do not respond to any therapy. CTP can be associated with hematological malignancies or disorders of the thyroid gland. Nevertheless, spontaneous remissions can occur, even after many years.
Topics: Blood Platelets; Humans; Platelet Count; Thrombocytopenia
PubMed: 33197928
DOI: 10.1182/blood.2020008218 -
The Journal of Pediatrics Dec 2023To understand better those factors relevant to the increment of rise in platelet count following a platelet transfusion among thrombocytopenic neonates.
OBJECTIVE
To understand better those factors relevant to the increment of rise in platelet count following a platelet transfusion among thrombocytopenic neonates.
STUDY DESIGN
We reviewed all platelet transfusions over 6 years in our multi-neonatal intensive care unit system. For every platelet transfusion in 8 neonatal centers we recorded: (1) platelet count before and after transfusion; (2) time between completing the transfusion and follow-up count; (3) transfusion volume (mL/kg); (4) platelet storage time; (5) sex and age of platelet donor; (6) gestational age at birth and postnatal age at transfusion; and magnitude of rise as related to (7) pre-transfusion platelet count, (8) method of enhancing transfusion safety (irradiation vs pathogen reduction), (9) cause of thrombocytopenia, and (10) donor/recipient ABO group.
RESULTS
We evaluated 1797 platelet transfusions administered to 605 neonates (median one/recipient, mean 3, and range 1-52). The increment was not associated with gestational age at birth, postnatal age at transfusion, or donor sex or age. The rise was marginally lower: (1) with consumptive vs hypoproductive thrombocytopenia (P < .001); (2) after pathogen reduction (P < .01); (3) after transfusing platelets with a longer storage time (P < .001); and (4) among group O neonates receiving platelets from non-group O donors (P < .001). Eighty-seven neonates had severe thrombocytopenia (<20 000/μL). Among these infants, poor increments and death were associated with the cause of the thrombocytopenia.
CONCLUSION
The magnitude of post-transfusion rise was unaffected by most variables we studied. However, the increment was lower in neonates with consumptive thrombocytopenia, after pathogen reduction, with longer platelet storage times, and when not ABO matched.
Topics: Humans; Infant, Newborn; Blood Platelets; Blood Transfusion; Platelet Count; Platelet Transfusion; Thrombocytopenia, Neonatal Alloimmune; Male; Female
PubMed: 37572863
DOI: 10.1016/j.jpeds.2023.113666 -
Journal of Drugs in Dermatology : JDD Feb 2022Psoriasis is a chronic, inflammatory skin condition that is growing in prevalence globally. Routinely available options to assess psoriasis severity and progression are...
BACKGROUND
Psoriasis is a chronic, inflammatory skin condition that is growing in prevalence globally. Routinely available options to assess psoriasis severity and progression are limited. More options are needed to monitor disease progression as therapeutic management is based on disease severity.
OBJECTIVES
This study evaluates the usage of complete blood count components (CBC) including platelet count, mean platelet volume (MPV), and red cell distribution width (RDW) as hematological markers for assessing psoriasis severity.
MATERIALS AND METHODS
In this cross-sectional study of 120 patients with psoriasis, disease severity was assessed using the PASI score followed by a blood draw to determine whether correlations existed between each marker and PASI score.
RESULTS
A significant, positive correlation was found between total platelet count and PASI while no such correlation was found in MPV and RDW. When stratifying for age, duration of disease, sex, and body parts involved, we found intriguing relationships and offer potential explanations for their occurrence.
CONCLUSION
Our findings suggest that hematological parameters MPV, platelet count, and RDW found in the CBC are useful in identifying psoriasis severity to some extent. We foresee the use of RDW, MPV, and platelet count biomarkers as a complement to the PASI score in assessing severity for psoriasis patients, while also as a gauge for likelihood of developing comorbidities such as cardiovascular disease. J Drugs Dermatol. 2022;21(2):156-161. doi:10.36849/JDD.6127.
Topics: Biomarkers; Cross-Sectional Studies; Erythrocyte Indices; Humans; Mean Platelet Volume; Platelet Count; Psoriasis
PubMed: 35133104
DOI: 10.36849/jdd.6127 -
Platelets May 2022Thrombocytopenia is common in critical illness. But there are no studies that focus on thrombocytopenia and platelet recovery in Sepsis-3 patients. We employed a large... (Observational Study)
Observational Study
Thrombocytopenia is common in critical illness. But there are no studies that focus on thrombocytopenia and platelet recovery in Sepsis-3 patients. We employed a large database to identify sepsis based on Sepsis-3 criteria. Patients were grouped by nadir platelet count during ICU, propensity score matching was used to eliminate covariates imbalance, multivariable cox proportional hazard model was used for evaluating mortality. A total of 9709 patients were enrolled based on Sepsis-3, 1794 (18%) patients developed thrombocytopenia, with 858 (8.8%) exhibiting thrombocytopenia at ICU admission (prevalent), 891 (9.2%) developed thrombocytopenia during ICU stay (incident). In the incident thrombocytopenia group, survivors exhibited higher nadir platelet count, higher rate in platelet count recovery and shorter time to platelet recovery compared to non-survivors. Platelet recovery was not observed until 1 days (IQR, 1-2) after weaning of mechanical ventilation and 1 days (IQR, 1-3) after discontinuation of vasopressor in survivors of incident thrombocytopenia. Furthermore, thrombocytopenia was associated with longer duration of ICU length of stay, longer duration of mechanical ventilation and vasopressor use compared to no thrombocytopenia. Moderate (20-50 × 10/L) and severe (<20 × 10/L) thrombocytopenia group showed increased 28 days mortality compared to no thrombocytopenia, while the mortality rate between mild (51-100 × 10/L) and no thrombocytopenia group (≥100 × 10/L) showed no significant difference. Taken together these data revealed that thrombocytopenia occurred in 18% Sepsis-3 patients; platelet recovery occurred more frequent and earlier in survivors; platelet recovery was not observed until clinical improvement. Thrombocytopenia in Sepsis-3 demonstrated increased disease severity, and patients with platelet count <50 × 10/L showed increased 28 days mortality.
Topics: Humans; Platelet Count; Prognosis; Retrospective Studies; Sepsis; Thrombocytopenia
PubMed: 34448680
DOI: 10.1080/09537104.2021.1970124 -
Blood May 2021
Topics: Platelet Count; Platelet Transfusion
PubMed: 33983425
DOI: 10.1182/blood.2021011269 -
Pediatric Hematology and Oncology Nov 2022Platelets play a role in hemostasis, thrombosis, and vascular integrity. They also play a major role in the development of inflammation and the activation of immune...
Platelets play a role in hemostasis, thrombosis, and vascular integrity. They also play a major role in the development of inflammation and the activation of immune responses. They have phagocytic activity, stimulate the secretion of immune modulators, and activate other immune cells, which results in platelet-neutrophil aggregation, platelet-induced neutrophil degranulation, and the formation of neutrophil extracellular traps. Data on 124 febrile neutropenia attacks were retrospectively examined. Patients' age, sex, diagnosis, and relapse history were obtained. The complete blood count levels on the first and last febrile day of the febrile neutropenia attacks, duration of fever, and number, type, and timing of thrombocyte suspension transfusions were recorded. The patients were divided into three groups according to the day of fever when the platelet suspension was administered (1 day, 2-3 days, and >3 days); the duration of fever was compared between the three groups. The fever duration of those who were transfused with platelet suspension on the first day of fever was found to be significantly shorter ( = 0.03 and < 0.001, respectively). When treating a patient with febrile neutropenia, if thrombocyte suspension transfusion is indicated, transfusing thrombocytes in the first days of fever shortens the fever duration and improves the prognosis of febrile neutropenia attack, supporting the hypothesis that not only neutrophils but also platelets may play a role in fighting against microorganisms.
Topics: Febrile Neutropenia; Fever; Humans; Platelet Count; Platelet Transfusion; Retrospective Studies
PubMed: 35855637
DOI: 10.1080/08880018.2022.2066236 -
Effects of Platelet Count on Blood Pressure: Evidence from Observational and Genetic Investigations.Genes Dec 2023Platelet count has been associated with blood pressure, but whether this association reflects causality remains unclear. To strengthen the evidence, we conducted a...
Platelet count has been associated with blood pressure, but whether this association reflects causality remains unclear. To strengthen the evidence, we conducted a traditional observational analysis in the Lifelines Cohort Study ( = 167,785), and performed bi-directional Mendelian randomization (MR) with summary GWAS data from the UK Biobank ( = 350,475) and the International Consortium of Blood Pressure (ICBP) ( = 299,024). Observational analyses showed positive associations between platelet count and blood pressure (OR = 1.12 per SD, 95% CI: 1.10 to 1.14 for hypertension; B = 0.07, 95% CI: 0.07 to 0.08 for SBP; B = 0.07 per SD, 95% CI: 0.06 to 0.07 for DBP). In MR, a genetically predicted higher platelet count was associated with higher SBP (B = 0.02 per SD, 95% CI = 0.00 to 0.04) and DBP (B = 0.03 per SD, 95% CI = 0.01 to 0.05). IVW models and sensitivity analyses of the association between platelet count and DBP were consistent, but not all sensitivity analyses were statistically significant for the platelet count-SBP relation. Our findings indicate that platelet count has modest but significant effects on SBP and DBP, suggesting causality and providing further insight into the pathophysiology of hypertension.
Topics: Humans; Blood Pressure; Cohort Studies; Platelet Count; Hypertension; UK Biobank
PubMed: 38137055
DOI: 10.3390/genes14122233 -
Sleep & Breathing = Schlaf & Atmung Jun 2022To investigate the correlation between obstructive sleep apnea (OSA) and coagulation status and to speculate on the underlying mechanism in children with OSA.
OBJECTIVE
To investigate the correlation between obstructive sleep apnea (OSA) and coagulation status and to speculate on the underlying mechanism in children with OSA.
METHODS
We divided 345 children with OSA (age 2-14 years) into four groups according to the apnea-hypopnea index (AHI). We compared platelet (PLT) and coagulation parameters among groups. Correlations between the polysomnography parameters and coagulation parameters were investigated.
RESULTS
Children with OSA had higher PLT counts than those without OSA (P < 0.001), while no significant difference was observed in prothrombin time, international normalized ratio, activated partial thromboplastin time, thrombin time, or fibrinogen among children with/without OSA. In linear regression analysis, the AHI and oxygen desaturation index (ODI) presented positive correlation with the PLT count (R = 0.155, beta = 0.307, P < 0.001 and R = 0.113, beta = 0.262, P < 0.001), and there was no correlation among the AHI, ODI, and other coagulation parameters. The minimum and mean oxygen saturation of arterial blood manifested negative correlation with the PLT count (R = 0.076, beta = - 0.116, P = 0.034 and R = 0.083, beta = - 0.140, P = 0.008, respectively).
CONCLUSIONS
Children with OSA have a higher PLT count, positively correlated with OSA severity, and no evidence of coagulation disorder.
Topics: Adolescent; Child; Child, Preschool; Humans; Oxygen; Platelet Count; Polysomnography; Sleep Apnea, Obstructive
PubMed: 34291360
DOI: 10.1007/s11325-021-02443-8 -
Shock (Augusta, Ga.) Oct 2019Perfluorocarbon emulsions (PFC) are a class of lipid-coated micelle slurries wherein the active center of the micelle is a completely halogen/fluorine-substituted...
Perfluorocarbon emulsions (PFC) are a class of lipid-coated micelle slurries wherein the active center of the micelle is a completely halogen/fluorine-substituted hydrocarbon capable of dissolving very large quantities of nonpolar gases. Due to their unique enhanced solubility for oxygen (O2) and nitrogen (N2), PFCs have been used in research as enhanced gas transport media for situations wherein the microcirculation is dysfunctional. In the early 1990s a PFC emulsion was approved for human use during coronary artery angioplasty and one is presently in use in Russia as well as other countries. The pharmaceutical class has had reported in the past associated with variable amounts of time-limited thrombocytopenia. Anxiety about cerebral embolism surfaced after a pivotal phase III trial leading to the cessation of all human research in the United States. At that time papers both published and submitted to the FDA opined (without proof) that the platelet count decrease might be caused by platelet white cell conjugates and/or platelet aggregates, thereby signaling a general inflammatory response to PFCs and a potential thrombosis risk. Although thrombocytopenia has been reported in response to PFC emulsion formulations, it is not ubiquitous and seems to be less associated with some formulations. As well, in some recent animal studies there is no evidence of platelet white cell adverse interactions. The mechanism for the reported thrombocytopenia is as yet not fully understood, and risk-benefit profiles will have to be carefully studied as contemporary human trials move forward.
Topics: Animals; Emulsions; Fluorocarbons; Humans; Inflammation; Platelet Count
PubMed: 29642229
DOI: 10.1097/SHK.0000000000001154 -
Transfusion Mar 2023
Topics: Humans; Swimming; Platelet Transfusion; Platelet Count
PubMed: 36494900
DOI: 10.1111/trf.17207