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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 -
Transfusion Dec 2023Thrombocytopenia is common in critically ill patients with cancer. However, the association of platelet count with spontaneous bleeding is controversial in critically... (Observational Study)
Observational Study
BACKGROUND
Thrombocytopenia is common in critically ill patients with cancer. However, the association of platelet count with spontaneous bleeding is controversial in critically ill patients and the association with cancer-related characteristics is unknown.
METHODS
This observational study includes patients with active cancer and severe thrombocytopenia. A logistic regression model adjusted for confounders was used to evaluate the association of daily platelet count and cancer-related characteristics (type of cancer and presence of metastasis) with spontaneous bleeding. Confounders were identified using directed acyclic graphs.
RESULTS
We screened 5822 patients, 255 (4.4%) met eligibility criteria resulting in 1401 daily observations. Fifty-three patients (20.8%) had spontaneous bleeding during the intensive care unit stay, 64% presenting minor, and 36% major bleeding. The adjusted odds ratio (OR) for spontaneous bleeding with platelet count between 49 and 20 × 10 /L was 4.6 (1.1-19.6), with platelet count between 19 and 10 × 10 /L was 14.2 (3.1-66.2), and with platelet count below 10 × 10 /L was 39.6 (6.9-228.5). The adjusted OR for spontaneous bleeding in patients with hematologic malignancies was 0.6 (0.4-1.2), and 4.3 (2.0-9.0) for patients with metastatic tumor.
CONCLUSIONS
In critically ill patients with active cancer and severe thrombocytopenia, lower counts of platelets and presence of metastasis are associated with increased risk of spontaneous bleeding, while hematologic malignancy is not associated with increased risk of spontaneous bleeding.
Topics: Humans; Platelet Count; Critical Illness; Hemorrhage; Thrombocytopenia; Neoplasms; Anemia; Platelet Transfusion
PubMed: 37818876
DOI: 10.1111/trf.17569 -
Recent Advances in Inflammation &... 2022Chronic Urticaria is an allergic disorder that affects about 0.5 to 5% of the population in different communities. The disease's chronic course and long-term onset...
BACKGROUND AND AIM
Chronic Urticaria is an allergic disorder that affects about 0.5 to 5% of the population in different communities. The disease's chronic course and long-term onset impose high economic and psychological costs on communities, adversely affecting individual and social life. Platelets play a role in various pathophysiological processes, including inflammation and immunology. Growing evidence suggests that platelets are actively involved in the pathogenesis of various inflammatory disorders, including inflammatory skin diseases. This study investigated the relationship between platelet and immunoglobulin-E markers and chronic idiopathic urticaria.
MATERIALS AND METHODS
In the present case-control study, for the study population, patients with chronic idiopathic urticaria were referred to the Asthma and Allergy Clinic, and their caregivers were selected as the case and control groups, respectively. In this study, the mean platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and Total IgE values were simultaneously measured in the case and control groups. After taking 5CCs of venous blood, a blood sample was sent to the laboratory for platelet and IgE marker measurements.
RESULTS
100 patients and 100 healthy persons were evaluated in this study. The mean age in the case group was 34.95, and in the control group was 35.78 years. The results showed that the mean values of PLT, MPV, PDW, and Total IgE in the case group were 12.86, 9.83, 252190, and 147.05, respectively. The mean values of PLT, MPV, PDW, and Total IgE in the control group were 16.93, 7.53, 231410, and 15.29, respectively, which was statistically significant (P = 0.001). Moreover, total IgE in the Autologous Serum Skin Test (ASST) positive group was higher than ASST negative group and was statistically significant (P = 0.001).
CONCLUSION
The study results indicate the possible role of platelets in urticaria and inflammation. MPV in patients with chronic urticaria was higher than in the control group. The present study showed no significant relationship between the severity of urticaria and platelet markers, but there was a significant relationship between the severity of urticaria and ASST. Moreover, the severity of urticaria was higher in the positive skin test group.
Topics: Humans; Adult; Platelet Count; Case-Control Studies; Mean Platelet Volume; Chronic Urticaria; Urticaria; Inflammation
PubMed: 35289259
DOI: 10.2174/2772270816666220314154951 -
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 -
Clinical Hemorheology and... 2020Platelet activation is associated with abdominal obesity and exercise training is an important modulator of body weight.
BACKGROUND
Platelet activation is associated with abdominal obesity and exercise training is an important modulator of body weight.
OBJECTIVE
We investigated the effects of two high intensity interval exercise (HIIE) protocols of different intensity and duration on platelet indices and platelet aggregation in overweight men.
METHODS
Ten overweight men performed 6 intervals of 30s exercise at 110% of peak power output (PPO) interspersed by 3 : 30 min active recovery (1/7 protocol) at 40% of PPO and 6 intervals of 2 min exercise at 85% of PPO interspersed by 2 min active recovery (1/1 protocol) at 30% of PPO in two separate sessions. Platelet indices and platelet aggregation were measured before and immediately after both HIIEs.
RESULTS
Platelet indices increased significantly following HIIE (P < 0.05), though, significant differences between the two protocols were only detected for platelet count, which was markedly increased following 1/1 protocol. Platelet aggregation increased significantly (P < 0.05) in response to the two HIIE protocols, with no significant difference being observed between the two protocols (P > 0.05).
CONCLUSIONS
It is concluded that HIIE leads to transient increases in markers of thrombus formation and that work to rest ratio is an important factor when investigating the changes in thrombocytosis following HIIE.
Topics: Adenosine Diphosphate; Adult; Exercise; High-Intensity Interval Training; Humans; Male; Overweight; Platelet Aggregation; Platelet Count; Young Adult
PubMed: 32390610
DOI: 10.3233/CH-200848 -
COPD Apr 2021Platelets play an important role in the pathophysiology of chronic obstructive pulmonary disease (COPD) by mediating thrombotic, inflammatory, and immune processes in... (Meta-Analysis)
Meta-Analysis
Platelets play an important role in the pathophysiology of chronic obstructive pulmonary disease (COPD) by mediating thrombotic, inflammatory, and immune processes in the lung. We conducted a systematic review and meta-analysis of studies investigating the platelet count and three platelet indices, mean platelet volume (MPV), platelet distribution width (PDW), and platelet to lymphocyte ratio (PLR) in stable COPD vs. non-COPD patients and in stable COPD vs. acute exacerbation of COPD (AECOPD) patients (PROSPERO registration number: CRD42021228263). PubMed, Web of Science, Scopus and Google Scholar were searched from inception to December 2020. Twenty-seven studies were included in the meta-analysis, 26 comparing 4,455 stable COPD patients with 7,128 non-COPD controls and 14 comparing 1,251 stable COPD with 904 AECOPD patients. Stable COPD patients had significantly higher platelet counts (weighted mean difference, WMD = 13.39 x10/L, 95% CI 4.68 to 22.11 x10/L; < 0.001) and PLR (WMD = 59.52, 95% CI 29.59 to 89.44; < 0.001) than non-COPD subjects. AECOPD patients had significantly higher PLR values than stable COPD patients (WMD = 46.03, 95% CI 7.70 to 84.35; = 0.02). No significant differences were observed in MPV and PDW. Between-study heterogeneity was extreme. In sensitivity analysis, the effect size was not modified when each study was sequentially removed. The was no evidence of publication bias. In our meta-analysis, specific platelet biomarkers were associated with stable COPD (platelet count and PLR) and AECOPD (PLR). However, the observed heterogeneity limits the generalizability of the findings. Further studies are required to determine their prognostic utility and the effects of targeted interventions in COPD.
Topics: Biomarkers; Blood Platelets; Humans; Lymphocytes; Platelet Count; Pulmonary Disease, Chronic Obstructive
PubMed: 33929925
DOI: 10.1080/15412555.2021.1898578 -
Clinical Laboratory Apr 2022Changes in platelet count are associated with a variety of diseases and treatments. Measuring it gives better insight into the expected outcome. Our aim was to evaluate...
BACKGROUND
Changes in platelet count are associated with a variety of diseases and treatments. Measuring it gives better insight into the expected outcome. Our aim was to evaluate the accuracy of three methods for platelet count in hyperlipidemia samples.
METHODS
Sixty non-lipid whole bloods from 60 individuals were included: 20 in low platelet count group, 20 in medium platelet count group, and 20 in high platelet count group. Then, 400 μL plasma was exchanged with 400 μL fat emulsion. Platelet count was measured after replacement by three methods, impedance method (Plt-I), optical method (Plt-O), and fluorescence method (Plt-F).
RESULTS
In the low platelet count group with fat emulsion plasma exchange, except for Plt-O, other methods showed the predefined acceptance criterion (± 10%) covered the mean bias and 95% CI of proportional bias (slope) which were obtained from Bland-Altman plot and Passing-Bablok algorithm, respectively. In medium and high platelet count group with fat emulsion plasma exchange, the predefined acceptance mean bias and criterion of 95% CI of proportional bias (slope) and intercept were met only in Plt-F. In the medium platelet count group, the mean bias was -1.600% and the 95%CI of slope and intercept were 1.000 (0.815 to 1.071) and -0.500 (-12.831 to 23.907), respectively. In the high platelet count group, the mean bias was -2.250% and the 95%CI of slope and intercept were 1.071 (0.974 to 1.225) and -33.8142 (-113.703 to 8.339), respectively.
CONCLUSIONS
Our results show that the Plt-F can more accurately reflect the true platelet count of lipemia specimens compared with Plt-I or Plt-O.
Topics: Blood Platelets; Emulsions; Hematologic Diseases; Humans; Hyperlipidemias; Platelet Count
PubMed: 35443598
DOI: 10.7754/Clin.Lab.2021.210708 -
Transfusion and Apheresis Science :... Jun 2024While there are various aspects of platelet biology that can be studied in the lab (i.e. adhesion, degranulation, integrin activation), the master test for platelet... (Review)
Review
While there are various aspects of platelet biology that can be studied in the lab (i.e. adhesion, degranulation, integrin activation), the master test for platelet function is that which gives a measure of the platelet aggregation capacity upon stimulation with an agonist. Platelet function testing is necessary for the diagnosis of platelet disorders and the monitoring of patients receiving anti-platelet treatments. Furthermore, it becomes relevant in the quality control of platelet concentrates for transfusion purposes, especially considering the global concern about long term storage, other forms of storage (i.e. cryopreservation, lyophilization), and the impact of Pathogen Reduction Treatments (PRTs) on platelet performance upon transfusion. However, it has been acknowledged as technically difficult and demanding, since a fine platelet function test must be carried out under specific conditions. Still, there might be occasions that preclude the platelet function testing abiding to the gold standard requirements, thus, leaving us with the necessity to redefine which variables may condition or limit the analysis of platelet function testing. In the present manuscript, we test different variables (such as the anticoagulant used or the time elapsed since extraction) and the possibility to reconstitute blood prior to platelet function analysis. This study aims to provide windows of action at the diagnostics lab, especially when not all of the recommended procedures and conditions can be followed: for example, when a sample is sent from a long distance, when there is a limitation on blood extraction volume or when certain parameters (platelet count) preclude reliable test results.
Topics: Humans; Platelet Function Tests; Platelet Count; Blood Platelets
PubMed: 38644062
DOI: 10.1016/j.transci.2024.103930 -
International Journal of Laboratory... Feb 2023The aim of this study performed on Sysmex XN is to compare platelet values on citrate and MgSO (TBX) in patients with K2EDTA-induced platelet clusters and to identify...
INTRODUCTION
The aim of this study performed on Sysmex XN is to compare platelet values on citrate and MgSO (TBX) in patients with K2EDTA-induced platelet clusters and to identify platelet biases of these matrices compared to K2EDTA.
METHODS
Sixty patients with K2EDTA-induced platelet clusters were re-sampled with K2EDTA, citrate and TBX. Platelet results were then compared, and smears were analysed for clumping. Platelet results from 120 patients without K2EDTA-induced platelet clusters were compared between K2 EDTA, citrate, and MgSO with impedance and fluorescence modes. Biases from regressions were analysed.
RESULTS
Out of the 60 patients with K2EDTA-induced platelet clusters, none showed platelet clusters with MgSO whereas 50% still showed clusters with citrate. Among those without platelet clusters on citrate, the mean relative difference between (citrate- MgSO )/MgSO was -12.7% in impedance and -9.8% in fluorescence. Among the 120 patients without K2EDTA-induced platelet clusters, in fluorescence the mean relative bias with respect to K2EDTA was -2.06% for MgSO and -10.3% for Citrate. For the MgSO versus K2 EDTA regressions, the maximum absolute values of the 95% CI of the relative biases at 150 × 10 /L (5.45%) and 450 × 10 /L (3.56%) were below the desirable analytical objectives of the EFLM.
CONCLUSION
In patients with K2EDTA-induced platelet clusters, MgSO is preferable to citrate. MgSO provides a bias with XN in fluorescence when compared to EDTA which is within analytical tolerance.
Topics: Humans; Platelet Count; Anticoagulants; Edetic Acid; Citric Acid; Blood Platelets
PubMed: 36093831
DOI: 10.1111/ijlh.13966 -
Chest Mar 2021ARDS is a devastating syndrome with heterogeneous subtypes, but few causal biomarkers have been identified.
BACKGROUND
ARDS is a devastating syndrome with heterogeneous subtypes, but few causal biomarkers have been identified.
RESEARCH QUESTION
Would multistage Mendelian randomization identify new causal protein biomarkers for ARDS 28-day mortality?
STUDY DESIGN AND METHODS
Three hundred moderate to severe ARDS patients were selected randomly from the Molecular Epidemiology of ARDS cohort for proteomics analysis. Orthogonal projections to latent structures discriminant analysis was applied to detect the association between proteins and ARDS 28-day mortality. Candidate proteins were analyzed using generalized summary data-based Mendelian randomization (GSMR). Protein quantitative trait summary statistics were retrieved from the Efficiency and safety of varying the frequency of whole blood donation (INTERVAL) study (n = 2,504), and a genome-wide association study for ARDS was conducted from the Identification of SNPs Predisposing to Altered Acute Lung Injury Risk (iSPAAR) consortium study (n = 534). Causal mediation analysis detected the role of platelet count in mediating the effect of protein on ARDS prognosis.
RESULTS
Plasma insulin-like growth factor binding protein 7 (IGFBP7) moderately increased ARDS 28-day mortality (OR, 1.11; 95% CI, 1.04-1.19; P = .002) per log2 increase. GSMR analysis coupled with four other Mendelian randomization methods revealed IGFBP7 as a causal biomarker for ARDS 28-day mortality (OR, 2.61; 95% CI, 1.33-5.13; P = .005). Causal mediation analysis indicated that the association between IGFBP7 and ARDS 28-day mortality is mediated by platelet count (OR, 1.03; 95% CI, 1.02-1.04; P = .01).
INTERPRETATION
We identified plasma IGFBP7 as a novel causal protein involved in the pathogenesis of ARDS 28-day mortality and platelet function in ARDS, a topic for further experimental and clinical investigation.
Topics: Biomarkers; Female; Genome-Wide Association Study; Humans; Insulin-Like Growth Factor Binding Proteins; Male; Mediation Analysis; Mendelian Randomization Analysis; Middle Aged; Mortality; Platelet Count; Platelet Function Tests; Polymorphism, Single Nucleotide; Prognosis; Proteomics; Respiratory Distress Syndrome; Risk Assessment
PubMed: 33189655
DOI: 10.1016/j.chest.2020.10.074