EDTA-DEPENDENT PSEUDOTHROMBOCYTOPENIA - A CLINICAL AND EPIDEMIOLOGIC-STUDY OF 112 CASES, WITH 10-YEAR FOLLOW-UP

被引:138
作者
BIZZARO, N
机构
[1] Laboratory of Clinical Pathology, Ospedale Civile, S. Donà di Piave, Venice
关键词
PSEUDOTHROMBOCYTOPENIA; EDTA; PLATELET CLUMPING; ANTIPLATELET ANTIBODIES; NATURAL ANTIBODIES;
D O I
10.1002/ajh.2830500206
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In the past 10 years, we have observed 112 cases of EDTA-dependent pseudothrombocytopenia (PTCP) due to in vitro platelet clumping at room temperature, 93 patients had antiplatelet antibodies (48 IgM, 30 IgG, 3 IgA, and 12 had two different isotypes concomitantly), In 20% of patients, the presence of IgM antibodies characteristically accompanied platelet agglutination also at 37 degrees C, and in citrated blood, The phenomenon was not age or sex related, nor was it associated with any particular pathology or use of specific drugs, and was present in both healthy subjects and patients with various diseases. Flow cytofluorimetric analysis of CD5-positive a cells, which are responsible for autoantibody production, did not demonstrate any changes in the percentage and absolute number of this lymphocyte subset. Average follow-up was 5 years (6 months-10 years); however, previous clinical records disclosed that PTCP was present for more than 15 years in four cases, and more than 20 years in three others, with no clinical manifestation of disease. This study confirms that EDTA-dependent PTCP is a phenomenon related to the presence of natural autoantibodies with antiplatelet activity, devoid of pathological significance. Its clinical interest resides in the need for its prompt and certain recognition in order to avoid unnecessary examinations and therapeutic interventions. The best and most rapid technique for obtaining accurate platelet counts in PTCP subjects is to collect and examine EDTA blood at 37 degrees C; however, clumping will still be present in about 20% of these cases, and even in citrated blood. To obviate this phenomenon, blood should be collected in ammonium oxalate, and platelets counted in a Burker chamber. (C) 1995 Wiley-Liss, Inc.
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页码:103 / 109
页数:7
相关论文
共 60 条
[1]  
AMITALTEPLIZKI H, 1993, NATURAL ANTIBODIES T, P175
[2]   STUDIES ON NATURAL ANTIBODIES AND AUTOANTIBODIES [J].
AVRAMEAS, S ;
DIGHIERO, G ;
LYMBERI, P ;
GUILBERT, B .
ANNALES D IMMUNOLOGIE, 1983, D134 (01) :103-113
[3]  
AVRAMEAS S, 1991, IMMUNOL TODAY, V12, P154
[4]   EDTA-DEPENDENT PSEUDOTHROMBOCYTOPENIA - A CLINICAL-STUDY OF 18 PATIENTS AND A REVIEW OF THE LITERATURE [J].
BERKMAN, N ;
MICHAELI, Y ;
OR, R ;
ELDOR, A .
AMERICAN JOURNAL OF HEMATOLOGY, 1991, 36 (03) :195-201
[5]   NATURAL MOUSE IGG REACTS WITH SELF ANTIGENS INCLUDING MOLECULES INVOLVED IN THE IMMUNE-RESPONSE [J].
BERNEMAN, A ;
TERNYNCK, T ;
AVRAMEAS, S .
EUROPEAN JOURNAL OF IMMUNOLOGY, 1992, 22 (03) :625-633
[6]  
BIZZARO N, 1993, ARCH PATHOL LAB MED, V117, P528
[7]   EDTA-DEPENDENT PSEUDOTHROMBOCYTOPENIA - ASSOCIATION WITH ANTIPLATELET AND ANTIPHOSPHOLIPID ANTIBODIES [J].
BIZZARO, N ;
BRANDALISE, M .
AMERICAN JOURNAL OF CLINICAL PATHOLOGY, 1995, 103 (01) :103-107
[8]   PLATELET SATELLITOSIS TO POLYMORPHONUCLEARS - CYTOCHEMICAL, IMMUNOLOGICAL, AND ULTRASTRUCTURAL CHARACTERIZATION OF 8 CASES [J].
BIZZARO, N .
AMERICAN JOURNAL OF HEMATOLOGY, 1991, 36 (04) :235-242
[9]  
BUSKILA D, 1993, NATURAL AUTOANTIBODI, P125
[10]  
CAIRNS E, 1985, J IMMUNOL, V135, P3839