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At least 703 records · Page 39Linked to original sources
PubMed1996

Heparin as a cause of thrombus progression. Heparin-associated thrombocytopenia is an important differential diagnosis in paediatric patients even with normal platelet counts.

UNLABELLED: A 15-year-old boy developed deep vein thrombosis of the right leg 9 days after appendectomy. In spite of three courses of thrombolysis with streptokinase and effective heparinization the thrombosis progressed with additional occlusion of the left iliac vein. Although platelet counts were constantly normal, heparin-associated thrombocytopenia was suspected as the cause of the new venous occlusions. This diagnosis was confirmed by detecting heparin-associated antibodies with the heparin-induced platelet activation test. Therapy was instituted replacing heparin by the low molecular weight heparinoid Orgaran. Bilateral recanalization occurred within 6 days. CONCLUSION: Heparin-associated thrombocytopenia must be considered if thrombosis occurs or progresses despite effective heparinization even in the absence of thrombocytopenia.

Adolescent↗
PubMed1998

Leg ulceration with associated thrombocytosis: healing of ulceration associated with treatment of the raised platelet count.

Thrombocytosis is the cause of various complications in myeloproliferative disorders. We present the case of a 54-year-old woman with chronic myelogenous leukaemia who developed large ulcers on both lower legs that were refractory to standard treatment. As concomitant thrombocytosis persisted despite treatment with hydroxyurea, the new megakaryocyte inhibitor anagrelide (Agrelin) was administered and led to normalization of the platelet count within 11 days. The leg ulcers started to heal after 2 weeks and disappeared over a period of 5 months. Our findings argue for a pathogenic role of platelets in the development of leg ulcers in patients with thrombocytosis due to a myeloproliferative disorder.

Female↗
PubMed1972

Evaluation of an automatic platelet counting system utilizing whole blood.

Technicon's newly developed platelet AutoCounter utilizes an electro-optical system which detects and counts particles by sensing the scattering of light which occurs when blood cells flow through the illuminated sensing chamber of a micro-optical system. The system utilizes whole blood collected into EDTA. Blood samples, which can be handled at the rate of 40 per hour, are diluted with 2M urea which in addition causes lysis of the erythrocytes. The haemolysate thus obtained is delivered to the particle counter after a two-minute reaction time, the cell count finally being displayed on a continuous chart recorder. An evaluation of this machine has been carried out in the Department of Haematology, the Royal Infirmary, Edinburgh, on hospital specimens from patients suffering from a wide variety of diseases. The results of this evaluation are presented. Reproducibility studies indicate a coefficient of variation of 4% at any platelet level. The percentage drift per sample ranges from +0.4 to -0.4% of the total count. Carry-over and departures from linearity are statistically significant; however, the magnitude of these deviations is not sufficient to cause concern in routine use. Acceptable agreement is noted between machine counts and the counts obtained by technicians using phase-contrast microscopy with the exception of two anomalous individuals. Discrepant counts were noted in patients with elevation of the erythrocyte sedimentation rate and also in patients with disturbance of immunoglobulins. A modification to the sampling probe which eliminates the former problem is described. The AutoCounter described in this paper provides a fast, reliable, and accurate service laboratory platelet counting system.

Analysis of Variance↗
PubMed1996

Increased release of tumor necrosis factor-alpha and interleukin-6 in women with the syndrome of hemolysis, elevated liver enzymes, and low platelet count.

BACKGROUND: Complement is activated in preeclampsia and complement products are known to activate macrophages. The aim of this study was to determine whether the macrophage derived cytokines, interleukin-1 beta, interleukin-6 and tumor necrosis factor-alpha, are released in patients with a form of severe preeclampsia characterized by the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome). METHODS: Complement activation and plasma levels of cytokines were studied in 11 women with HELLP syndrome and in 11 controls with uncomplicated pregnancies. To further evaluate the connection between complement activation and cytokine release an in vitro study on heparinized whole blood incubated with recombinant C5a was performed. RESULTS: In the HELLP group, complement anaphylatoxin C5a was increased in plasma at delivery (p < 0.01) and one day after delivery (p < 0.05), terminal C5b-9 complement complex was elevated in plasma at delivery (p < 0.001) and one day after (p < 0.01), plasma levels of interleukin-6 were increased one day after delivery (p < 0.01), and plasma concentrations of tumor necrosis factor-alpha were elevated at delivery (p < 0.01), compared with corresponding levels in controls. All parameters normalized within one week. Interleukin-I beta did not differ between the groups. In vitro, recombinant C5a incubated in whole blood gave a dose-dependent release of interleukin-6. No increased release of interleukin-1 or tumor necrosis factor-alpha was seen after incubation. CONCLUSIONS: Since cytokine release occurs in severe preeclampsia, inflammatory mechanisms may participate in the pathophysiology of severe preeclampsia.

Adult↗
PubMed2001

Lipid hydroperoxides and free radical scavenging enzyme activities in preeclampsia and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome: no evidence for circulating primary products of lipid peroxidation.

OBJECTIVE: Preeclampsia is reportedly accompanied by increased plasma lipid peroxidation. However, to date the assays that have been applied to measure lipid peroxides have been relatively nonspecific. A highly specific high-performance lipid chromatographic-chemiluminescence technique was used here to measure lipid hydroperoxides in plasma and red blood cells of patients with preeclampsia and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. STUDY DESIGN: Lipid peroxidation products, both lipid hydroperoxides and thiobarbituric acid reactive substances (TBARS), and free radical scavenging enzyme activities were measured in either plasma or erythrocytes of patients with normal pregnancies (n = 36), preeclampsia (n = 28), or HELLP syndrome (n = 10). RESULTS: Whereas lipid hydroperoxides were undetectable (<0.02 micromol/L), plasma TBARS and glutathione peroxidase activity in plasma and erythrocytes were significantly increased in patients with HELLP syndrome. There were no differences in glutathione transferase and reductase activities or superoxide dismutase activity between the groups. CONCLUSIONS: We were unable to corroborate results of studies that suggested that increased TBARS are representative of circulating plasma lipid hydroperoxides in preeclampsia. However, elevated glutathione peroxidase activity and TBARS are in line with increased oxidative stress in preeclampsia.

Adult↗