Clinical studiesAutoantibodies against platelet glycoproteins in critically ill patients with thrombocytopenia
Section snippets
Subjects
The study was conducted between May 1 and October 30, 1997, in a medical (Broussais hospital) and a surgical (Tenon hospital) intensive care unit. Patients who developed thrombocytopenia (less than 100 × 109 platelets/L) were identified prospectively. Platelet counts were performed daily for all patients. Because the patient characteristics were similar in the two institutions, the results were pooled.
Patients with a history of platelet disorders, hematologic malignancies or chemotherapy, and
Results
During a 6-month period, 132 patients were admitted to the intensive care unit at Broussais hospital, and 161 were admitted at Tenon hospital. They had mean age of 61 ± 17 years, and 65% were men. Their mean first-day APACHE II score was 19 ± 10, their median length of stay in the intensive care unit was 4 (1 to 10) days, 54% came from other medical departments or the emergency department, 31% had scheduled or unscheduled surgery (mainly abdominal, orthopedic, and thoracic surgery), 9% had a
Discussion
We found that 30% of intensive care unit patients with thrombocytopenia had elevated platelet-associated IgG values, approximately 30% of whom had autoantibodies directed against platelet glycoproteins. None of the 15 control patients or 43 thrombocytopenic patients without platelet-associated IgG had these autoantibodies. Thrombocytopenic patients with elevated platelet-associated IgG were less likely to have normalization of their platelet counts but did not require more blood products,
References (34)
- et al.
Thrombocytopenia in the critically ill patient
J Crit Care
(1990) - et al.
Thrombocytopenia in the sepsis syndromerole of hemophagocytosis and macrophage colony-stimulating factor
Am J Med
(1997) Platelet immunoglobulin Gits significance for the evaluation of thrombocytopenia and for understanding the origin of α-granule proteins
Blood
(1990)- et al.
The clinical implications and the pathogenetic significance of circulating immune complexes in infective endocarditis
Am J Med
(1981) - et al.
Monoclonal antibody-specific immobilization of platelet antigens (MAIPA)a new toll for the identification of platelet-reactive antibodies
Blood
(1987) - et al.
Autoantibodies against platelet glycoproteins in autoimmune thrombocytopenic purpuratheir clinical significance and response to treatment
Blood
(1993) - et al.
Prospective evaluation of the clinical usefulness of an antigen-specific assay (MAIPA) in idiopathic thrombocytopenic purpura and other immune thrombocytopenias
Blood
(1996) - et al.
Infusion of Fcg fragments for treatment of children with acute immune thrombocytopenic purpura
Lancet
(1993) - et al.
Natural autoantibodies
Curr Opin Immunol
(1995) - et al.
The amount of platelet-bound albumin parallels the amount of IgG on washed platelets from patients with immune thrombocytopenia
Blood
(1983)