Laboratory abnormalities in thrombotic thrombocytopenic purpura

British Journal of Haematology - Tập 103 Số 4 - Trang 1031-1036 - 1998
Rock1, John G. Kelton2, Kenneth H. Shumak3, Noel A. Buskard4, David Sutton3, Barrett Benny4
1Department of Medicine, University of Ottawa, Ontario, Canada
2Department of Medicine, McMaster University, Hamilton, Ontario
3Departments of Medicine and Pathology, University of Toronto, Toronto, Ontario,
4Department of Medicine, University of British Columbia, Vancouver, BC, Canada

Tóm tắt

Thrombotic thrombocytopenic purpura is an uncommon disorder that requires prompt recognition and intervention to prevent death. To date, information regarding the classic laboratory abnormalities in the disease has been derived from small numbers of patients whose laboratory tests have been done at many different sites. We report the laboratory findings in 135 patients who presented with thrombotic thrombocytopenic purpura to 17 Canadian centres. 50 men and 85 women had a mean platelet count of 25.3 ± 19.4 × 109/l. The initial platelet count correlated with mortality; 32% of patients with a platelet count of 20 × 109/l or less died compared with 18% of patients with a platelet count >20 × 109/l (P = 0.058). The platelet‐associated IgG was elevated in 88% at presentation whereas the indirect platelet suspension immunofluorescence test was positive in only 18%. 93% of the sera showed reactivity against platelets following protein blotting. All sera tested also showed reactivity against endothelial cells. Immune complexes were seen in all patients, whereas the platelet aggregating factor was detected in 59%. Although the von Willebrand factor was elevated in the majority of patients at entry, the multimer pattern was variable and showed no predictive pattern. Renal dysfunction was common (18%).

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British Journal of Haematology

Tập 103 Số 4

1031-1036

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