We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Evaluation of a diagnostic platelet aggregation test strategy for platelet rich plasma samples with low platelet counts.
- Authors
Altahan, Rahaf Mahmoud; Mathews, Natalie; Bourguignon, Alex; Tasneem, Subia; Arnold, Donald M.; Lim, Wendy; Hayward, Catherine P. M.
- Abstract
Introduction: Light transmission aggregometry (LTA) is important for diagnosing platelet function disorders (PFD) and von Willebrand disease (VWD) affecting ristocetin‐induced platelet aggregation (RIPA). Nonetheless, data is lacking on the utility of LTA for investigating thrombocytopenic patients and platelet rich plasma samples with low platelet counts (L‐PRP). Previously, we developed a strategy for diagnostic LTA assessment of L‐PRP that included: (1) acceptance of referrals/samples, regardless of thrombocytopenia severity, (2) tailored agonist selection, based on which are informative for L‐PRP with mildly or severely low platelet counts, and (3) interpretation of maximal aggregation (MA) using regression‐derived 95% confidence intervals, determined for diluted control L‐PRP (C‐L‐PRP). Methods: To further evaluate the L‐PRP LTA strategy, we evaluated findings for a subsequent patient cohort. Results: Between 2008 and 2021, the L‐PRP strategy was applied to 211 samples (11.7% of all LTA samples) from 192 unique patients, whose platelet counts (median [range] × 109/L) for blood and L‐PRP were: 105 [13–282; 89% with thrombocytopenia] and 164 [17–249], respectively. Patient‐L‐PRP had more abnormal MA findings than simultaneously tested C‐L‐PRP (p‐values <0.001). Among patients with accessible electronic medical records (n = 181), L‐PRP LTA uncovered significant aggregation abnormalities in 45 (24.9%), including 18/30 (60%) with <80 × 109 platelets/L L‐PRP, and ruled out PFD, and VWD affecting RIPA, in others. The L‐PRP LTA strategy helped diagnose VWD affecting RIPA, Bernard Soulier syndrome, familial platelet disorder with myeloid malignancy, suspected ITGA2B/ITGB3‐related thrombocytopenia, and acquired PFD. Conclusion: Diagnostic LTA with L‐PRP, using a strategy that considers thrombocytopenia severity, is feasible and informative.
- Subjects
BLOOD platelet aggregation; PLATELET count; BLOOD coagulation disorders; RESEARCH funding; BLOOD collection; PLATELET-rich plasma; DESCRIPTIVE statistics; THROMBOCYTOPENIA; PLATELET function tests; BLOOD platelet disorders; GENETIC disorders; ELECTRONIC health records; COMPARATIVE studies; HEMOSTASIS; VON Willebrand disease; CONFIDENCE intervals; SENSITIVITY &; specificity (Statistics); VASCULAR diseases
- Publication
International Journal of Laboratory Hematology, 2024, Vol 46, Issue 2, p362
- ISSN
1751-5521
- Publication type
Article
- DOI
10.1111/ijlh.14216