Marcadores hematológicos de corredores amadores do município de Vitória/ES / Hematological profile of street runners from Vitória/ES

Introdução: O sistema imunológico apresenta estreita relação com o exercício físico. Todavia, poucos estudos verificaram o perfil imunológico de corredores amadores. Objetivo: Descrever o perfil de marcadores imunológicos de corredores amadores do município de Vitória/ES no período pós-treinamento. Métodos: Foram selecionados 31 corredores pertencentes a dois grupos de corrida, ambos de Vitória/ES. A análise hematológica dos parâmetros imunológicos foi realizada a partir da contagem total de leucócitos por meio de leucograma. Resultados: A contagem de plaquetas apresentou diferença estatística quanto ao gênero, sendo os valores maiores encontrados no gênero feminino em relação ao treinamento contínuo. Além disso, foram encontrados valores menores de neutrófilos no gênero masculino com relação ao treinamento intervalado. Não foi observada diferença estatística entre homens e mulheres nos demais parâmetros analisados. Conclusão: Os resultados deste estudo sugerem que o exercício físico influencia o sistema imunológico de corredores amadores de Vitória/ES, promovendo elevação das células plaquetárias e redução dos neutrófilos.

Introduction: The immune system presents close relationship to physical exercise. Meanwhile, few studies have verified the immune profile of amateur runners. Objective: To describe immune markers profile of amateur runners at Vitória/ES in the post-training period. Methods: Thirty-one runners of two distinct groups of race, both of Vitória/ES, were selected. The hematological analysis of immunological parameters was performed from the total count of leukocytes by leukogram. Results: The platelets count showed statistical differences according to gender, and the higher values were found in females compared to continuous training. Furthermore, lower values of neutrophils in males were found in the interval training. No statistical difference was observed between men and women in the other parameters. Conclusion: The results of this study suggest that physical exercise influences the immune system of amateur runners from Vitória/ES, promoting an increase in the number of platelet cells and a reduction of neutrophils.

Evaluation of oral-motor movements and facial mimic in patients with head and neck burns by a public service in Brazil

OBJECTIVES: The purpose of this study was to analyze the characteristics of oral-motor movements and facial mimic in patients with head and neck burns. METHODS: An observational descriptive cross-sectional study was conducted with patients who suffered burns to the head and neck and who were referred to the Division of Orofacial Myology of a public hospital for assessment and rehabilitation. Only patients presenting deep partial-thickness and full-thickness burns to areas of the face and neck were included in the study. Patients underwent clinical assessment that involved an oral-motor evaluation, mandibular range of movement assessment, and facial mimic assessment. Patients were divided into two groups: G1 - patients with deep partial-thickness burns; G2 - patients with full-thickness burns. RESULTS: Our final study sample comprised 40 patients: G1 with 19 individuals and G2 with 21 individuals. The overall scores obtained in the clinical assessment of oral-motor organs indicated that patients with both second- and third-degree burns presented deficits related to posture, position and mobility of the oral-motor organs. Considering facial mimic, groups significantly differed when performing voluntary facial movements. Patients also presented limited maximal incisor opening. Deficits were greater for individuals in G2 in all assessments. CONCLUSION: Patients with head and neck burns present significant deficits related to posture, position and mobility of the oral myofunctional structures, including facial movements. .

The Role of Platelets in Malarial Acute Lung Injury and Acute Respiratory Distress Syndrome: A World of Possibilities.

In recent decades our understanding of platelets’ role in immune response has increased. Traditionally platelets were considered as bleeding-stopping and thrombosis-causing cells. In recent years the platelets’ role in malarial innate and adaptive immune responses is being recognized. Platelets play critical role in pathogenesis of malaria infection leading to variety of outcomes. It is being realized that platelets play dual role in case of malaria (i) by preventing early stage exponential growth of parasitemia (ii) promoting exaggerated immune responses later. Platelets role in pathogenesis of severe and cerebral malaria has been widely studied. However their role in malaria related acute lung injury and respiratory distress has gained less attention. Recently the presence of active megakaryocytes and proplatelets have been explained in human lungs. Simultaneously, the platelets role in pathogenesis of acute lung injury and respiratory distress (ALI/ARDS) was also recognized. This gives a hint that there is a possible association of platelets with malaria related respiratory diseases as well. ALI/ARDS are characterized by lung edema due to increased permeability of the alveolar-capillary barrier and subsequent impairment of arterial oxygenation. In this review we have attempted to establish the importance of role of platelets in malaria related acute lungs injury and malaria acute respiratory distress syndrome and try to explain the underlying mechanism of this process. In ALI/ARDS, including those caused by malaria, platelets participate sequestration to the vascular bundle facilitating the recruitment of immune cells viz. neutrophils. Additionally, they secrete or induce the secretion of chemokines that result into vascular damage.

Papel do fator de ativação de plaquetas na infecção de macrófagos por leishmania infantum e identificação de uma Paf-Acetilhidrolase no parasita / Role of platelet-activating factor in macrophage infection by Leishmania infantum and identification of the parasite PAF acetylhydrolase

A leishmaniose visceral é causada pelo parasita Leishmania infantum. A infecção ocorre quando flebótomos infectados se alimentam na derme do hospedeiro vertebrado, inoculando o parasita. A infecção produz uma resposta com diversas moléculas inflamatórias, como os mediadores lipídicos. O fator de ativação de plaquetas (PAF) é um potente mediador lipídico derivado de um lisofosfolipídio. PAF participa da fisiologia normal da célula e possui um perfil pró-inflamatório. A participação de mediadores lipídicos, como eicosanóides e PAF, já foi identificada na imunopatogênese das leishmanioses. PAF gerado pelo hospedeiro tem efeito leishmanicida e de controle da infecção por L. amazonensis. PAF-acetilhidrolases (PAF-AH) são fosfolipases A2 que hidrolisam PAF e foi demonstrado que PAF-AH podem ser um fator de virulência devido a essa habilidade. O objetivo desse estudo foi avaliar o papel do PAF e de uma PAF-AH na infecção de macrófagos por L. infantum. Foi observado que PAF 1μM, quando adicionado durante e após a infecção, foi capaz de diminuir 50% da infecção após 72 horas, bem como a viabilidade dos parasitas dentro dos macrófagos num mecanismos independente do seu receptor PAFR e da produção de óxido nítrico. PAF 10μM interrompeu o crescimento de promastigotas de L. infantum em cultura axênica. Uma PAFAH, com elevada identidade e semelhança com PLA2/PAF-AH de outros tripanossomatídeos, foi identificada no genoma de L. infantum. A clonagem e expressão recombinante produziu uma proteína de cerca de 69kDa, com atividade PAF-AH. Frações celulares do parasita, enriquecidas com estruturas de membrana também apresentaram atividade PAF-AH. Os resultados indicam que PAF é capaz de diminuir a infecção de macrófagos por L. infantum e que o parasita possui uma PAF-AH funcional possivelmente envolvida com sua virulência.

Visceral leishmaniasis is caused by Leishmania infantum parasites. Infection occurs when infected sandflies feed on vertebrate host skin delivering the parasite which survive, multiply and spread on the parasitophorous vacuoles of macrophages. The inflammatory response during the infection leads to the production of diverse bioactive molecules, as lipid mediators. The platelet activating factor (PAF) is a lipid mediator derived from a lysophospholipid. PAF has a role in normal cellular physiology, acting as proinflamatory molecule. The participation of some lipid mediators, as eicosanoids and PAF has been identified in leishmaniasis. PAF produced by the host is able to kill the parasite and control the infection by L. amazonensis. PAF-acetylhydrolases (PAF-AH) are phospholipases A2 (PLA2) that hydrolyse PAF, and possibly involved in pathogen virulence. The aim of this study was to evaluate the role of PAF on macrophages infection by L. infantum and identify a PAF-AH expressed by the parasite. PAF 1μM, added during and after the infection, was able to reduce approximately 50% of infection, as well as, the viability of parasites inside macrophages. Apparently this reduction occurs by an classical PAF receptor and nitric oxide production independent mechanism. PAF 10μM inhibited L. infantum promastigotes growing in axenic culture. A PAF-AH with high identity to PLA2/PAF-AH of others trypanosomatids was identified in L. infantum genome. The cloning and recombinant expression produced a 69kDa protein with PAF-AH activity. Cellular fractions from parasites, with membrane structures also presented PAF-AH activity. The results suggest that PAF is able to decrease machophage infection by L. infantum witch has a functional PAFAH possibly related to its virulence.

Cells and mediators of inflammation (C-reactive protein, nitric oxide, platelets and neutrophils) in the acute and convalescent phases of uncomplicated Plasmodium vivax and Plasmodium falciparum infection

The haematological changes and release of soluble mediators, particularly C-reactive protein (CRP) and nitric oxide (NO), during uncomplicated malaria have not been well studied, especially in Brazilian areas in which the disease is endemic. Therefore, the present study examined these factors in acute (day 0) and convalescent phase (day 15) patients infected with Plasmodium falciparum and Plasmodium vivax malaria in the Brazilian Amazon. Haematologic parameters were measured using automated cell counting, CRP levels were measured with ELISA and NO plasma levels were measured by the Griess reaction. Our data indicate that individuals with uncomplicated P. vivax and P. falciparum infection presented similar inflammatory profiles with respect to white blood cells, with high band cell production and a considerable degree of thrombocytopaenia during the acute phase of infection. Higher CRP levels were detected in acute P. vivax infection than in acute P. falciparum infection, while higher NO was detected in patients with acute and convalescent P. falciparum infections. Although changes in these mediators cannot predict malaria infection, the haematological aspects associated with malaria infection, especially the roles of platelets and band cells, need to be investigated further.

Identification of platelet refractoriness in oncohematologic patients

OBJECTIVES: To identify the occurrence and the causes of platelet refractoriness in oncohematologic patients. INTRODUCTION: Platelet refractoriness (unsatisfactory post-transfusion platelet increment) is a severe problem that impairs the treatment of oncohematologic patients and is not routinely investigated in most Brazilian services. METHODS: Forty-four episodes of platelet concentrate transfusion were evaluated in 16 patients according to the following parameters: corrected count increment, clinical conditions and detection of anti-platelet antibodies by the platelet immunofluorescence test (PIFT) and panel reactive antibodies against human leukocyte antigen class I (PRA-HLA). RESULTS: Of the 16 patients evaluated (median age: 53 years), nine (56 percent) were women, seven of them with a history of pregnancy. An unsatisfactory increment was observed in 43 percent of the transfusion events, being more frequent in transfusions of random platelet concentrates (54 percent). Platelet refractoriness was confirmed in three patients (19 percent), who presented immunologic and non-immunologic causes. Alloantibodies were identified in eight patients (50 percent) by the PIFT and in three (19 percent) by the PRA-HLA. Among alloimmunized patients, nine (64 percent) had a history of transfusion, and three as a result of pregnancy (43 percent). Of the former, two were refractory (29 percent). No significant differences were observed, probably as a result of the small sample size. CONCLUSION: The high rate of unsatisfactory platelet increment, refractoriness and alloimmunization observed support the need to set up protocols for the investigation of this complication in all chronically transfused patients, a fundamental requirement for the guarantee of adequate management.

Titers of ABO antibodies in group O blood donors

BACKGROUND: Plasma components of group O blood donations are rarely submitted to ABO antibody titrations even though it is well known that passively acquired antibodies may destroy the recipient's own red cells and tissue grafts. OBJECTIVE: Thus, group O donations stratified by gender and age were randomly titrated to identify the best source of products for apheresis and exsanguinous transfusion. METHODS: Samples from 603 blood donors were tested by ABO antibody titration using the conventional tube technique at room temperature. ABO antibody levels higher than 64 were considered high. After correction for gender, statistical analyses were performed using the Fisher exact and Kruskal-Wallis tests. RESULTS: Most donors in the blood bank were male (65.7 percent). ABO antibody titers ranged from 1 to 2048. The estimations of prevalence for the titers were: anti-A,B < 128 = 86.9 percent and > 128 = 2.16 percent; Anti-A > 128 = 9.29 percent and anti-B > 128 = 4.81 percent. Low mean titers for both anti-A and anti-B antibodies were found in over 50-year-old men (p-value = 0.040). High anti-B antibody levels were found in young women (p-value = 0.002). CONCLUSION: This study confirms that over 50-year-old O group men should be selected as blood donors in non-identical ABO transfusion situations. Also, titration of ABO antibodies in blood banks will increase safety in non-identical ABO transfusions.

Idiopathic thrombocytopenic purpura and oral surgery: case report / Púrpura trombocitopênica idiopática e cirurgia bucal: relato de caso

OBJECTIVES: To review the function of platelets in the blood clotting mechanism. To address,conceptualize and classify thrombocytopenic purpura, especially idiopathic thrombocytopenic purpura (ITP),emphasizing the immunological aspects involved in the etiology of the disease. To address the clinicalmanifestations of the disease and the appropriate therapy. To present the case study of a patient with ITPwho requires oral surgical intervention. DISCUSSION: Leukopenia in ITP can be subclinical. The firstmanifestation of the disease can be severe hemorrhaging due to small lacerations or minor medical anddental surgical procedures. The cause of the platelet reduction is idiopathic; an autoimmune reaction in whichthe antibodies destroy the platelets appears to participate in the process. A variety of situations can occur,leading to mild to severe thrombocytopenia. One frequent aspect is the instability of the platelet count,which oscillates inconsistently and may be related to infections and other factors that have not been clearlydetermined, including stress. In the case presented here, the leukopenia in the patient was mild in presentation.However, it was decided that the patient should be referred to a hematologist for preparation and clearance.Oral surgery that compromises the bone, such as exodontia, can present significant difficulties in localizingand clamping intraosseous vessels, which does not only occur in small soft tissue surgeries. CONCLUSIONS:Platelet destruction in ITP occurs from a complex process that is comprised of multiple components of theimmune system. The platelets are prematurely destroyed by antibodies that are aimed at the platelet glycoprotein,which can results in serious, even fatal consequences. It is important to emphasize the significance of themedical history and the appropriate physical examination during the diagnostic process, as well as collaborationwith the patient’s medical...

OBJETIVOS: Revisar a função das plaquetas no mecanismo de coagulação sanguínea. Conceituare classificar a púrpura trombocitopênica, especialmente a púrpura idiopática, enfatizando osaspectos imunológicos envolvidos na etiologia da doença. Enfocar as manifestações clínicas dadoença e a terapia apropriada. Apresentar um caso de manifestação clínica da doença e a terapiaapropriada. Apresentar o caso de uma paciente com púrpura que necessitava de intervençãocirúrgica bucal. DISCUSSÃO: A leucopenia na púrpura trombocitopênica idiopática pode sersubclínica. A primeira manifestação da doença pode ser uma hemorragia severa por causa depequenas lacerações ou pequenos procedimentos médicos e odontológicos. A causa da reduçãodas plaquetas é idiopática; uma reação autoimune na qual os anticorpos destroem as plaquetasparece participar do processo. Uma variedade de situações pode ocorrer, levando àtrombocitopenia discreta a severa. Um aspecto frequente é a instabilidade da contagem plaquetária,que oscila inconsistentemente e pode relacionar-se com infecções e outros fatores ainda nãoclaramente determinados, incluindo estresse. No presente caso, o paciente apresentava discretaleucopenia. Entretanto, decidiu-se que o paciente deveria ser avaliado por um hematologista,para preparação e liberação para cirurgia, pois a cirurgia bucal que compromete osso, como aexodontia, pode apresentar dificuldades significativas na localização e pinçamento de vasosintraósseos, o que não acontece em pequenas cirurgias de tecidos moles. CONCLUSÕES: Adestruição plaquetária na púrpura trombocitopênica ocorre por meio de um complexo processo,com múltipos componentes do sistema imune. As plaquetas são destruídas prematuramente poranticorpos dirigidos contra as glicoproteínas plaquetárias, o que pode resultar em sérias – emesmo fatais – consequências. É importante enfatizar o significado da história médica e o examefísico adequado no processo diagnóstico...

Antiplatelet antibodies in cases of Glanzmann's thrombasthenia with and without a history of multiple platelet transfusion.

Antiplatelet antibodies are known to be present in a wide spectrum of patients, which include chronic Idiopathic Thrombocytopenic Purpura (ITP), infections, etc., including Glanzmann's thrombasthenia (GT) patients who receive multiple platelet transfusions. The presence of natural antibodies to platelet receptors is not studied in cases of GT. We studied the antiplatelet antibodies in 23 patients with GT, 15 of which had received multiple transfusions and eight that had not received transfusions, along with 50 cases of chronic ITP. The prevalence and specificity of platelet-bound antibodies were detected by inhibition assays using O-group platelets on flow cytometry. The mean antiplatelet antibodies in 15 patients of GT who had not received transfusions and eight patients with multiple transfusions was 8427 + 2131.88 and 9038 + 2856 antibodies/platelet, respectively, while in case of the 50 ITP patients studied, it was 22166 + 5616 antibodies/platelet (Normal Range 1500–3200 antibodies/platelet). We conclude that GT patients who have not received transfusions may develop antiplatelet antibodies to the missing/abnormal receptor. Whether this is due to a molecular mimicry or due to some other mechanism needs to be explored.

Púrpura trombocitopénica inmune en la infancia: 20 años de experiencia: 1985-2005 estado Cojedes-Venezuela / Autoimmune thrombocytopenic purpura in infancy: 20 years of experience: 1985-2005 Cojedes state-Venezuela

La púrpura trombocitopénica idiopática (PTI) es un síndrome caracterizado por diátesis hemorrágica consecuencia de la excesiva destrucción periférica de plaquetas, globalmente es considerada la trombocitopenia inmune más frecuente en niños. Describir el comportamiento clínico-epidemiológico de la PTI en el estado Cojedes, Venezuela. Se realizó un estudio descriptivo, prospectivo en niños con clínica de PTI que acudieron entre 1985 y 2005 al Hospital "Dr. Egor Nucete" de referencia del estado Cojedes, Venezuela. Las variables estudiadas fueron: época del año, procedencia, edad, género, antecedentes, manifestaciones clínicas, signos hematológicos, variedad clínica y tratamiento. Se realizó análisis estadístico descriptivo con distribuciones de frecuencia, porcentajes y gráficos de segmentos. 112 niños con PTI, incidencia acumulada promedio anual de 4,4/100.000 menores de 12 años; marzo, junio, julio y agosto mostraron el mayor número de casos y también los municipios San Carlos (30,36%), Falcón (18,75%) y Rómulo Gallegos (17,86%). Hubo mayor incidencia de PTI entre los 5 y 8 años (39%), sin diferencia entre géneros, pero con antecedentes de afección respiratoria superior en 82%; en lugar de predominó la forma aguda (91%), trombocitopenia menor de 50.000 plaquetas/mm3, sólo el 9% no recibió tratamiento terapéutico. La PTI es una patología de importante morbilidad en el estado Cojedes, de comportamiento epidemiológico similar al resto de América Latina y el mundo, su aparición está influenciada por factores ambientales, se resalta el predomino de la enfermedad entre los 2-8 años, sin distingo de género, con antecedentes infecciosos como factor de riesgo en la génesis del cuadro clínico y evolución satisfactoria aún sin tratamiento.

The immune thrombocytopenic purpura (ITP) it is a syndrome characterized by hemorrhagic, diathesis consequence of the excessive peripheric destruction of platelets, widely spread in the world and considered the most frequent thrombocytopenia in children. To description the clinic-epidemic behavior of the ITP in Cojedes state, Venezuela. It was done a descriptive prospective study with children with clinic of ITP who request medical assistance at the Hospital "Dr. Egor Nucete" of Cojedes state in a 20 years period. The variables studied were: time of the year, origin, age, gender, antecedents, clinical features, hematological signs, clinical variety and treatment. It was carried out statistical analysis. 112 children with ITP, cumulative annual average incidence of 4.4 for each 100.000 children less 12 years old; March, June, July and August showed most cases and also the municipalities of San Carlos (30.36%), Falcón (18.75%) and Rómulo Gallegos(17.86%). There was higher incidence of ITP among 5-8 years (39%), without difference among gender, but with antecedents of respiratory upper tract infection in 82% of the cases; The acute disease was predominant (91%), thrombocytopenia lower than 50.000 platelets/mm³, only 9% didn't receive treatment. The ITP is a disease of important morbility in the Cojedes state, with similar epidemic behavior than the rest of Latin America and the world, being its occurrence influenced by environmental factors, prevalence of the illness among the 2-8 years, without distinguish of gender, with infection antecedents as factor of risk in the genesis of the clinical features and satisfactory evolution without treatment.

Cytokine generation in stored platelet concentrate: comparison of two methods of preparation.

BACKGROUND & OBJECTIVES: Contaminating white blood cells (WBCs) in stored platelet concentrates (PC) are the main source of pro-inflammatory cytokines including interleukin-6 (IL-6), interleukin- 8 (IL-8) and tumour necrosis factor-alpha (TNF-alpha) that are implicated in transfusion reactions. We compared the levels of these cytokines in stored platelet preparations prepared by two methods. Effect of pre-storage leucofiltration on these cytokine levels was also studied. METHODS: Twelve units of pooled PCs were prepared by platelet rich plasma (PRP) method and buffy-coat (BC) method each and stored for 5 days. IL-6, IL-8 and TNF-alpha levels were measured in platelet supernatants on day 0, 1, 3 and 5 of the storage using commercially available immunoassays. Pre-storage leucofiltration was done in 4-pooled units of PRP-PC and cytokine levels compared with unfiltered PCs. RESULTS: Median IL-6 levels increased from day 0 to day 5 in both PRP-PC and BC-PC. In PRP-PC, IL-8 increased from <3 pg/ml on day 0 to 817 pg/ml on day 5, while in BC-PC the corresponding levels were 10 and 346.5 pg/ml, respectively. No significant increase in levels of TNF-alpha was observed in BC-PC during storage period, while levels increased significantly in PRP-PC on day 1 only. There was no significant change in the levels of all three cytokines in leucofiltered PCs over 5 days of storage. INTERPRETATION & CONCLUSION: Findings of our study showed that method of preparation and WBC content are the critical factors in determining the cytokine levels in stored PCs.

Manejo actual de la refractariedad plaquetaria / Present handling of platelet refractivity

En nuestra experiencia, y la de otros autores, la prevalencia de aloinmunización plaquetaria en pacientes politransfundidos es de alrededor del 3 al 4 por ciento. El 80 por ciento de la misma es debida a la presencia de anticuerpos anti-HLA y el resto anti-HPA. La refractariedad plaquetaria por factores no inmunes puede ocurrir hasta en un 80 por ciento de los pacientes. La conducta en estos casos es que si luego de transfundir plaquetas frescas, con menos de 48 horas de extraídas. Si ello tampoco produce un resultado satisfactorio nosotros recomendamos evaluar refractariedad no inmune. Una vez descartada esta, presumimos que se trata de una refractariedad aloinmune y realizamos anticuerpos HLA. Si fueran positivos deberíamos seleccionar donantes compatibles, con la LCT en nuestra posibilidad. Si los pacientes no respondieran con donantes LCT negativos o no existieran donantes LCT negativos utilizamos simultáneamente las siguientes estrategias: - transfundir GR al paciente severamente anémico. - administrar gran cantidad de unidades (>10) de donantes múltiples. - administración de ácido epsilon amino caproico (EACA).

Inmunoglobulina "G" intravenosa como tratamiento de la púrpura trombocitopénica inmune en niños / Intravenous immunoglobulin \"G\" as a treatment of the thrombocytopenic purpura immune in children

Evaluar la eficacia y tolerancia de la Inmunoglobulina G Intravenosa (IgG IV) en niños con púrpura Trombocitópenica Inmune (PTI). Estudio prospectivo, longitudinal y descriptivo. Se trataron 25 niños diagnosticados con P.T.I. en la consulta de Hematología del Hospital general San Carlos Dr. Egor Nucete, San Carlos estado Cojedes (Enero 2.000-Diciembre 2.003) con inmunoglubina endovenosa. Al ingreso, el recuento plaquetario fue menos de 20 x 109/L. Veinte pacientes (80%) alcanzaron más de 50 x 109/L. Plaquetas en las primeras 72 horas de terapia. A los 21 días, 18 pacientes (72%) manifestaron una respuesta excelente (mayor de 150 x 109/L. plaquetas). Seis pacientes (24%) evolucionaron hacia la cronicidad. Ningún paciente presentó hemorragia intracraneana. No se observaron reacciones adversas al medicamento. Se demuestra una buena eficacia y tolerancia con la administración de la Ig G IV a la dosis de 0.4 g/ Kg/ día, por 3 días.

Platelet alloimmunization in multitransfused patients with haemato-oncological disorders.

BACKGROUND: We studied the incidence of platelet alloimmunization in multitransfused patients with haemato-oncological disorders and determined the factors influencing alloimmunization. We also assessed the effect of alloimmunization on response to platelet transfusion. METHODS: Fifty patients with haemato-oncological disorders who received multiple transfusions were included. The patients were tested for antibodies before they received any transfusion and then after 3-4 weeks of transfusion. Lymphocytotoxicity and platelet immunofluorescence suspension tests were used to detect antiplatelet antibodies. Symptomatic improvement was used to assess the response to platelet transfusions. RESULTS: Thirty patients were positive by the lymphocytotoxicity test, giving an incidence of 60% for anti-HLA antibodies. The panel reactivity of the antibodies ranged from 3% to 100%. Nineteen patients were positive by the platelet immunofluorescence suspension test, 16 of whom were also positive by the lymphocytotoxicity test. The overall incidence of antiplatelet antibodies was 66%. The number of transfusions received and the underlying haemato-oncological disorder were not risk factors for the development of antibodies. Patients with a past history of transfusions and those with a positive obstetric history had a significantly higher incidence of antibodies. The response to transfusion therapy was poor in patients with antibodies, as 71.4% of patients with antibodies were nonresponsive compared to only 26.6% of antibody-negative patients. CONCLUSION: A high percentage of multitransfused patients developed antiplatelet antibodies. Previous sensitization was an important risk factor for the development of antibodies. Patients with high panel reactivity (HLA) showed non-responsiveness to platelet transfusions. Testing for the presence of antiplatelet antibodies and provision of compatible platelets should be important components in the management of patients with platelet transfusion refractoriness.

survey on platelet surface glycoprotiens in patients with bernard-souliar syndrome by flowcytometry

The gold standard diagnosis of the Bernard-Souliar syndrome [BSS], a rare disease, is to prove the absence of Ib/IX surface complex on platelets with the use of aggregometric methods. Flowcytometry is an ideal method in analysis of surface markers on cells. The use of flowcytometric analysis in diagnosis of Bernard-Souliar syndrome. 15 suspected BSS, 20 healthy persons as control group and 3 ITP patints were selected to be analysed for the presence of GPIb alpha and GPIIIa on the surface of platelets with the application of FITC conjugated monoclonal antibodies using flowcytometry. All healthy persons in control group and 3 ITP patients showed normal expression of both glycoprotiens on platelets using flowcytometry. All 15 suspected BSS patients showed lack of GPIb? but a normal expression of GPIIIa on platelets. The application of flowcytometry for diagnosis of BSS is a quick, accurate, and precise method, which together with aggregometric method can be used for diagnosis of BSS