The Clinical Implications of Antiplatelet Antibody / 임상검사와정도관리

ABSTRACT

BACKGROUND: Antiplatelet antibody test is the most important tool for the diagnosis of immune mediated thrombocytopenia. But antiplatelet antibody can occur in various diseases and the detection rates of antiplatelet antibody differ among investigators. In this study we investigated the prevalence of antiplatelet antibody in thrombocytopenic patients with various clinical conditions and analyzed the clinical significance of antiplatelet antibody in thrombocytopenia. METHODS: We tested 130 thrombocytopenic patients from 1999 January to 2000 October. The clinical diagnosis of the patients were 30 idiopathic thrombocytopenic purpura (ITP), 12 hematological diseases, 29 sepsis, 17 liver diseases, 11 pregnancy, 8 solid tumor, 2 malaria and 21 unclassified disorders. Antiplatelet antibody was detected by means of indirect immunofluorescence test. RESULTS: Antiplatelet antibody was detected in 6.2% of total patients (8/130) ; ITP 10% (3/30), malaria infection 50%(1/2), sepsis 3.5%(1/29), liver diseases 5.9%(1/17), solid tumors 12.5%(1/8), other unclassified disorders 4.8%(1/21). Antiplatelet antibody was negative in three drug induced thrombocytopenic patients. CONCLUSIONS: The positive rate of indirect immunofluorescent antiplatelet antibody was unexpectedly low in immune mediated thrombocytopenia. The positive results of non-immune mediated thrombocytopenia may be related to various conditions such as past platelet transfusions.