ABSTRACT
A patient with pseudothrombocytopenia due to the anticoagulant EDTA is described. The thrombocytopenia was secondary to platelet agglutination and required the presence of EDTA in a critical concentration and the patient's plasma. Both homologous and autologous platelets were affected by this plasma factor in the presence of EDTA. The platelet agglutination was temperature independent and could be prevented by divalent cations. The agglutination phenomenon was irreversible. The platelet count in oxalate, not heparin, and citrate anticoagulated blood was normal. The patient's clinical course was benign and no hemorrhagic complications occurred. We believe this is the first reported case of pseudothrombocytopenia associated with a vasculitis. The diagnosis of this disorder, its implications and the pertinent literature is discussed.
Subject(s)
Thrombocytopenia/complications , Vasculitis/complications , Edetic Acid/adverse effects , Humans , Male , Middle Aged , Platelet Aggregation , Thrombocytopenia/blood , Thrombocytopenia/chemically induced , Vasculitis/bloodABSTRACT
Bone marrow acid phosphatase has been reported to be a sensitive indicator of early bony metastasis from adenocarcinoma of the prostate. In order to evaluate this hypothesis, we measured bone marrow acid and alkaline phosphatase, lactic dehydrogenase, and calcium levels in a group of 84 patients with a variety of problems, including 18 with cancer of the prostate. We found that the bone marrow acid and alkaline phosphatase and lactic dehydrogenase were elevated and calcium was depressed in most patients. Among patients with prostate cancer, bone marrow acid phosphatase was not significantly different between those with or without bone metastases. In addition, the patients with prostatic cancer did not have higher levels of bone marrow acid phosphatase than subjects with other malignant and nonmalignant conditions. The level of acid and alkaline phosphatase, lactic dehydrogenase and calcium varied predictably with the aspiration technique used and was independent of sex, disease state or method of chemical determination. Due to this variation, we believe that bone marrow enzyme and calcium levels are of no value in the detection of metastases in patients with prostate cancer.
Subject(s)
Adenocarcinoma/metabolism , Bone Marrow/metabolism , Bone Neoplasms/metabolism , Calcium/metabolism , Prostatic Neoplasms/metabolism , Acid Phosphatase/metabolism , Adenocarcinoma/pathology , Alkaline Phosphatase/metabolism , Bone Neoplasms/pathology , Female , Humans , L-Lactate Dehydrogenase/metabolism , Male , Neoplasm Metastasis/metabolism , Neoplasm Staging/methods , Prostatic Neoplasms/pathologyABSTRACT
Two patients with idiopathic refractory sideroblastic anemia (IRSA) were found to have acquired hemoglobin H. Both developed leukemic syndromes. Six other patients with IRSA had normal hemoglobin electrpohoretic patterns, and none has developed acute leukemia in up to five years. We suggest that hemoglobin electrphoresis be performed routinely in IRSA. The finding of hemoglobin H in this population may be a relatively frequent occurrence and may serve to distinguish the preleukemic patients from those not destined to develop leukemia.
