The clinical importance of acquired abnormalities of platelet function

Article Abstract:

Circulating platelets play an important role in limiting bleeding. When a blood vessel is broken, some platelets adhere to the underlying subendothelial matrix. The platelets also aggregate among themselves, and begin the formation of a plug to block the broken vessel. The adhesion of platelets to the subendothelial matrix also results in platelet activation, which leads to the secretion of granules from the platelets and the synthesis of thromboxane A2; these events recruit more platelets into the growing plug. Abnormalities in platelet function are not rare. However, it is often difficult to adequately assess the importance of abnormal platelet function. There are patients with some signs of platelet abnormality, such as common nosebleeds and easy bruising, who are healthy and are found to have normal platelet function on laboratory testing. Conversely, there are patients with abnormal laboratory values, but no symptoms. The situation is complicated by the vast number of everyday substances associated with platelet abnormalities. While the effects of aspirin on platelet function and the risk of bleeding are firmly established, a great many other substances are likely to exert similar effects, including substances in onions, garlic, and Chinese black tree fungus. (In restaurants, this fungus is generally referred to with the more palatable, but less accurate description of ''mushroom''.) The authors provide a detailed description of the antipsychotics, antibiotics, cardiovascular drugs, and chemotherapeutic agents that can produce abnormalities of platelet function. They also provide a detailed description of the role laboratory evaluation of platelet function should play in the evaluation and management of patients. Fortunately, however, in most cases the clinical effects of abnormal platelet function are mild. With the exception of a few surgical procedures in which the consequences of bleeding can be especially dangerous, such as neurosurgical procedures, it is generally not necessary to postpone surgery because of platelet abnormalities. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement

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Thrombocytopenia and the neglected megakaryocyte

Article Abstract:

HIV-associated thrombocytopenia is not yet understood, but megakaryocyte infection appears to play a role in its development. Megakaryocytes are bone marrow cells that release blood platelets. HIV-associated thrombocytopenia is a decrease in the number of blood platelets and differs from classic thrombocytopenia in that spontaneous remission occurs in 10% to 20% of HIV-related cases and no antiplatelet antibodies are seen. Also, treatment with the drug zidovudine is often beneficial in HIV-associated cases. In a recent study, patients with HIV-related thrombocytopenia had moderately lowered platelet survival and markedly decreased platelet production, with no observations of increased platelet clearance in the spleen or liver. Patients with classic thrombocytopenia, however, have dramatically reduced platelet survival and increased platelet destruction in the spleen and liver. These findings suggest zidovudine and possibly growth factor treatment should be administered early after diagnosis of HIV-related thrombocytopenia.

Editorial, Complications and side effects, HIV infection, HIV infections, Thrombocytopenia

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Platelet activation and atherothrombosis

Article Abstract:

The article explains the importance and phenomenon of activation of platelets in a human body. It discusses the importance of platelets in atherothrombosis.

Science & research, Care and treatment, Research, Thrombosis, Thrombin, Platelet activation, Blood clot

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