Abstract
Using indium-111 tropolone-labelled platelets, a study of platelet kinetics was performed on the basis of the relationship between platelet count, platelet survival time, platelet dynamics, platelet-associated immunoglobulin G (PA-IgG) and splenic volume in 31 patients with liver cirrhosis and a platelet count of less than 100 × 109/l. The mean platelet count was 46.6±25.3 × 109/l, and the mean platelet survival time was 6.50±1.33 days. The mean uptake into the spleen was 43.2%±14.8% on the 1st day, and 53.7%±14.3% on the 7th day. The mean PA-IgG level was 107.6±66.0 ng/107 platelets in five patients with chronic active hepatitis who were studied as controls, the mean platelet count was 197±30 × 109/l, the mean platelet survival time 9.33±0.78 days, and the mean PA-IgG 21.2±2.9 ng/107 platelets. The former two parameters were significantly higher (P<0.05), and the latter significantly lower (P<0.05). In liver cirrhosis, the platelet count showed a positive correlation with the platelet survival time and a negative correlation with PA-IgG and the splenic volume. These results suggest that the increases in both the splenic platelet pool and platelet destruction in the spleen through immunological mechanisms may influence thrombocytopenia in liver cirrhosis.
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References
Aster RH (1964) Pooling of platelets in the spleen: role in the pathogenesis of “hypersplenic” thrombocytopenia. J Clin Invest 45:645–657.
Barrison I, Knight I, Viola L et al. (1981) Platelets associated immunoglobulins in chronic liver disease. Br J Haematol 48:347–350.
Burns TR, Salleem A (1983) Idiopathic thrombocytopenic purpura. Am J Med 75:1001–1007.
Castaldi PA, Firkin BG (1963) Studies of the life span and fate of platelets. Aust Ann Med 12:333–341.
Cohen P, Gardner FH, Barnett GO (1961) Reclassification of the thrombocytopenias by the Cr51 labeling method for measuring platelet life span. N Engl J Med 264:1294–1299.
Dameshek W (1955) Hypersplenism. Bull NY Acad Med 31:113.
Dewanjee MK, Rao SA, Didisheim P (1981) Indium-111 tropolone, a new high-affinity platelet label: preparation and evaluation of labeling parameters. J Nucl Med 22:981–987.
Harada M (1984) Changes in membrane lipid composition, morphology and cell function of the erythrocyte in cirrhotic patients: their clinical significance. J Kurume Med Assoc 47:1031–1041.
Harker LA, Finch CA (1969) Thrombokinetics in man. J Clin Invest 48:963–974.
International Committee for Standardization in Hematology (1977) Recommended methods for radioisotope platelet survival studies. Blood 50:1137–1144.
Kelton JG, Gibbons S (1982) Autoimmune platelet destruction: idiopathic thrombocytopenic purpura. Semin Thromb Hemost 8:83–104.
Kiefel V, Becker T, Mueller-Eckhardt G et al. (1985) Platelet survival determined with 51Cr and 111In. Klin Wochenschr 63:84–89.
Kutti J, Weinfeld A, Westin J (1972) The relationship between splenic platelet pool and spleen size. Scand J Haematol 9:351–354.
Mayer M, Herrman I, Kempgens U et al. (1977) In vivo labeling of platelets with 75Se-selenomethionine in patients with hepatic cirrhosis and thrombocytopenia. Throm Haemost 37:47.
McMillan R (1981) Chronic idiopathic thrombocytopenic purpura. N Engl J Med 304:1135–1147.
McMillan R, Longmire RL, Yekenosky R et al. (1972) Immunoglobulin synthesis in vitro by splenic tissue in idiopathic thrombocytopenic purpura. N Engl J Med 286:681–684.
McMillan R, Longmire RL, Yekenosky R et al. (1974) Quantitation of platelet-binding IgG produced in vitro by spleens from patients with idiopathic thrombocytopenic purpura. N Engl J Med 291:812–817.
Mueller-Eckhart C, Kayser W, Mersch-Baumert K et al. (1980) The clinical significance of platelet-associated IgG: a study of 298 patients with various diseases. Br J Haematol 46:123–131.
Panzer S, Niessner H, Lechner K et al. (1986) Platelet-associated immunoglobulins IgG, IgM, IgA and complement C3c in chronic idiopathic autoimmune thrombocytopenia: relation to the sequestration pattern of 111Indium labelled platelets. Scand J Haematol 37:97–102.
Thakur ML, Welch MJ, Joist JH et al. (1976) Indium-111 labeled platelets. Studies on preparation and evaluation of in vitro and in vivo functions. Thromb Res 9:345–357.
Toghill PJ, Green S (1983) Platelet dynamics in chronic liver disease using the 111Indium oxine label. Gut 24:49–52.
Van Thiel DH, Hagler NG, Schade RR et al. (1985) In vivo hepatic volume determination using sonography and computed tomography. Gastroenterology 88:1812–1817.
Watanabe Y (1981) The mechanism of the thrombocytopenia in patients with hepatic cirrhosis. Jpn J Gastroenterol 78:1216–1225.
Wessels P, Heyns A du P, Pieters H et al. (1985) An improved method for the quantification of the in vivo kinetics of a representative population of 111In-labeled human platelets. Eur J Nucl Med 10:522–527.
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Aoki, Y., Hirai, K. & Tanikawa, K. Mechanism of thrombocytopenia in liver cirrhosis: kinetics of indium-111 tropolone labelled platelets. Eur J Nucl Med 20, 123–129 (1993). https://doi.org/10.1007/BF00168872
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DOI: https://doi.org/10.1007/BF00168872