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Thromb Haemost 1980; 43(02): 154-157
DOI: 10.1055/s-0038-1650038
Original Article
Schattauer GmbH Stuttgart

Reduced Platelet Aggregation in Hemolytic-Uremic Syndrome

Bernard S Kaplan
The Nephrology Service, The Montréal Children’s Hospital and McGill University-Montréal Children’s Hospital Research Institute, Montréal, Canada
,
Jack S C Fong
The Nephrology Service, The Montréal Children’s Hospital and McGill University-Montréal Children’s Hospital Research Institute, Montréal, Canada
› Author Affiliations
Further Information

Publication History

Received 02 January 1980

Accepted 08 April 1980

Publication Date:
13 July 2018 (online)

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Summary

Platelet aggregation was studied in three patients during the course of the hemolytic-uremic syndrome (HUS) when the platelet count was below 100,000/mm3 and after the platelet count had normalized. Platelet aggregation was examined in response to epinephrine, adenosine diphosphate (ADP) and collagen. Aggregation did not occur in response to epinephrine when the patients were thrombocytopenic but normal tracings were obtained when the platelet counts had returned to normal. In contrast, platelet-rich plasma from normal subjects diluted with platelet-poor plasma from patients to comparable platelet counts, showed normal aggregation responses. This study demonstrates that platelet aggregation is reduced in the early phase of the HUS.

Keywords

Platelets aggregation - Hemolytic-uremic syndrome
 

  • References

  • 1 Avalos JS, Vitacco M, Penalver J, Gianantonio CA. Coagulation studies in the hemolytic-uremic syndrome. J Pediatr 1970; 76: 538-548
    CrossrefPubMedGoogle Scholar
  • 2 Piel CF, Phibbs RH. The hemolytic-uremic syndrome. Pediatr Clin North Am 1966; 13: 295-314
    CrossrefPubMedGoogle Scholar
  • 3 Gilchrist GS, Lieberman E, Ekart H, Fine RN. Heparin therapy in the haemolytic-uraemic syndrome. Lancet 1979; 1: 1123
    PubMedGoogle Scholar
  • 4 Courtecuisse V, Habib R, Monnier C. Nonlethal haemolytic and uraemic syndromes in children: an eledctron-microscopic study of renal biopsies from six cases. Experimental and Molecular Pathology 1969; 7: 327-347
    PubMedGoogle Scholar
  • 5 Brain MC. The haemolytic-uraemic syndrome. Seminars in Hematology 1969; 6: 162-180
    PubMedGoogle Scholar
  • 6 Katz J, Krawitz S, Sacks PV, Levin SE, Thomson P, Levin J, Metz J. Platelet, erythrocyte, and fibrinogen kinectics in the hemolytic-uremic syndrome of infancy. J Pediatr 1973; 83: 739-748
    CrossrefPubMedGoogle Scholar
  • 7 van Wieringen PM V. Het haemolytisch-uraemisch syndroom op de kinderleeftijd. M D Thesis, Catholic University of Nijmegen, van Mameren B. V. – Nijmegen 1977
    PubMedGoogle Scholar
  • 8 Kass L. Megakaryocyte abnormalities in thrombotic thrombocytopenic purpura. Am J Clin Pathol 1974; 61: 639-644
    CrossrefPubMedGoogle Scholar
  • 9 Fong JS C, White JG, Godd RA. Inhibition of endotoxic lipopolysaccharide-mediated platelet aggregation by cobra venom anticomplementary factor. Blood 1974; 44: 399-409
    PubMedGoogle Scholar
  • 10 Hovig T. Aggregation of rabbit blood platelets produced in vitro by saline "extract" of tendons. Thromb Diath Haemorrh 1963; 9: 248-263
    PubMedGoogle Scholar
  • 11 Horowitz HT, Stein IM, Cohen BD, et al. Further studies on the platelet inhibitory effect of guaridinosuccinic acid and its role in uremic bleeding. Amer J Med 1970; 49: 336-345
    CrossrefPubMedGoogle Scholar
  • 12 Rabiner SF, Molinas F. The role of phenol and phenolic acids on the thrombocytopathy and defective platelet aggregation of patients with renal failure. Am J Med 1970; 49: 346-351
    CrossrefPubMedGoogle Scholar
  • 13 Levine PH. The effect of thrombocytopenia on the determination of platelet aggregation. Am J Clin Pathol 1976; 65: 79-82
    CrossrefPubMedGoogle Scholar
  • 14 Eknoyan G, Wacksman SJ, Glueck HI, Will JJ. Platelet function in renal failure. New Eng J Med 1969; 280: 677-681
    CrossrefPubMedGoogle Scholar
  • 15 Cameron JS. Platelets and glomerulonephritis. Nephron 1977; 18: 253-8
    CrossrefPubMedGoogle Scholar
  • 16 George CR, Clark WF, Cameron JS. Role of platelets in glomerulonephritis. Adv Nephrol 1975; 5: 19-65
    PubMedGoogle Scholar
  • 17 Arkel YS. Evaluation of platelet aggregation in disorders of hemostasis. Med Clin North Am 1976; 60: 881-911
    CrossrefPubMedGoogle Scholar
  • 18 Arenson EB, August CS. Preliminary report: Treatment of the hemolytic-uremic syndrome with aspirin and dipyridamole. J Pediatr 1975; 86: 957-961
    CrossrefPubMedGoogle Scholar
  • 19 Mandal BK, McNulty M. Treatment of heamolytic-uraemic syndrome with phenformin and enthyloestrenol. Lancet 1971; 2: 1036
    PubMedGoogle Scholar
  • 20 Ponticelli C, Maestri O, Imbasciati E, Brancaccio D, Rossi E. Late recovery of renal function in a woman with the hemolytic uremic syndrome. Clin Nephrol 1977; 8 (2): 367-370
    PubMedGoogle Scholar
  • 21 Powell HR, Ekert H. Streptokinase and anti-thrombotic therapy in the hemolytic-uremic syndrome. J Pediatr 1974; 84: 345-9
    CrossrefPubMedGoogle Scholar
  • 22 Stuart J, Winterborn MH, White RH R, Flinn RM. Thrombolytic therapy in haemolytic-uraemic syndrome. Br Med. J 1974; 3: 217-221
    CrossrefPubMedGoogle Scholar
  • 23 Sutor AH, Schindera F, Jacobi H, Kunzer WM. Haemolyticuraemic syndrome: thrombocyturia after treatment with streptokinase and aspirin. Lancet 1972; 2: 762
    PubMedGoogle Scholar
  • 24 Thorsen CA, Rossi EC, Green D, Carone FA. The treatment of the hemolytic-uremic syndrome with inhibitors of platelet function. Am J Med 1979; 66: 711-16
    CrossrefPubMedGoogle Scholar
  • 25 Wehinger H, Sutor HA, Schindera F, Kunzer W. Zur Therapie des hämolytisch-urämischen Syndroms. Dtsch. Med. Wochenschr. 1974; 99: 840-1
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 O'Brien JR. "Exhausted" platelets continue to circulate. Lancet 1978; 2: 1316
    PubMedGoogle Scholar
  • 27 Editorial Platelets, endothelium, and renal disease. Lancet 1979; 2: 890
    PubMedGoogle Scholar
  • 28 Hladovec J. Is the antithrombotic activity of "antiplatelet" drugs based on protection of endothelium?. Thromb Hemost 1979; 41: 774-8
    Article in Thieme ConnectPubMedGoogle Scholar