Pancytopenia with severe thrombocytopenia in a patient treated with twice-weekly LDL-apheresis by polyacrylate adsorption from whole blood

2010 ◽  
pp. NA-NA
Author(s):  
Rainer Nowack ◽  
Günther Wiedemann
Keyword(s):  
Whole Blood ◽  
Severe Thrombocytopenia ◽  
Ldl Apheresis

scholarly journals Whole blood transfusion improves vascular integrity and increases survival in artemether-treated experimental cerebral malaria

2021 ◽  
Author(s):  
Saba Gul ◽  
Flavia L. Ribeiro-Gomes ◽  
Aline S. Moreira ◽  
Guilherme S. Sanches ◽  
Fabiana G. Conceição ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Cerebral Malaria ◽  
Whole Blood ◽  
Plasmodium Berghei ◽  
Severe Thrombocytopenia ◽  
Blood Components ◽  
Vascular Integrity ◽  
Experimental Cerebral Malaria ◽  
Angiopoietin 2 ◽  
Lymphocyte Populations

Abstract Pathological features observed in both human and experimental cerebral malaria (ECM) are endothelial dysfunction and changes in blood components. Blood transfusion has been routinely used in patients with severe malarial anemia and can also benefit comatose and acidotic malaria patients. In present study Plasmodium berghei-infected mice were transfused intraperitoneally with 200 µL of whole blood along with 20 mg/kg of artemether. ECM mice showed severe thrombocytopenia and decreases in hematocrit. Artemether treatment markedly aggravated anemia within 24 hours. Whole blood administration significantly prevented further drop in hematocrit and partially restored the platelet count. Increased levels of plasma angiopoietin-2 (Ang-2) remained high 24 hours after artemether treatment but returned to normal levels 24 hours after blood transfusion, indicating reversal to quiescence. Ang-1 was depleted in ECM mice and levels were not restored by any treatment. Blood transfusion prevented the aggravation of the breakdown of blood brain barrier after artemether treatment and decreased spleen congestion without affecting splenic lymphocyte populations. Critically, blood transfusion resulted in markedly improved survival of mice with ECM (75.9% compared to 50.9% receiving artemether only). These findings indicate that whole blood transfusion can be an effective adjuvant therapy for cerebral malaria.

Primary Immune-Mediated Thrombocytopenia in Cats

2010 ◽  
Vol 46 (1) ◽  
pp. 12-19 ◽  
Author(s):  
Christina Wondratschek ◽  
Christiane Weingart ◽  
Barbara Kohn
Keyword(s):  
Flow Cytometry ◽  
Differential Diagnosis ◽  
Whole Blood ◽  
Rare Condition ◽  
Antibody Test ◽  
Blood Type ◽  
Severe Thrombocytopenia ◽  
Triggering Factors ◽  
Immune Mediated ◽  
Underlying Diseases

Feline primary immune-mediated thrombocytopenia (pIMT) is a rare condition, and only a few cases have been described in veterinary literature. Five cats with severe thrombocytopenia most likely due to pIMT are described. A flow cytometry platelet-bound antibody test was positive in all cats; underlying diseases or triggering factors causing thrombocytopenia were not detected. Three cats were transfused with blood type-compatible fresh whole blood; one cat received Oxyglobin as well. All cats were treated with prednisolone; one cat received chlorambucil in addition. Four cats responded to treatment and were discharged from the hospital. One cat was euthanized due to dyspnea. Primary immune-mediated thrombocytopenia is rarely diagnosed in cats, but it is important as a differential diagnosis in cats presented with surface bleeding.

Comparison of Different Ldl-Apheresis Techniques

1998 ◽  
Vol 21 (6_suppl) ◽  
pp. 66-71 ◽  
Author(s):  
C. Stefanutti ◽  
S. Di Giacomo ◽  
A. Vivenzio
Keyword(s):  
High Risk ◽  
Plasma Exchange ◽  
Whole Blood ◽  
Pediatric Patients ◽  
Early Age ◽  
Efficacy And Safety ◽  
Ldl Apheresis ◽  
Cell Plasma ◽  
Risk Patients ◽  
Direct Adsorption

LDL-apheresis is an extracorporeal technique which removes all apo B100-containing lipoproteins (VLDL, LDL, Lp(a)) from plasma, in patients whith homozygous, and double heterozygous, familial hypercholesterolemia (FH). One of the most significant technical characteristics of LDL-apheresis is the selectivity in the removal of atherogenic lipoproteins, namely LDLs, which has been improved in the most recently developed techniques. The oldest system for therapeutic plasmapheresis in the treatment of severe hyperlipoproteinemias, is plasma-exchange, where all plasma components are unselectively removed. More recently, the systems (dextransulphate cellulose LDL-apheresis [DSC/LDL-A], heparin induced LDL precipitation-apheresis [HELP/LDL-A], immunoadsorption LDL-apheresis [IMA/LDL-A], direct adsorption of lipids [DALI]) have permitted a selective removal of LDL and of other apo B100-containing lipoproteins. The higher selectivity, thus the higher efficacy and safety, has also allowed the treatment of high risk patients with severe cardiovascular conditions, and pediatric patients. Therefore, it is currently possible to begin treatment with LDL-apheresis, even at a very early age. The most recent system for LDL-apheresis (DALI: Direct Adsorption of Lipids) even permits the removal of LDL from whole blood, without previous cell/plasma separation. This system is promising for further progress in the technology related to LDL-apheresis.

Comparison of Platelet Function and Bleeding in Thrombocytopenic Patients with Immune Thrombocytopenic Purpura (ITP) and Chemotherapy-Induced Thrombocytopenia (CIT).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2094-2094 ◽  
Author(s):  
Bethan Psaila ◽  
James B. Bussel ◽  
Matthew D. Linden ◽  
You Fu Li ◽  
Marc R. Barnard ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Blood Flow ◽  
Platelet Function ◽  
Whole Blood ◽  
Bleeding Risk ◽  
Severe Thrombocytopenia ◽  
Platelet Surface ◽  
Platelet Counts ◽  
Activated Platelets ◽  
Immature Platelet Fraction

Abstract Because of methodologic problems, platelet function in thrombocytopenic patients has never been adequately studied, and therefore individual differences in bleeding risk are poorly understood. Whole blood flow cytometry analyzes the function of individual platelets, thereby enabling assessment of platelet function in severe thrombocytopenia (Michelson, A. Platelets, 2nd ed, Elsevier, 2007). In this study, platelet function was compared in 31 ITP patients, 14 CIT patients, and 16 healthy controls. Clinical bleeding was related to platelet function testing. The immature platelet fraction (IPF, or reticulated platelets) was measured in a Sysmex XE-2100. Platelet surface P-selectin and activated integrin αIIbβ3 (reported by monoclonal antibody PAC1) were measured by whole blood flow cytometry in the presence and absence of 0.5 μM ADP, 20 μM ADP, 1.5 μΜ TRAP, or 20 μM TRAP. Bleeding was quantified by a comprehensive score that allocates grades of 0 (no), 1 (minor) or 2 (marked) bleeding at 10 anatomic sites (Page, L.K. Br J Haematol 2007). Mean platelet volume (MPV) and IPF were higher in ITP than CIT, reflecting, as expected, a higher rate of platelet production (Table 1). Platelet surface P-selectin without added agonist (i.e. circulating activated platelets) was significantly higher in both ITP and CIT patients than in controls (Table 2). However, upregulation of platelet surface P-selectin and activated αIIbβ3 in response to ADP and TRAP (platelet ‘activatability’) was reduced in CIT patients compared with ITP patients and controls (Table 2). Stratification of bleeding scores by platelet count showed that CIT patients had more GI, urinary, and pulmonary bleeding at platelet counts <20 × 109/L whereas ITP patients had more skin/oral bleeding (Table 1). In sum, the higher platelet surface P-selectin and activated αIIbβ3 in CIT and ITP patients than in controls is consistent with a role for circulating activated platelets in maintenance of vascular integrity in thrombocytopenia. However, platelet activation in response to ADP and TRAP is reduced in CIT compared with both ITP and controls, which may reflect the relative senescence (as evidenced by lower IPF) of CIT platelets and/or effects of chemotherapy or the underlying leukemia. These data demonstrate that bleeding in different thrombocytopenic conditions is not entirely explained by the thrombocytopenia per se. Reduced responses to ADP and TRAP in CIT patients compared with ITP patients may be clinically significant, given that, at equivalent degrees of thrombocytopenia, CIT patients had more significant bleeding (GI, urinary, pulmonary) than ITP patients. Table 1. All Patients Patients with platelet counts <20 × 109/L MPV IPF% Absolute IPF ×109/L Skin/oral bleeding Bleeding other than skin/oral *P <0.05 CIT 7.2 11.0 1.7 6/10 5/10 ITP 9.2* 18.1 5.8* 10/11 0/11* Table 2. (mean fluorescence intensity) CIT ITP Controls a = P<0.05 for CIT vs ITP; b = P<0.05 for ITP or CIT vs controls No Agonist P-selectin 7.6b 6.2b 3.1 ActivatedαIIbβ3 7.0 10.2 7.2 High ADP P-selectin 41.8a,b 114.0 87.5 ActivatedαIIbβ3 154.4a,b 390.2 381.7 High TRAP P-selectin 69.9a,b 296.6 505.6 ActivatedαIIbβ3 46.9a,b 241.2b 457.7

LDL Hemoperfusion-A New Procedure for LDL Apheresis: First Clinical Application of an LDL Adsorber Compatible with Human Whole Blood

2008 ◽  
Vol 21 (9) ◽  
pp. 977-982 ◽  
Author(s):  
T. Bosch ◽  
B. Schmidt ◽  
W. Kleophas ◽  
C. Gillen ◽  
V. Otto ◽  
...  
Keyword(s):  
Clinical Application ◽  
Whole Blood ◽  
Ldl Apheresis ◽  
Human Whole Blood
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