Abstract
Antiplatelet antibodies are known to be present in a wide spectrum of patients, which include chronic Idiopathic Thrombocytopenic Purpura (ITP), infections, etc., including Glanzmann's thrombasthenia (GT) patients who receive multiple platelet transfusions. The presence of natural antibodies to platelet receptors is not studied in cases of GT. We studied the antiplatelet antibodies in 23 patients with GT, 15 of which had received multiple transfusions and eight that had not received transfusions, along with 50 cases of chronic ITP. The prevalence and specificity of platelet-bound antibodies were detected by inhibition assays using O-group platelets on flow cytometry. The mean antiplatelet antibodies in 15 patients of GT who had not received transfusions and eight patients with multiple transfusions was 8427 + 2131.88 and 9038 + 2856 antibodies/platelet, respectively, while in case of the 50 ITP patients studied, it was 22166 + 5616 antibodies/platelet (Normal Range 1500–3200 antibodies/platelet). We conclude that GT patients who have not received transfusions may develop antiplatelet antibodies to the missing/abnormal receptor. Whether this is due to a molecular mimicry or due to some other mechanism needs to be explored.
Highlights
Immune recognition to self-antigens is obtained in early fetal life in utero
These patients require platelet transfusions when they have a bleeding episode. Some such multitransfused Glanzmann’s thrombasthenia (GT) patients become clinically refractory to platelet transfusions.[2,3]. It is not known whether GT patients who have not received any platelet or blood transfusions show the presence of antibodies that may be produced as a result of a molecular homology to some of the common intestinal microbes or natural bacterial or viral infections in the same way as natural blood group antibodies are formed
After washing thrice in buffered citrated saline, these platelets were incubated with FITC-anti-human globulins for 20 min at room temperature and the fluorescence was measured as mean fluorescence intensity (MFI) by flow cytometry
Summary
Antiplatelet antibodies in cases of Glanzmann’s thrombasthenia with and without a history of multiple platelet transfusion. Antiplatelet antibodies are known to be present in a wide spectrum of patients, which include chronic Idiopathic Thrombocytopenic Purpura (ITP), infections, etc., including Glanzmann’s thrombasthenia (GT) patients who receive multiple platelet transfusions. We studied the antiplatelet antibodies in 23 patients with GT, 15 of which had received multiple transfusions and eight that had not received transfusions, along with 50 cases of chronic ITP. We conclude that GT patients who have not received transfusions may develop antiplatelet antibodies to the missing/abnormal receptor. Whether this is due to a molecular mimicry or due to some other mechanism needs to be explored
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