Plasma And Urine Betathromboglobulin Concentration In Deep Vein Thrombosis

Abstract

To investigate the involvement of platelets in the genesis of deep vein thrombosis (DVT) plasma and urine betathromboglobulin (BTG) concentration (normal; plasma 2 8 ± 8 ng/ml; urine 0.18 ± 0.18 ng/ml; mean ± SD) was measured serially in high-risk postoperative patients undergoing surveillance with 125Iodine-fibrinogen leg scanning. BTG cone, was consistently increased postoperatively but returned to normal within 2-3 days. In 30 patients with negative 125I-fibrinogen leg scans, BTG remained normal. In the 10 patients who developed DVT, BTG cone, became elevated before the 125I-fibrinogen scan became positive and remained elevated for several days and then returned to normal. The pattern of BTG elevation was not related to anticoagulant therapy. To evaluate BTG in the diagnosis of DVT, plasma (n=l52) and urine BTG (n=72) were measured in symptomatic patients referred for venography. In the patients with positive venograms, mean plasma BTG cone, at presentation (75 ± 77 ng/ml) and mean urine BTG cone.(0.63 ± 0.77 ng/ml) were significantly elevated compared with plasma BTG (42 ± 36 ng/ml) or urine BTG (0.15 ± 0.13 ng/ml) in patients with negative venograms (p< 0.005) and compared with normal values (p < 0.005). Mean plasma and urine BTG cone, were not different between patients with calf vein thrombi compared with proximal vein thrombi. There was a significant correlation between plasma and urine BTG cone. (r=0.68, p<0.005). The sensitivity, specificity and accuracy of elevated plasma BTG (>50 ng/ml) at presentation for the diagnosis of DVT were 35%, 80% and 64% respectively and for urine BTG(>0.54 ng/ml) were 37%, 100% and 74%. The results indicate that platelet release occurred with DVT but in most instances was limited to the early phase. BTG cone, may have value for surveillance but measurement of BTG is of little value for the diagnosis of DVT in symptomatic patients.