Elevated Platelet Count Research Articles

Unveiling the hidden link: elevated platelets and T cell subsets in 5% of moderate COVID-19 patients 48 days post-onset.

Platelets are hyperactived during acute COVID-19, promoting clotting and modulating immune-cell responses. Immune thrombocytopenia in adults can manifest as an uncommon complication resulting from various viral infections or as a rare adverse event associated with vaccination. However, their role in convalescent COVID-19 patients remains underexplored. This study examines platelet dynamics early in the pandemic, 48 days post-symptom onset, in unvaccinated patients. This longitudinal study included 298 unvaccinated COVID-19 patients (17 mild, 281 moderate) from multiple centers. Clinical evaluations and peripheral lymphocyte subset analyses via flow cytometry were conducted upon admission and on day 48 post-symptom onset (DPSO 48). At DPSO 48, 5.3% of moderate COVID-19 patients exhibited high platelet counts (>300×109/L), associated with elevated total T-cells (26.4%), CD4 T-cells (24.4%), CD8 T-cells (36.9%), and Tregs (33.9%) compared to patients with normal platelet counts. However, the CD4/CD8 T-cell ratio and T-cell subset frequencies remained unaffected, indicating ongoing T-cell homeostasis restoration. Additionally, a significant positive correlation (r=0.636, p=0.03) was found between platelet counts and B cells in patients with elevated platelet counts. Platelets may play a pivotal role in immune regulation during the recovery phase of COVID-19. Targeting platelets and their secreted mediators could improve immune balance in patients with immune disorders, highlighting a potential therapeutic approach for enhancing recovery in post-COVID-19 patients.

Impact of Serum Platelet Count on Infertility in Polycystic Ovary Syndrome: A Retrospective Case-Control Study

Background: This study intended to investigate the correlation between insulin resistance (IR) and coagulation parameters in women with polycystic ovary syndrome (PCOS) and their effects on infertility. Methods: We retrospectively included 380 PCOS patients and 143 healthy controls between January 2018 and January 2021. Clinical data, including age; body mass index; white blood cell (WBC), neutrophil (NE), lymphocyte (Lym), and platelet (PLT) counts; and D-dimer, plasma sex hormone, fasting blood sugar, and fasting insulin levels, were collected. The relationship between these markers and PCOS was assessed. Results: Elevated homeostatic model assessment of insulin resistance score was independently related to infertility in women with PCOS (odds ratio [OR] = 1.825, 95% confidence interval [CI]: 1.091–3.055, p = 0.022). WBC (7.29 [5.99–8.59] vs. 6.25 [5.33–7.40], p < 0.001), NE (3.91 [3.22–4.98] vs. 3.36 [2.62–4.51], p = 0.001), PLT (276 [244.5–317.5] vs. 251.5 [219.25–281.5], p < 0.001), and Lym (2.51 [2.02–3.11] vs. 2.08 [1.85–2.53], p < 0.001) counts, and D-dimer levels (0.22 [0.15–0.42] vs. 0.20 [0.12–0.31], p = 0.023) in the serum were markedly higher in PCOS patients with IR. Furthermore, multivariate logistic regression analysis revealed that increased serum PLT count (OR = 3.066, 95% CI: 1.052–8.939, p = 0.040) and BMI (OR = 5.06, 95% CI: 1.166–21.963, p = 0.030) were independently correlated with the risk of IR in PCOS patients. Moreover, increased PLT count was independently related to infertility (OR = 3.380, 95% CI: 1.272‒8.982, p = 0.015). Conclusions: Elevated PLT count serve as an independent responsible role for infertility in PCOS women with IR, which indicate that PLT count might be a potential predictive marker for infertility in PCOS women with IR.

Lactate dehydrogenase as a biochemical marker for prediction of maternal and perinatal outcomes in hypertensive disorders in pregnancy

Hypertensive disorder of pregnancy includes new onset hypertension in pregnancy that is gestational hypertension and already existing hypertension that is chronic hypertension and gestational hypertension sometimes worsened by preeclampsia. Preeclampsia can cause complications such as eclampsia, HELLP syndrome, renal failure, pulmonary edema, stroke, and left ventricular failure. We aim to assessthe predictive role ofLactate Dehydrogenase value in Hypertensive disorders in pregnancy.After obtaining the informed consent, pregnant patients who were visiting Tertiary care centre and who were more than 28 weeks period of gestation were enrolled. Patients from both antenatal OPD clinics and from those who were presenting in emergency were included in this study. Serum levels of LDH were tested. Patients were monitored till delivery and 6 weeks following childbirth.The Mean serum levels of lactate dehydrogenase (LDH) in eclamptic group was 1495.000±859.1230, 804.569±224.5519 in severely preeclamptic group and in mild preeclamptic group ,mean LDH levels were 520.062±110.3944. The difference between both the groups was statistically significant (p < 0.001).Women with serum LDH levels > 800 IU/L and LDH levels between 601-800 IU/L, experienced considerably greater complications in preeclamptic-eclamptic group as compared to those with serum LDH levels < 600 IU/L.Thepreeclamptic-eclamptic group of women had increased serum LDH levels. Greater LDH levels were linked to worse outcomes for mothers including placental abruption, hemolysis elevated liver enzymes low platelet count (HELLP syndrome), pulmonary edema and maternal death and they were also linked to fetal complications including intrauterine fetal death (IUFD), intrauterine growth restriction and neonatal intensive care unit (NICU) admission.

Association of clonal haematopoiesis with recurrent venous thromboembolism: A case-control study.

Venous thromboembolism (VTE) is the third most common cardiovascular disease. Clonal haematopoiesis (CH) is linked to cardiovascular disease risk, but its potential association with VTE remains poorly understood. We assessed the prevalence of CH in patients with recurrent VTE (n = 107; median age [IQR] 57 [48-63] years, 44.9% female) and matched healthy controls (n = 127; median age [IQR] 53 [45-60] years, 51.2% female) to investigate a putative association of CH with VTE risk. We detected 12 CH-associated mutations in 11 (10.3%) VTE cases and six mutations in 5 (3.9%) controls. Thus, patients with recurrent VTE tended to have higher odds of presenting with CH compared to controls (OR: 2.74, 95% CI: 0.95-9.16). Moreover, the odds of detecting CH were significantly higher in VTE cases in the subgroup of individuals without thrombophilia (OR: 4.58, 95% CI: 1.48-15.99). VTE cases with CH showed elevated platelet counts compared to cases and controls without CH (median [IQR]: 292 [254-298], 223 [198-260] and 220 [185-259] × 109/L; both p < 0.01). Fibrinogen, sP-selectin, D-dimer and hsCRP levels did not differ according to CH status. Overall, we identified a trend for an association between CH and recurrent VTE, particularly in individuals without underlying thrombophilia, warranting further research in this patient group.

Afebrile Kawasaki disease: A case report

Objective: Kawasaki disease (KD) is an acute, self-limiting vasculitis and the most common cause of acquired heart disease in children under 5 years old. Despite over 50 years of research, the etiology and long-term prognosis of KD remain unclear.Case presentation: A 2-year-7-month-old boy presented with all the typical KD symptoms, including conjunctival injection, cracked lips, strawberry tongue, and membranous desquamation of the fingers and toes, but without fever. The patient was admitted with a 9-day history of peeling skin on his fingers, and no history of illness or fever in the past two weeks. Laboratory tests revealed elevated platelet count. An echocardiogram showed normal coronary arteries. The patient was diagnosed with KD and treated with low-dose aspirin and dipyridamole. He was discharged on the third day and showed complete symptom resolution and normal coronary arteries at follow-up.Conclusions: This case report describes an instance of afebrile KD, emphasizing the need for clinical vigilance and comprehensive assessment for diagnosis and treatment. Afebrile KD poses a diagnostic challenge as fever is a major diagnostic criterion. However, clinicians should consider afebrile KD when other clinical features and laboratory results suggest KD, and initiate appropriate treatment to prevent severe complications like coronary artery lesions. This case underscores the importance of early diagnosis, timely intervention, and multidisciplinary team collaboration for effective management of KD.

Single-cell mass cytometry analysis unveils prothrombotic expression and heterogeneity in essential thrombocythemia

Abstract Background/Introduction Essential thrombocythemia (ET) is recognized for its hallmark elevated platelet count and a consequent increased risk of thromboembolic events including coronary events. Despite its clinical significance, the pathophysiological mechanisms predisposing ET patients to thrombosis remain largely undefined. Purpose The aim of this pioneering study was to shed light on the increased thrombotic risk in ET by conducting a detailed phenotypical characterization of platelet expression using single-cell mass cytometry, comparing ET patients to age- and sex-matched healthy controls. Methods Platelet samples from six patients diagnosed with ET and six healthy individuals were analyzed. This analysis utilized an extensive panel of 18 transmembrane regulators pivotal for platelet function and activation. Measurements were taken both at baseline and after ex-vivo stimulation with thrombin receptor-activating peptide (TRAP). Advanced clustering analysis via the FlowSOM algorithm helped identify specific subclusters of platelets with a prothrombotic expression profile. Results Our investigation revealed a significant overexpression of the activation marker CD62P (P-Selectin, p=0.049) and of the collagen receptor GPVI (p=0.044) in non-stimulated ET platelets (Figure 1A-C). Conversely, a notable decrease in expression was observed for the fibrinogen receptor GPIIb/IIIa units CD41 (p=0.036) and CD61 (p=0.044), as well as for the von Willebrand factor receptor CD42b (p=0.044). The FlowSOM analysis distinguished two prothrombotic subclusters of ET platelets, particularly highlighting one cluster, which was significantly overrepresented in ET (22.13% of total ET platelets versus 2.94% in controls, p=0.035, Figure 1D-E). Conclusion This study presents compelling evidence of a distinct prothrombotic phenotype in ET, marked by significant alterations in platelet expression profiles. The overexpression of CD62P and GPVI, alongside the underexpression of CD41, CD61, and CD42b, underscores the complex pathophysiological landscape of ET. Importantly, we identified a specific subcluster, particularly overrepresented in ET, with a specific prothrombic signature. Our findings, while only hypothesis generating, propose GPVI as a potential therapeutic target to mitigate thrombosis in ET patients, paving the way for targeted interventions in this high-risk population.

The effects of an aggressive breast tumor on thrombosis after antithrombin downregulation in a hypercoagulable mouse model

BackgroundDespite improvements in therapy, breast cancer still contributes to high mortality rates. Survival of these patients becomes progressively worse upon diagnosis with cancer-associated thrombosis (CAT). Unfortunately, the mechanism causing CAT has remained unclear. ObjectiveSet up an acute and non-invasive hypercoagulable mouse model with an aggressive breast cancer and study the mechanism of cancer-associated thrombosis. MethodsMice were grafted with the aggressive breast cancer cell line MDA-MB-231 or sham-treated. Subsequently, an acute imbalance in coagulation was introduced by injecting a synthetic small interfering (si) RNA targeting hepatic Serpinc1 to knockdown antithrombin – a condition known to predispose to cause a hypercoagulant state in vivo. ResultsSilencing Serpinc1 with siRNA decreased plasma antithrombin levels. siRNA treatment had no short-term effects on tumor characteristics, but increased distant metastasis within the timeframe of this study. The systemic pro-inflammatory status, with elevated platelet counts and fibrinogen levels in tumor-bearing mice, was also not affected by antithrombin silencing. While elevated fibrin deposition in the liver upon Serpinc1 targeting was not significantly affected by the presence of breast cancer, knockdown of antithrombin did significantly increase intratumoral fibrin deposition and inflammation. Surprisingly, in the presence of an aggressive tumor, a protective outcome with less clinical features coinciding with venous thrombosis were observed in mice with antithrombin knockdown. ConclusionWe conclude that the presence of a breast tumor protects hypercoagulant mice from severe consumption of coagulation factors after lowering hepatic antithrombin levels, possibly due to elevated platelet counts. However, the consequences on cancer-associated thrombosis remained inconclusive.

Newly diagnosed essential thrombocythemia leading to cardiogenic shock: a case report

BackgroundEssential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by uninhibited platelet production. It can present with vasomotor symptoms, and less commonly, severe thrombotic events such as myocardial infarction. ST-segment elevation myocardial infarction (STEMI) secondary to the hypercoagulable state in ET is a diagnostic challenge as the complication is rare, especially outside the typical demographics affected by ET such as the female and elderly populations.Case presentationHere we report a case of a 32-year-old male found to have STEMI and a markedly elevated platelet count. Angiography revealed occlusion of the left anterior descending and left circumflex arteries, requiring percutaneous intervention and Impella support. The patient was later diagnosed with essential thrombocythemia, treated with hydroxyurea and antiplatelet therapy, and discharged with a wearable cardioverter defibrillator.ConclusionsThis case illustrates the potential for severe thrombotic complications such as STEMI due to ET. Severe thrombotic complications are less common manifestations of ET in general, particularly in young males. Recognition and diagnosis of ET are critical for the institution of appropriate therapy and prevention of STEMI and cardiogenic shock among other complications.

Cerebral venous sinus thrombosis associated with JAK2 V617F mutation-related pre-primary myelofibrosis: a case report and literature review

BackgroundCerebral venous sinus thrombosis (CVST) is a rare but potentially life-threatening subtype of stroke. Prompt and appropriate anticoagulation is crucial for improving the prognosis of CVST and preventing its recurrence. Identifying the underlying cause of CVST is decisive for guiding anticoagulant selection and determining treatment duration.Case PresentationA 50-year-old man presented with a 35-day history of headache, nausea, vomiting, and blurred vision. Digital subtraction angiography performed at another facility revealed CVST. A contrast-enhanced black-blood MRI at our center confirmed the diagnosis, which was supported by a high intracranial pressure of 330mmH2O. Laboratory tests showed elevated leukocytes and platelet counts, raising suspicion of an underlying myeloproliferative neoplasms (MPNs). A bone marrow biopsy demonstrated increased megakaryocytes and granulocytes, and genetic testing identified the presence of the Janus kinase 2 V617F (JAK2 V617F) mutation, leading to a diagnosis of pre-primary myelofibrosis (pre-PMF). During hospitalization, anticoagulation with nadroparin calcium and fibrinolytic therapy were initiated. Upon discharge, rivaroxaban and aspirin were prescribed to prevent CVST recurrence and arterial thrombosis.ConclusionThis case highlights the importance of recognizing dynamic changes in routine blood tests that may link CVST to underlying hematological disorders. The JAK2 mutation is not only associated with MPNs but also increases the risk of thrombosis, including CVST. Further investigation is warranted to better understand the mechanisms by which JAK2 mutations contribute to thrombosis and to explore the potential benefits of JAK2 inhibitors in reducing this risk.

Pink1/Parkin deficiency alters circulating lymphocyte populations and increases platelet-T cell aggregates in rats

Parkinson’s disease (PD) is the most common progressive neurodegenerative movement disorder and results from the selective loss of dopaminergic neurons in the substantia nigra pars compacta. Pink1 and Parkin are proteins that function together in mitochondrial quality control, and when they carry loss-of-function mutations lead to familial forms of PD. While much research has focused on central nervous system alterations in PD, peripheral contributions to PD pathogenesis are increasingly appreciated. We report Pink1/Parkin regulate glycolytic and mitochondrial oxidative metabolism in peripheral blood mononuclear cells (PBMCs) from rats. Pink1/Parkin deficiency induces changes in the circulating lymphocyte populations, namely increased CD4 + T cells and decreased CD8 + T cells and B cells. Loss of Pink1/Parkin leads to elevated platelet counts in the blood and increased platelet-T cell aggregation. Platelet-lymphocyte aggregates are associated with increased thrombosis risk suggesting targeting the Pink1/Parkin pathway in the periphery might have therapeutic potential.

Prognostic Implications of Changes in Platelet Trajectories in Patients With Sepsis: A Retrospective Analysis Using the Medical Information Mart for Intensive Care-IV Database.

Patients with sepsis often experience reductions or increases in platelet counts, but the implications of these temporal patterns on prognosis remain unclear. The aim of this study was to investigate the impact of changes in platelet trajectories on the clinical prognosis of sepsis. This study was a retrospective analysis using data from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Patients with sepsis were identified from the database, and their platelet trajectories were categorized into four distinct models based on the changes in platelet counts over a period of 14 days post-diagnosis of sepsis. The effect of these trajectories on patient prognosis was subsequently evaluated. A total of 15,250 patients with sepsis were included to construct a model, and the following four distinct platelet count trajectories were identified: normal platelet levels (phenotype 1); persistently low platelet levels (phenotype 2); gradually increasing platelet levels exceeding the normal range (phenotype 3); and consistently significantly elevated platelet levels (phenotype 4). Statistically significant differences were found in the 28-day mortality, in-hospital mortality, and 90-day mortality among the four phenotypes. Multivariate regression analysis showed that compared to the group with normal platelet levels (phenotype 1), the group with persistently low platelet levels (phenotype 2) had higher in-hospital mortality (odds ratio [OR] = 1.34, 95% confidence interval [CI]: 1.16-1.54), 28-day mortality (OR = 1.69, 95% CI: 1.47-1.94), and 90-day mortality (OR = 1.50, 95% CI: 1.32-1.69). There was no difference in in-hospital mortality between phenotypes 3 and 4 compared to phenotype 1, although phenotype 4 showed an increase in 28-day mortality (p < 0.05), and phenotype 3 showed a decreasing trend in 90-day mortality (p < 0.05). The results of inverse probability weighting adjusted by regression were basically consistent with the above findings, except that there was no statistical difference in 28-day mortality between phenotype 4 and phenotype 1. In the subgroups based on age, weight, and antiplatelet drugs or therapies, there was an interaction between platelet levels and these factors. In patients with sepsis, a decrease in platelet count is associated with increased mortality, while a moderate increase in platelet count can reduce 90-day mortality. However, for patients with persistently elevated platelet counts, caution is advised when using antiplatelet drugs or therapies, as it may increase mortality.

A chronic myeloid leukemia presenting as panuveitis combined with retinal and choroidal vascular occlusion: a case report

BackgroundChronic myeloid leukemia (CML) can manifest ocular complications stemming from hematologic irregularities or direct infiltration of neoplastic cells. This article details the case of a patient with newly diagnosed CML exhibiting elevated platelet counts (PLT) who developed panuveitis accompanied by retinal vascular occlusion.Case presentationA 52-year-old woman experienced a notable decline in vision in her left eye over a 2-week period. Classical anterior uveitis, vitreous cavity opacity, optic nerve edema, and retinal vascular obstruction were observed. The right eye exhibited papilledema and retinal vein tortuosity. Despite admission, the condition of both eyes deteriorated, accompanied by a continuous increase in PLT. She was diagnosed with CML based on bone marrow biopsy and chromosomal examination. Following platelet apheresis therapy and chemotherapy, the condition of her right eye significantly improved, but the left eye’s condition remained irreversible.ConclusionsThis is a rare case of newly diagnosed CML presenting with diverse ocular manifestations in both eyes. The disparate outcomes in eyes with varying lesion stages underscore the importance of prompt diagnosis.

Prevalence and associated risk factors of myocardial ischemia in children living with sickle cell anemia in Lagos, Nigeria.

Myocardial ischemia (MI) in children living with sickle cell anemia (SCA) is rarely reported. MI among children living with this disease could portend untoward outcomes on their quality of life and survival. This study evaluated the prevalence and associated risk factors of MI in children living with SCA during a vaso-occlusive crisis (VOC) compared with those with SCA who had no symptoms nor an MI in the past (those in "steady state") in Lagos, Nigeria. This comparative cross-sectional study was conducted over 10 months (between March and December 2019) among 250 children living with SCA aged 6 months-18 years (125 in VOC and 125 age and sex-matched controls in steady state). The assessment of MI was determined by measuring cardiac troponin T (cTnT) and electrocardiography (ECG). The prevalence of MI measuring cTnT alone in children with SCA during VOC and steady state was 42.4% and 23.2%, respectively. Comparatively, measuring ECG alone, the prevalence of MI in VOC and steady state was 40.8% and 20.8%, respectively. The prevalence of MI measuring cTnT and ECG in children with SCA in VOC and steady state was 38.4% and 20%, respectively. Older age, severity of pain, longer duration of illness, frequent crises per year, elevated white blood cells, and platelet count were significantly associated with MI in participants with SCA. However, with multivariate analysis, age, severity of pain, and elevated platelet counts remained significantly associated with the occurrence of MI. This study affirms the high prevalence of MI in children with SCA irrespective of the diagnostic criteria. Routine evaluation should be done in this cohort to avert MI-associated sequelae.

Prognostic Factors for Survival in Patients with Metastatic Colon Carcinoma

Colorectal cancers are the most common cancers of the gastrointestinal system. They rank third after prostate and lung cancer in men and after breast and lung cancer in women. In Turkiye, colon cancer is the third most common among all cancers. In such cancer, beyond the stage of the disease, there are many biological, molecular, genetic, and tissue-related factors that determine the prognosis. Among these, vascular invasion, the number of affected regional lymph nodes, and the levels of preoperative carcinoembryonic antigen (CEA) are prominent factors. In this study, we investigated the personal, clinical, tumoral, metastatic, and treatment characteristics of metastatic colon cancer (MCC) that may be associated with long survival. This study included the data of 103 patients diagnosed with MCC who were followed at the Medical Oncology Department of Karadeniz Technical University Faculty of Medicine between 2010 and 2016. In univariate analyses, primary surgery (p&lt; 0.001), targeted therapy (p= 0.01), being less than 65 years old (p=0.02), having normal CEA levels (p= 0.03), and not having elevated platelet counts (p= 0.001) were significant factors associated with prolonged survival. Multivariate analysis indicated that survival was longer in patients who underwent primary surgery (p= 0.001, 95% CI: 0.07–0.52) and had normal or low platelet levels at the time of diagnosis (p= 0.001, 95% CI: 1.77–9.16), regardless of other factors. In patients diagnosed with MCC, those who had primary tumor surgery and had normal or low platelet levels at the time of diagnosis had a better prognosis regardless of other factors. Therefore, prognostic factors are important in MCC, and more comprehensive studies are needed on this subject. Keywords: Metastatic colorectal cancer, Survival, Prognostic factors

A Comparison of Kawasaki Disease during the SARS-CoV-2 Pandemic with Multisystem Inflammatory Syndrome in Children.

The purpose of this study was to compare and contrast Kawasaki disease (KD) with multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic. A retrospective analysis of the medical records of patients diagnosed with KD and MIS-C at a single institution from July 2020 to November 2021 was performed. The study included 39 MIS-C patients (84.6% male) with a median age of 138 months and 17 KD patients (58.8% male) with a median age of 36 months. The MIS-C patients were older (p < 0.001) and had prolonged hospitalizations (p = 0.023), elevated neutrophil counts (p < 0.001), C-reactive protein (p < 0.001), procalcitonin (p < 0.001), interleukin-6 (p < 0.014), ferritin (p < 0.001), fibrinogen (p < 0.001), troponin I (p = 0.001), NT-proBNP (p < 0.001), and D-dimer levels (p < 0.001). There were more cases of hypotension (p = 0.024), decreased left ventricular function (p = 0.023), and a greater need for corticosteroids (p < 0.001), enoxaparin (p = 0.045), and therapeutic plasma exchange (p < 0.001). Kawasaki disease patients had a greater incidence of rash (p < 0.001), changes in oral mucosa (p < 0.001), conjunctival injection (p < 0.001), extremity changes (p < 0.001), and cervical lymphadenopathy (p < 0.001). They had a longer duration of fever (p < 0.001), elevated white blood cell count (p < 0.001), platelet count (p < 0.001), and alanine aminotransferase level (p < 0.001). The two groups were similar regarding the hemoglobin levels, erythrocyte sedimentation rates, albumin levels, and the frequency of coronary aneurysm, myocarditis, pericarditis, invasive mechanical ventilatory support, and intravenous immunoglobulin treatment. Advanced patient age, a greater presence of gastrointestinal and cardiac findings associated with hypotension, increased NT-proBNP levels, decreased left ventricular function, the use of various treatment modalities, and longer hospital stays suggest MIS-C, whereas prolonged fever and classical clinical features of KD favor KD.

The impact of psychological stress on physiological indicators in healthcare workers: a cross-sectional study.

Medical health workers play an essential role in the healthcare system and face unique workplace stressors. However, the impact of psychological stress on their physical health has received less attention compared to the general population. We retrospectively analyzed the Self-rating Depression Scale (SDS) questionnaires and blood testing results from 1963 medical health workers. Multivariate linear regression analysis using a backward stepwise selection strategy to identify physical examination indicators that were significantly affected by depression. Depression severity, as measured by SDS index score, was positively correlated with the levels of hemoglobin (coefficient 0.0027, p = 0.0412), platelet count (coefficient 0.0005, p = 0.0198), and uric acid (coefficient 0.0004, p = 0.0492), while negatively correlated with red blood cell count (coefficient-0.0895, p = 0.0406). Similar results were observed in the subgroup analysis stratified by age and sex. Our study found a significant association between higher levels of depression and specific physiological indicators in healthcare professionals, including elevated hemoglobin, platelet counts, and uric acid levels, as well as decreased red blood cell counts. These changes in blood parameters may reflect underlying physiological stress and inflammation, potentially increasing overall health risks for healthcare workers. Addressing these physiological changes may be crucial for mitigating the health risks associated with depression. To validate our findings and develop targeted interventions, larger multi-center studies are needed to further explore the relationship between depression severity and blood parameters in healthcare professionals.

Higher Platelet Count Mostly in the Normal Range Is Associated with the First Episode of Peritonitis Risk in Incident Peritoneal Dialysis Patients

Introduction: Platelets play parts in infection and immune processes. However, the association between platelet count and the risk of peritoneal dialysis (PD)-associated peritonitis is unclear. Methods: This was a retrospective, observational, single-center cohort study. A Cox regression analysis was used to evaluate the independent association of platelet count with the occurrence of first PD-associated peritonitis. Models were adjusted for gender, age, body mass index, cardiovascular disease, diabetes mellitus, white blood cell count, neutrophil-lymphocyte ratio, hemoglobin level, albumin level, potassium level, and anti-platelet medication usage. Results: A total of 2,374 patients were enrolled in this study (59% men; mean age 47.40 ± 12.12). The average platelet count was 229.30 ± 82.12 × 109/L. 467 (20%) patients suffered from PD-associated peritonitis at least once. In the multivariable model, the adjusted hazard ratios (HRs) for quartiles 2, 3 and 4 versus quartile 1 were 1.428 (95% CI 1.060–1.924, p = 0.019), 1.663 (95% CI 1.240–2.229, p < 0.001) and 1.843 (95% CI 1.363–2.492, p < 0.001) with baseline data. A nonlinear relationship between platelet count and first PD-associated peritonitis was observed. Further, the association between platelet and first PD-associated peritonitis was significant in the patients with hypokalemia (P for interaction = 0.040). Conclusion: In PD patients, elevated platelet counts were significantly associated with an increased risk of the first onset of PD-associated peritonitis.

Unmasking Essential Thrombocythemia: Myocardial Infarction as a Rare Complication in a Young Patient

Essential thrombocythemia (ET) is a rare myeloproliferative disorder characterized by elevated platelet counts and seldom presents with myocardial infarction (MI), particularly in younger individuals without traditional cardiovascular risk factors. We report the case of a 41-year-old woman with no significant medical history who presented with acute chest pain and elevated troponin levels. Her laboratory results indicated a markedly high platelet count, and coronary angiography revealed thrombotic stenosis in the proximal left anterior descending artery. Diagnosis of ET was confirmed by JAK2-V617F mutation and bone marrow biopsy. The patient was initially treated with hydroxyurea to reduce platelet levels, allowing for successful angioplasty three weeks later. This case highlights the importance of considering ET in the differential diagnosis of MI, especially in younger patients without other risk factors, and underscores the need for tailored management and close monitoring in such rare presentations.

Avatrombopag Elevates Platelet Counts and Reduces Platelet Transfusions in Patients With Chronic Liver Diseases During the Perioperative Period of Liver Transplantation

ABSTRACTBackgroundAvatrombopag has been approved for elevating platelet counts in patients with chronic liver diseases (CLDs) accompanied by thrombocytopenia (TCP). However, limited research focuses on its safety and efficacy in CLD patients during the perioperative period of liver transplantation (LT).MethodsWe retrospectively enrolled CLD patients with severe TCP who received avatrombopag during the perioperative period of LT and analyzed therapeutic efficacy, changes in platelet counts, and related adverse events. Comparisons were conducted between liver transplant recipients who received avatrombopag and those who did not use platelet‐raising drugs, focusing on intraoperative and postoperative bleeding as well as platelet transfusions.ResultsOf 93 patients who received avatrombopag, 67 cases (72%) achieved remission, with their platelet counts increasing to over 50 × 109/L without transfusion. Additionally, 38 cases (40.9%) reached platelet counts above 100 × 109/L, achieving complete remission. The overall remission rate was significantly correlated with the baseline platelet counts, suggesting that individuals with higher baselines (25−50 × 109/L vs. &lt; 25 × 109/L) were more likely to achieve remission (82.1% vs. 57.7%, χ2 = 5.989, p = 0.014). Using propensity score‐overlap weighting to balance the baseline bias, we compared 33 liver transplant recipients who received avatrombopag to those who did not receive any platelet‐raising drugs. Recipients who used avatrombopag achieved significantly higher platelet counts both before and after propensity score‐overlap weighting ([63.76 ± 31.33] × 109/L vs. [45.73 ± 16.44] × 109/L, p = 0.004; [65.37 ± 38.41] × 109/L vs. [42.73 ± 17.27] × 109/L, p = 0.044) and required fewer intraoperative and postoperative platelet transfusions (p &lt; 0.05). No adverse events related to avatrombopag were observed.ConclusionsAvatrombopag is safe and effective for CLD patients with TCP during the perioperative period of LT, resulting in elevated platelet counts and reduced need for platelet transfusions.

Haematological and biochemical studies on Justicia secunda infusion used in treatment of anaemia

The effect of ethanolic and infusion of Justicia secunda leaves in the animal organs was investigated using standard analytical protocols. A total of 40 albino rats divided into four groups of five rats each comprising one normal groups and three groups treated with 125, 250 and 500mg/kg body weight respectively. The infusion of J. secunda leaves was prepared using conventional methods. The hematological, biochemical and histological studies were also carried out as reported in previous literatures. The findings confirmed that Justicia secunda leaves are not toxic at the doses administered, there were significant concentrations of essential minerals such as sodium, potassium, calcium, iron, phosphorus, and sulfur. The hematological study conducted on the infusion of the leaves revealed several positive effects on blood parameters in experimental rats. The extract significantly P&lt;0.05 elevated hemoglobin and platelet count, particularly at higher doses, compared to the control group. The liver function tests showed no significant alterations in AST, ALT, TP, and ALB levels; however, the infusion resulted in some alterations in ALP activity and total bilirubin concentration. The histopathological examination of liver tissues showed mild congestion and degenerative changes in higher dose groups, indicating potential dose-dependent hepatomegaly and stress on hepatic architecture.