Diabetic Microangiopathic Hemolytic Anemia and Thrombocytopenia With Antiphospholipid Syndrome

Morita, Hiroyuki; Suwa, Tetsuya; Daidoh, Hisashi; Takeda, Noriyuki; Ishizuka, Tatsuo

doi:10.1097/00000441-199603000-00009

Cited by 9 publications

(3 citation statements)

References 8 publications

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“…Although there are some previous reports that indicated the possibility of platelet decrease in the hyperglycemic patients (4,5), the average platelet count in the diabetic cases is not lower but nonsignificantly higher than the non-diabetic cases. In addition, we detect no correlation between platelet count and blood glucose level in this study.…”

Section: To the Editormentioning

confidence: 63%

“…However, Petersen and Gormsen reported no significant differences could be demonstrated in platelet aggregation between the normal controls and the patients with diabetes mellitus (3). Concerning the platelet quantity, some previous reports (4,5) documented decreased platelets in diabetic patients while the other reported the opposite observation (6).…”

Section: To the Editormentioning

confidence: 89%

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Platelet Count Neither Decreases nor Relates to Blood Glucose Level

Soogarun

Wiwanitkit

Suwansaksri

2004

Clin Appl Thromb Hemost

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There are abnormalities of hemostasis and rheologic properties in uncontrolled diabetics that could well be involved in the pathogenesis of diabetic microangiopathy and macroangiopathy (1). Platelets from diabetic patients showed increased aggregation when measured in whole blood. This phenomenon seems to be mediated by erythrocytes because normal platelets became hyperaggregable in the presence of "diabetic" erythrocytes (1). According to the study of Kaplar and colleagues in type 2 diabetes, a non-significant, but remarkable, tendency between elevation of postprandial serum glucose levels and platelet-monocyte aggregate formation was observed (2). However, Petersen and Gormsen reported no significant differences could be demonstrated in platelet aggregation between the normal controls and the patients with diabetes mellitus (3). Concerning the platelet quantity, some previous reports (4,5) documented decreased platelets in diabetic patients while the other reported the opposite observation (6).Here we studied the correlation between the platelet count and the blood sugar levels in 40 healthy Thai subjects. Blood samples from each

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Section: To the Editormentioning

confidence: 63%

Section: To the Editormentioning

confidence: 89%

Platelet Count Neither Decreases nor Relates to Blood Glucose Level

Soogarun

Wiwanitkit

Suwansaksri

2004

Clin Appl Thromb Hemost

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“…A total of 63 patients with TMHA associated with aPL were found in the literature search, but 18 of them (corresponding to six articles) [20][21][22][23][24][25] were not included because their clinical and immunological characteristics were not described. Because of this, 46 patients-45 from the literature 4 5 13 14 26-51 and one from our clinics (see appendix 1)-with 47 episodes of TMHA (one patient had two episodes of TMHA 40 ) were finally reviewed.…”

Section: Resultsmentioning

confidence: 99%

Thrombotic microangiopathic haemolytic anaemia and antiphospholipid antibodies

Espinosa

Bucciarelli²,

Cervera³

et al. 2004

Annals of the Rheumatic Diseases

143

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Objective: To analyse the clinical and laboratory features of patients with thrombotic microangiopathic haemolytic anaemia (TMHA) associated with antiphospholipid antibodies (aPL). Methods: A computer assisted (PubMed) search of the literature was performed to identify all cases of TMHA associated with aPL from 1983 to December 2002. Results: 46 patients (36 female) with a mean (SD) age at presentation of TMHA of 34 (15) years were reviewed. Twenty eight (61%) patients had primary antiphospholipid syndrome (APS). TMHA was the first clinical manifestation of APS in 26 (57%) patients. The clinical presentations were haemolytic-uraemic syndrome (26%), catastrophic APS (23%), acute renal failure (15%), malignant hypertension (13%), thrombotic thrombocytopenic purpura (13%), and HELLP (haemolysis, elevated liver enzymes, and low platelet count in association with eclampsia) syndrome (4%). Lupus anticoagulant was detected in 86% of the episodes of TMHA, and positive anticardiolipin antibodies titres in 89%. Steroids were the most common treatment (69% of episodes), followed by plasma exchange (PE) (62%), anticoagulant or antithrombotic agents (48%), immunosuppressive agents (29%), and immunoglobulins (12%). Recovery occurred in only 10/29 (34%) episodes treated with steroids, and in 19/27 (70%) episodes treated with PE. Death occurred in 10/46 (22%) patients. Conclusions:The results emphasise the need for systematic screening for aPL in all patients with clinical and laboratory features of TMHA. The existence of TMHA in association with an APS forces one to rule out the presence of the catastrophic variant of this syndrome. PE is indicated as a first line of treatment for all patients with TMHA associated with aPL.

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Hemocytopenias in Antiphospholipid Syndrome

Montecucco¹,

Caporali²

2000

Hughes Syndrome

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Diabetic Microangiopathic Hemolytic Anemia and Thrombocytopenia With Antiphospholipid Syndrome

Cited by 9 publications

References 8 publications

Platelet Count Neither Decreases nor Relates to Blood Glucose Level

Platelet Count Neither Decreases nor Relates to Blood Glucose Level

Thrombotic microangiopathic haemolytic anaemia and antiphospholipid antibodies

Hemocytopenias in Antiphospholipid Syndrome

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