Modification of Solid Phase Red Cell Adherence Assay for the Detection of Platelet Antibodies in Patients With Thrombocytopenia

Abstract

Platelet refractoriness is caused by HLA antibodies and platelet-specific antibodies. Current methods used to detect antiplatelet antibodies have limitations. Solid phase red cell adherence (SPRCA) lacks sensitivity and requires a second assay using chloroquine-treated intact platelets to specify the response due to anti-HLA. We modified SPRCA by using 2 types of antihuman platelet antibodies with different specificities toward platelet lysate and tested samples from 361 patients (69 with unexplained thrombocytopenia and 292 with poor response to platelet transfusions not explicable by alloimmunization or the clinical situation) and 50 from healthy volunteers. Our method compared favorably with platelet suspension direct immunofluorescence. All samples from healthy volunteers were negative; of the samples from the patient population, 240 were positive (147 samples had only antiplatelet and 3 samples had only anti-HLA antibodies). This modified technique had a sensitivity of 98% and a specificity of 91%.

Detection of clinically relevant platelet antibodies in the Asian population

“…The clinical and experimental data of 635 cases of NAITP (71), PTR (562) and PTP (2), diagnosed and studied by Asian platelet immunology laboratories, were reviewed from the literature by searching the PubMed database and Chinese BioMedical (CBM) from 1989 to 2013. Of 635 cases, 168 were Japanese patients in Japan, 159 were Chinese patients in China, 33 were in India, 24 were Chinese patients in Taiwan, five were in South Korea, 241 were in Thailand, two were in Kuwait, and one case each from Oman, Lebanon and Palestine.…”