Parra OI, Ruiz AG

Language: Spanish
References: 19
Page: 93-96
PDF size: 208.54 Kb.

ABSTRACT

Background: The sticky platelet syndrome is an inherited thrombophilic condition stemming from platelet hyperaggregability.
Objective: To describe the research results of 18 trombophilic patients who assisted to the Hematology and Internal Medicine Center of Puebla because of having a thrombophilia state, characterized by “adhesive platelets syndrome”.
Material and methods: Eighteen individuals with the sticky platelet syndrome were prospectively identified in the Centro de Hematología y Medicina Interna de Puebla. In addition to the studies looking for the sticky platelet syndrome, other laboratory markers of thrombophilia were also studied. The activated protein C resistance phenotype, coagulation protein C activity and antigen, coagulation protein S, antithrombin III, plasminogen, tissue-type plasminogen activator activity, plasminogen activator inhibitor activity, plasminogen activator inhibitor type 1, IgG and IgM isotypes of anti-phospholipid antibodies, homocysteine levels, the factor V gene Leiden, Cambridge, Hong Kong and Liverpool mutations, the 677 C-›T mutation in the 5,10-methylen-tetrahydrofolate-reductase (MTHFR) and the G20210A polymorphism in the 3’-untranslated region of the prothrombin gene.
Results: Of the 18 patients with sticky platelet syndrome, the variant was found to be: Type I (39%), type II (33%) and type III (28%). In 5 individuals (24%), no other marker of thrombophilia was found, whereas in 76%, additional thrombophilic markers were identified; In 9 patients (50%), the mutation 667 C›T in MTHFR was found, (6 heterozygous and 3 homozygous), in 3 patients (17%), the factor V Leiden mutation was found, in 3 (17%) there was also hyperfibrinogenemia, in 2 (11%) antinuclear antibodies and in 2 (11%) anti-phospolipid antibodies,,
Conclusions: The sticky platelet syndrome is a common but unknown cause of thrombophilia, it is responsible for approximately 20% of arterial thrombotic events and 13% of the venous thrombotic events. Most cases of the sticky platelet syndrome are associated with the presence of other either inherited or acquired thrombophilic conditions. The results are consonant with the idea that most cases of thrombophilia in Mexico are multifactorial.

REFERENCES

1. Chittoor SR, Elsehety AE, Roberts GF, Laughlin WR. Sticky platelet syndrome: A case report and review of the literature. Clin Appl Thromb Hemost 1998;4:280-4.

2. Holliday PL, Mammen EF, Gilroy J, Buday J, Barnhart M. Sticky platelet syndrome and cerebral infarction in young adults. Ninth International Joint Conference on Stroke and Cerebral Circulation 1983; Phoenix, AZ. Abstracts.

3. Mammen EF. Sticky platelet syndrome. Semin Thromb Hemost 1999;25:361-5.

4. Ruiz Argüelles GJ, Ruiz Delgado GJ, López Martínez B. El “síndrome de las plaquetas pegajosas” una causa frecuente pero ignorada de trombofilia. Rev Invest Clin 2002;54:394-6.

5. Rubenfire M, Blevins RD, Barnhart M, et al. Platelet hyperaggregability in patients with chest pain and angiographically normal coronary arteries. Am J Cardiol 1986;57:657-60.

6. Mammen EF. Ten years experience with the sticky platelet syndrome. Clin Appl Thromb Hemost 1995;1:66-72.

7. Bick RL. Sticky platelet syndrome: A common cause of unexplained arterial and venous thrombosis. Clin Appl Thromb Hemost 1998;4:77-81.

8. Hernández-Hernández D, Villa R, Murillo-Bonilla LM, et al. Hiperagregabilidad plaquetaria y síndrome de plaquetas pegajosas (SPP) en eventos vasculares cerebrales en jóvenes. Rev Hematol 2002;3:19.

9. Ruiz Argüelles GJ, González Estrada S, Garcés Eisele J, Ruiz Argüelles A. Primary thrombophilia in Mexico: A prospective study. Am J Hematol 1999;60:1-5.

10. Ruiz Argüelles GJ, Garcés Eisele J, Reyes Nuñez V, Ramírez Cisneros F. Primary thrombophilia in Mexico II: Factor V G1691A (Leiden), prothrombin G20210A and methylenetetrahydrofolate reductase C677T polymorphism in thrombophilic Mexican mestizos. Am J Hematol 2001;66:28-31.

11. Ruiz Argüelles GJ, López Martínez B, Cruz Cruz D, Reyes Aulis MB. Primary thrombophilia in Mexico III. A prospective study of the sticky platelets syndrome. Clin Appl Thromb Hemost 2002;8;273-7.

12. Ruiz Argüelles GJ, Poblete Naredo I, Reyes Nuñez V, et al. Primary thrombophilia in Mexico IV: Thrombophilic mutations in the factor V gene in Mexican mestizos. Rev Invest Clin Mex 2004;56:600-4.

13. Ruiz Argüelles GJ, Valdés Tapia P, Ruiz Delgado GJ. El concepto de trombofilia multifactorial: El caso de México. Rev Hematol 2005;6:35-42.

14. Ruiz Argüelles GJ, López Martínez B, Valdés Tapia P, et al. Primary thrombophilia in Mexico. V. A comprehensive prospective study indicates that most cases are multifactorial. Am J Hematol 2005;78:21-6.

15. Born GVR, Cross MJ. The aggregation of blood platelets. J Phsycol 1963;168:178-83.

16. Zöller B, Dahlbäck B. Linkage between inherited resistance to activated protein C and factor V gene mutation in venous thrombosis. Lancet 1994;343:1536-8.

17. Lunghe B, Castoldi E, Mingozzi F, Bernardi F. A new factor V gene polymorphism (His 1254 Arg) present in subjects of African origin mimics the R2 polymorphism (His 1299 Arg). Blood 1998;91:364-5.

18. Kluijmans LA, Van den Heuvel LP, Boers GH, et al. Molecular genetic analysis in mild hyperhomocystinemia: A common mutation in the methyltetrahydrofolate reductase gene is a genetic risk factor for cardiovascular disease. Am J Hum Genet 1996;58:35-41.

19. Schafer AI. Inherited and acquired causes of trombosis. In: Schafer AI, Levine MN, Konkle BA, Kearon C. Thrombotic disorders: Diagnosis and treatment. Education program book. San Diego; American Society of Hematology, 2003;pp:520-2.