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Evaluating platelet function disorders in children with bleeding tendency - A single center study.

Authors
  • Tanous, Osama1
  • Steinberg Shemer, Orna2, 3
  • Yacobovich, Joanne2, 3
  • Zoldan, Meira2
  • Horovitz, Yoseph1
  • Yaniv, Isaac2, 3
  • Rabizadeh, Esther4
  • Tamary, Hannah2, 3
  • Nakav, Sigal4
  • Lahav, Judith4
  • 1 a Pediatric Ward A , Haemek Medical Center , Afula , Israel. , (Israel)
  • 2 b Pediatric Hematology-Oncology , Schneider Children's Medical Center of Israel , Petach Tikva , Israel. , (Israel)
  • 3 c Sackler School of Medicine, Tel Aviv University , Tel Aviv , Israel. , (Israel)
  • 4 d The Coagulation Laboratory, Rabin Medical Center , Beilinson Hospital, Petach Tikva , Israel. , (Israel)
Type
Published Article
Journal
Platelets
Publisher
Informa UK (Taylor & Francis)
Publication Date
Nov 01, 2017
Volume
28
Issue
7
Pages
676–681
Identifiers
DOI: 10.1080/09537104.2016.1257784
PMID: 28060550
Source
Medline
Keywords
License
Unknown

Abstract

Platelet function disorders (PFDs) are a common cause of mild bleeding tendency. However, they cannot be recognized by standard screening studies. The gold standard test for PFD is platelet aggregation, performed by light transmission aggregometry (LTA). A newer and less validated method is the closure time (CT), performed by the platelet function Analyzer 100 (PFA-100). Data regarding the validity of these tests in children are limited. The aim of this study was to evaluate the usefulness of LTA and PFA-100 for the diagnosis of pediatric patients with bleeding tendency. This retrospective study included patients one month-18 year old that had LTA tests performed at the coagulation laboratory of Rabin Medical Center between the years 2006-2015. Bleeding severity was assessed using a pediatric bleeding score. Patients were excluded from analysis if they had thrombocytopenia, thrombocytosis or coagulation factors deficiencies. One hundred and thirty-seven (137) patients were included in the analysis. The median age was 7.5 years (range one month-18 years). Most patients (93%) had a bleeding score of 2 or more. Abnormal LTA was found in 40% and prolonged CT in 23% of the patients. Abnormal LTA was significantly more common in patients with a bleeding score of 2 or more compared to patients with a lower bleeding scores (P = 0.04). No significant correlation was found between the bleeding severity and the number of agonists which induced abnormal responses (p = 0.52) or the CT (p = 0.35). Furthermore, no correlation was found between abnormal LTA and prolonged CT. To conclude, we were able to diagnose 40% of children who presented with bleeding tendency with platelet aggregation defects by LTA. Abnormal LTA was significantly more prevalent in patients with a bleeding score of 2 and above. In contrast, CT was not found to be sensitive as a screening tool for PFD. Therefore, our data extend the validity of the use of LTA for the evaluation of pediatric patients with bleeding tendency.

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