Spontaneous Intestinal Perforation (SIP) is not Necrotizing Enterocolitis (NEC) But Remains the Major Confounder of NEC Data
David J. Hackam in Necrotizing Enterocolitis, 2021
Another quantifiable variable is the platelet count on the first complete blood count (CBC) at time of diagnosis. Recent data demonstrate that infants diagnosed with NEC with a platelet count <150,000/dL have a significantly higher mortality than infants diagnosed with NEC and platelet counts >150,000/dL (74). Moreover, there are reports in the literature of worse outcomes in NEC if platelet consumption persists over days (75, 76). In contrast, there are very few reports of thrombocytopenia with SIP and no evidence of profound or persistent thrombocytopenia as a common aspect of SIP presentation in large datasets. Based on these findings, thrombocytopenia <150,000/µL at presentation and persistent over several days from the time of diagnosis should be considered to support the diagnosis of NEC. The absence of thrombocytopenia makes SIP more probable. Once again, this variable is not absolute but serves to improve the probability of correct diagnosis.
The Immune System and its Function
Istvan Berczi in Pituitary Function and Immunity, 2019
The principal role of the platelet is related to blood coagulation. Platelets adhere specifically to several substances such as collagen; they may aggregate and/or undergo a secretory response called the release reaction.29 It is clear, however, that platelet aggregation and release can be triggered immunologically by immune complexes, activated complement components, and also by lymphokines. Thus, it is not surprising that platelets were shown to have a role in systemic anaphylaxis30,31 and in graft rejection.32 Moreover, mouse platelets were shown to lyse antibody-coated erythrocytes, but nucleated cells were unaffected. Most classes of mouse immunoglobulins can initiate the platelet-mediated lytic reaction.33 The IgE mediated killing of schistosomes by human and rat platelets has also been observed recently.23 Taking into consideration that platelets represent 34% of the leukocyte volume they may indeed exert a massive defense mechanism against parasites. Similarly, thrombocytes, which are three times more abundant than other circulating phagocytes, were identified as the primary circulating phagocytic cells in chickens.34
Blood and immune system disorders
Steve Hannigan in Inherited Metabolic Diseases: A Guide to 100 Conditions, 2018
Symptoms usually present soon after birth or during the first year of life with a combination of recurrent infection, low levels of platelets in the blood, eczema and autoimmune symptoms. Individuals with Wiskott-Aldrich syndrome are particularly prone to recurrent infections of the middle ear (otitis media), inflammation of the lungs (pneumonia) and sometimes inlammation of the membranes that protect the brain and spinal cord (meningitis). Another symptom is a reduced number of platelets in the blood (thrombocytopenia). Platelets are cells in the blood that help to stop bleeding. The lack of platelets is due to the fact that they have an abnormal shape (they are also very small) and are removed from the blood by the spleen. Low numbers of platelets can cause small purple spots on the skin from small bleeds below the skin’s surface (petechiae), as well as blood in the stools, bleeding gums, prolonged nosebleeds and an enlarged spleen (splenomegaly).
Evaluation of blood cellular and biochemical parameters in rats under a chronic hypoxic environment at high altitude
Published in Annals of Medicine, 2023
Chunlong Yan, Dengfeng Tian, Chenhong Zhang, Qiang Zhang, Yanqiu Sun
Platelets are small pieces of cytoplasm detached from the cytoplasm of mature megakaryocytes in the bone marrow [17]. In addition, the main function of platelets is to coagulate and stop bleeding and to repair damaged blood vessels [18–19]. Table 3 shows that compared with the Control group, PLT in the HA group decreased significantly (p < 0.05) (Figure 3(A)), PDW, MRV, and P-LCR increased significantly (p < 0.05) (Figure 3(B–D)), and PCT in the HA group decreased compared with the Control group, but the difference was not statistically significant (p > 0.05). These results show that the composition of platelets in the blood of rats at high altitude changes, with a decrease in platelet count and increases in the distribution of platelet size in the blood, the average platelet volume, and the percentage of large platelets in total blood platelets. This may indicate that coagulation and hemostasis functions may be affected in the low hypoxic environment at high altitudes, with a risk of bleeding.
Platelet to white blood cell ratio was an independent prognostic predictor in acute myeloid leukemia
Published in Hematology, 2022
Shuqi Zhao, Hanzhang Pan, Qi Guo, Wanzhuo Xie, Jinghan Wang
Notably, clinical parameters are still important factors for classification in CN-AML [3]. In clinical practice, patients with AML often present with leukocytosis and thrombocytopenia. Leukocytosis is usually caused by leukemia blasts, which release from bone marrow storage pool to peripheral blood. At the same time, leukemia blasts can suppress hematopoiesis including the inhibition of the generation of platelets [4]. Notably, high WBC had been regarded as a reliable indicator of poor clinical outcome [5]. Generally, platelet count has been used to predict bleed risk in AML. Low platelet count can contribute to bleeding complications, which is a dangerous and potentially fatal complication [5]. Recently, a combinational index of platelet and WBC had been proved as an independent prognostic predictor in several diseases such as acute-on-chronic liver failure, renal malignancy, ischemic stroke, and acute promyelocytic leukemia [5–8]. However, whether this ratio of platelet and WBC counts (PWR) has somewhat prognostic indication in CN-AML is still not investigated. Therefore, we analyzed the prognostic value of PWR in a large cohort of CN-AML patients.
Tigecycline treatment causes a decrease in peripheral blood platelet
Published in Journal of Chemotherapy, 2022
Yu Huang, Libin Chen, Handuo Su, Zhenwei Huang, Xiaoyi Li, Shubao Huang
Decreased platelet count could be caused by severe infection related bone marrow suppression [15]. To exclude the effect of bone marrow suppression and sever inflammation in platelet count, we further investigated inflammation index (leukocyte count, c-reactive protein (CPR) level and procalcitonin level) before and after tigecycline treatment. There were no differences between normal group and platelet decreased group in inflammation index before tigecycline treatment (Table 1). The incidence of decreased leukocyte count after tigecycline treatment between normal group and platelet decreased group was not significantly different (Table 1). In the platelet decreased group, 10 of 18 patients’ leukocyte count was significantly decreased after3 days of tigecycline treatment compared with before treatment (Figure 2).