The use of indium-111 oxine platelet scintigraphy and survival studies in pediatric patients with thrombocytopenia.
We have utilized 111In-labeled heterologous platelets to investigate the mechanism of thrombocytopenia in ten children. From the scintigraphic findings, platelet survival times, and clinical information, thrombocytopenia was ascribed to decreased production or to increased destruction. Two patients were found to have bone marrow production defects. Two patients with hemangiomas were studied. In one, the hemangioma was shown not to be the cause of thrombocytopenia. In the second, the hemangioma was proven the source of platelet destruction, but was much more extensive than clinically evident. In both, surgical manipulation of the hemangioma was avoided. Six additional patients had thrombocytopenia due to accelerated destruction. In four, the spleen was shown responsible. In two, however, the spleen was shown not to be responsible for the low platelet counts, and splenectomy was avoided. Thus, 111In-platelet scintigraphy and survival studies are valuable in the classification and management of childhood thrombocytopenia. We believe that this study should be performed, when possible, in any child with thrombocytopenia where the mechanism is unclear or the therapeutic intervention involves splenectomy or resection of a hemangioma.
Castle
V P
VP
Department of Pediatrics, University of Michigan Medical Center, Ann Arbor.
Shulkin
B L
BL
Coates
G
G
Andrew
M
M
D000293:Adolescent; D001792:Blood Platelets / Q000473:pathology; D002470:Cell Survival; D002648:Child; D002675:Child, Preschool; D006391:Hemangioma / Q000150:complications / Q000601:surgery; D006801:Humans; D007205:Indium Radioisotopes; D007223:Infant; D009942:Organometallic Compounds; D015125:Oxyquinoline / Q000031:analogs & derivatives; D010976:Platelet Count; D011877:Radionuclide Imaging; D013156:Splenectomy; D013921:Thrombocytopenia / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology
D007205:Indium Radioisotopes; D009942:Organometallic Compounds; C032950:indium oxine; D015125:Oxyquinoline