title: Evaluation of thrombopoiesis in thrombocytopenic disorders by simultaneous measurement of reticulated platelets of whole blood and serum thrombopoietin concentrations.
abstract: To evaluate thrombopoiesis in thrombocytopenic disorders, we simultaneously determined reticulated platelet counts in whole blood by FACScan flow cytometry and serum thrombopoietin (TPO) concentrations by a sensitive sandwich ELISA. The subjects were 40 healthy volunteers and 45 thrombocytopenic patients. In idiopathic thrombocytopenic purpura (ITP), the percentage of reticulated platelets was significantly elevated (5.61 +/- 2.02%: mean +/- SD) relative to normal controls (2.17 +/- 0.90%), but serum TPO concentrations (1.91 +/- 1.27 fmol/l) did not differ significantly from the normal range (1.43 +/- 0.62 fmol/l). The patients with aplastic anemia (AA) had decreased reticulated platelet counts and markedly increased serum TPO concentrations (13.65 +/- 10.64 fmol/l). In thrombocytopenic patients with liver cirrhosis (LC), the absolute number of reticulated platelets (1.65 +/- 1.11 x 10(9)/l) decreased similarly that in AA. However, serum TPO concentrations (1.38 +/- 0.50 fmol/l) did not increase in contrast to AA. Our findings suggested a possible dual mechanism of thrombocytopenia in LC; that is, thrombocytopenia in LC results from the decreased TPO production primarily in the liver adding to an increase in platelet sequestration in the spleen.
authors.affiliation: First Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Koike
authors.forename: A
authors.initials: A
authors.lastname: Yoneyama
authors.forename: J
authors.initials: J
authors.lastname: Shirai
authors.forename: T
authors.initials: T
authors.lastname: Ishida
authors.forename: E
authors.initials: E
authors.lastname: Shoda
authors.forename: K
authors.initials: K
authors.lastname: Miyazaki
authors.forename: S
authors.initials: S
authors.lastname: Sunaga
authors.forename: R
authors.initials: R
authors.lastname: Horie
authors.forename: K
authors.initials: K
authors.lastname: Aoki
authors.forename: K
authors.initials: K
authors.lastname: Koike
authors.forename: I
authors.initials: I
authors.lastname: Ogata
authors.forename: T
authors.initials: T
authors.lastname: Tahara
authors.forename: T
authors.initials: T
authors.lastname: Kato
authors.forename: K
authors.initials: K
authors.lastname: Nakahara
authors.forename: T
authors.initials: T
authors.lastname: Kariya
authors.forename: M
authors.initials: M
authors.lastname: Higashihara
mesh_terms: D000741:Anemia, Aplastic / Q000097:blood / Q000150:complications; D001327:Autoimmune Diseases / Q000097:blood / Q000503:physiopathology; D015415:Biomarkers; D001792:Blood Platelets / Q000648:ultrastructure; D001853:Bone Marrow / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D006410:Hematopoiesis; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications; D008111:Liver Function Tests; D008533:Megakaryocytes / Q000473:pathology; D010976:Platelet Count; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000150:complications; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000503:physiopathology; D013921:Thrombocytopenia / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D013926:Thrombopoietin / Q000097:blood*
chemical_list: D015415:Biomarkers; D013926:Thrombopoietin