Alterations of platelet function, number and indexes during acute pancreatitis.
OBJECTIVE
Acute pancreatitis constitutes a systemic inflammatory process which is often accompanied by thrombosis and bleeding disorders. The role of platelets in the pathophysiology of the disease has not been elucidated yet. The present study focuses on two successive end-points: (1) the activation of platelets during acute pancreatitis and (2) the alterations of platelet number and indexes between onset and remission of the disease, which reflect the bone marrow response.


METHODS
A cohort of 54 patients with acute pancreatitis was enrolled. Cause and severity of the disease (APACHE II score) were estimated. Activated platelet ratio (APR) was estimated using flow cytometry at onset and remission. Platelet number (PLT), mean platelet volume (MPV), platelet large cell ratio (P-LCR) and platelet distribution width (PDW) were collected at onset and remission.


RESULTS
The first end-point was reached in patient 14 as APR was found elevated at onset of acute pancreatitis (p = 0.01). The second end-point was fulfilled in patient 12 for MPV, P-LCR and PDW, which were found elevated at remission of the disease (p < 0.01) but not for PLT until the last patient (p = 0.34).


CONCLUSIONS
Platelets are directly involved in the systemic inflammatory process of acute pancreatitis, which leads to consumption, compensated by an immediate bone marrow response.
First Department of Internal Medicine, Democritus University of Thrace Medical School, Alexandroupolis, Greece. kmimidis@otenet.gr
K
K
Mimidis
V
V
Papadopoulos
J
J
Kotsianidis
D
D
Filippou
E
E
Spanoudakis
G
G
Bourikas
C
C
Dervenis
G
G
Kartalis
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000166:cytology / Q000502:physiology*; D001854:Bone Marrow Cells / Q000502:physiology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D015539:Platelet Activation; D010976:Platelet Count; D012044:Regression Analysis; D012075:Remission, Spontaneous