Assessment of platelet adhesiveness and aggregation in mild acute pancreatitis using the PFA-100 system.
BACKGROUND
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 remains to be elucidated.


OBJECTIVE
In the present study, we evaluated the alterations of platelet function in patients suffering from acute edematous pancreatitis using the recently developed platelet function analyzer PFA-100.


METHODS
A cohort study with one end-point (difference between patients with acute edematous pancreatitis and normal controls concerning at least one PFA-100 closure time at the P<0.01 level of statistical significance).


METHODS
The hemostatic capacity of platelets was tested in citrated blood and standard cartridges containing collagen-ADP or collagen-epinephrine.


METHODS
We studied 16 patients (6 women and 10 men, mean age 62.1 years) with acute edematous pancreatitis, who had been admitted to our Internal Medicine Department, along with 32 normal controls of similar age and having the same woman-man ratio.


RESULTS
The mean closure time using collagen-ADP cartridges was 69.6 s (95% CI: 60.4-78.7 s) in patients and 96.1 s (95% CI: 93.0-99.3 s) in normal controls (t-value: 7.2; P<0.001). The mean closure time using collagen-epinephrine cartridges was 110.7 s (95% CI: 100.1-121.3 s) in patients and 119.7 s (95% CI: 114.6-124.8 s) in normal controls (t-value: 1.8; P=0.078). The hematocrit in all patients was less than the upper reference value.


CONCLUSIONS
The PFA-100 represents a simple and easy to use test for investigating primary hemostasis. Although the method has been widely used in hemorrhagic conditions, this is the first time it has been applied in the prethrombotic model of acute pancreatitis, suggesting increased platelet adhesiveness and aggregation.
Mimidis
Konstantinos
K
First Department of Internal Medicine, Democritus University of Thrace Medical School, Alexandroupolis, Greece. kmimidis@otenet.gr
Papadopoulos
Vassilios
V
Kartasis
Zafiris
Z
Baka
Maria
M
Tsatlidis
Vassilios
V
Bourikas
Georgios
G
Kartalis
Georgios
G
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000473:pathology; D010973:Platelet Adhesiveness / Q000502:physiology*; D010974:Platelet Aggregation / Q000502:physiology*; D010979:Platelet Function Tests / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data