title: Platelet dysfunction-eosinophilia syndrome in parasitized Venezuelan children.
abstract: Platelet dysfunction was detected in six children with purpura and eosinophilia. We conducted clinical evaluations, hematologic and platelet function tests, clotting studies (bleeding time, prothrombin time, partial thromboplastin time, thrombin time, factor XIII, factor VIII, and von Willebrand factor), assays for IgG and IgM antibodies to platelets, and a search for stool parasites. Mild bleeding phenomena (ecchymoses, petechiae, epistaxis, and gingival) were transient. All children showed intestinal parasites and marked eosinophilia (mean count = 2,615.2 cells/muL, 95% confidence interval = 1,259.6-5,429.8). Main abnormalities included prolonged bleeding times (50%) and defective aggregation with collagen (100%) adrenaline (66%), or ADP (66%). Antibodies to platelets were not detected. Anti-parasite therapy reversed the hemorrhagic manifestations and normalized eosinophil counts and platelet alterations. No relationship could be established between excess eosinophils, intensity of bleeding, or type and degree of platelet abnormalities. Thrombocytopathic features mimicked the intrinsic defect of storage pool disease. The possible pathogenic roles of eosinophilia and parasitism are reviewed. This is the first report of this pathologic combination in Latin American children.
authors.affiliation: Banco Municipal de Sangre del Distrito Capital, Caracas, Venezuela.
authors.forename: Arlette
authors.initials: A
authors.lastname: Ruiz-Sáez
authors.forename: Luz Núñez
authors.initials: LN
authors.lastname: Sifontes
authors.forename: Rosa
authors.initials: R
authors.lastname: Feijoo
authors.forename: Gabriela
authors.initials: G
authors.lastname: Certad
authors.forename: Alejandro
authors.initials: A
authors.lastname: Arenas-Pinto
authors.forename: Leonor
authors.initials: L
authors.lastname: Pocaterra
authors.forename: Guiseppe
authors.initials: G
authors.lastname: Ferrara
authors.forename: Rita
authors.initials: R
authors.lastname: Giménez
authors.forename: Obdulita
authors.initials: O
authors.lastname: Torres
authors.forename: Carlos
authors.initials: C
authors.lastname: Goldstein
authors.forename: Norma
authors.initials: N
authors.lastname: Bosch
mesh_terms: D001780:Blood Coagulation Tests; D001791:Blood Platelet Disorders / Q000150:complications* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004802:Eosinophilia / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000150:complications* / Q000469:parasitology; D008297:Male; D010979:Platelet Function Tests; D011696:Purpura, Thrombocytopenic / Q000150:complications / Q000473:pathology; D013577:Syndrome; D014687:Venezuela