title: [Influence of Anticoagulants on Detection of ITP Platelet-Specific Autoantibodies and Relationship of Autoantibody Types with Glucocorticoid Efficacy].
abstract: OBJECTIVE
  To investigate the influence of divalent cation chelator EDTA and heparin sodium on the detection of ITP platelet-specific autoantibodies by the modified monoclonal antibody immobilization of platelet antigen assay (MAIPA) and to explore the relationship between types of platelet specific autoantibodies and glucocorticoid efficacy.
  
  
  METHODS
  The samples were obtained from EDTA- and heparin- anticoagulant ITP patients, respectively, so as to detect the platelet-specific autoantibodies (GPIIb/IIIa and GPIbα) in 140 ITP samples by modified MAIPA, then the differences between these two methods were compared.
  
  
  RESULTS
  Out of 140 cases in EDTA group, 55 cases were positive for GPIIb/IIIa, while 76 cases in heparin group were positive for GPIIb/IIIa, 42 cases in both group were repeatable; among them 13 cases were positive in EDTA group and negative in heparin group, while 34 cases were positive in heparin group and negative in EDTA group, there was significant difference between them (x (2) = 9.38, P < 0.05), 62 cases in 140 cases of EDTA group were positive for GPIba, while 51 cases in heparin group were positive for GPIba, 42 cases in both group were repeatabe; among them 20 cases were positive in EDTA group and negative in heparin group, while 9 cases were positive in heparin group and negative in EDTA group, there was no significant difference between them (x (2) = 3.44, P > 0.05). A total of 320 cases received a standard glucocorticoid treatment, out of them 143 cases were positive for GPIbα with effective rate 39.9%, 177 cases were negative for GPIbα with effective rate 79.7%, there was statisticalty significant difference between them (x (2) = 53.115, P < 0.05).
  
  
  CONCLUSIONS
  EDTA anticoagulant (a divalent cation chelator) has a significant influence on detection of ITP platelet-specific autoantibodies (GPIIb/IIIa) by a modified MAIPA method and the GPIbα antibody positive may be one of the important factors that results in un-sensitivity of ITP patients to glucocorticoid treatment.
authors.affiliation: Department of Hematology, Nanjing Jiangning Hospital, Nanjing 211101, Jiangsu Province, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Ge
authors.affiliation: Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China.
authors.forename: Min
authors.initials: M
authors.lastname: Ruan
authors.affiliation: Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China.
authors.forename: Lin-Yang
authors.initials: LY
authors.lastname: Zhu
authors.affiliation: Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China. E-mail: zengqingshu@medmail.com.cn.
authors.forename: Qing-Shu
authors.initials: QS
authors.lastname: Zeng
authors.affiliation: Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China.
authors.forename: Rui-Xiang
authors.initials: RX
authors.lastname: Xia
authors.affiliation: Department of Laboratory Medicine and Pathobiology, University of Toronto, CANADA M2J46A.
authors.forename: He-Yu
authors.initials: HY
authors.lastname: Ni
mesh_terms: D000911:Antibodies, Monoclonal; D000925:Anticoagulants / Q000627:therapeutic use*; D016824:Antigens, Human Platelet; D001323:Autoantibodies / Q000097:blood*; D001792:Blood Platelets / Q000276:immunology*; D005343:Fibrinolytic Agents; D005938:Glucocorticoids / Q000627:therapeutic use*; D006493:Heparin; D006801:Humans; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000276:immunology*
chemical_list: D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D016824:Antigens, Human Platelet; D001323:Autoantibodies; D005343:Fibrinolytic Agents; D005938:Glucocorticoids; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D006493:Heparin