Circulating microparticles and the risk of thromboembolic events in Egyptian beta thalassemia patients.
The presence of elevated numbers of circulating microparticles (MPs) has been hypothesized to be responsible for the occurrence of thromboembolic events (TEEs) in thalassemic patients. Our aim is to evaluate the presence and the thrombotic risk of circulating MPs in thalassemia patients and to determine the difference in MPs between β-thalassemia major (β-TM) and thalassemia intermedia (TI). The percentage of the annexin-labeled MPs, platelet-derived MPs (PMPs), erythrocyte-derived MPs (RMPs), and endothelial-derived MPs (EMPs) was measured by flow cytometry, in 87 thalassemia patients (39 β-TM and 48 TI). By multiple regression analysis, we then assessed the various independent risk factors for the occurrence of TEE. The thalassemic patients who experienced TEE had a significantly higher platelet count, higher percentage of annexin-labeled MPs, and higher percentage of PMPs (p value = 0.014, 0.003, and 0.014, respectively). There was no significant difference between β-TM and TI patients at the level of any of the studied MPs. The predictive risk factors for TEE in thalassemic patients were splenectomy, total and direct bilirubin, the RMPs, and the EMPs (OR = 10.07 (CI = 3.7-27.1), 4.3 (CI = 2.1-8.7), 1.4 (CI = 1.5-6.2), 1.6 (CI = 1.1-2.2), 3.0 (CI = 1.9-4.9), respectively). In conclusion, the elevated numbers of circulating MPs is a risk factor for the TEE in thalassemia patients.
Departments of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt. ilhamyoussry@yahoo.com.
Ilham
I
Youssry
Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Nohair
N
Soliman
Departments of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mona
M
Ghamrawy
Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Rania Mohamed
RM
Samy
Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Amal
A
Nasr
Departments of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed
M
Abdel Mohsen
Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed
M
ElShahaat
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Rayan
R
Bou Fakhredin
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Ali
A
Taher
D000293:Adolescent; D000328:Adult; D055252:Cell-Derived Microparticles / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011897:Random Allocation; D012307:Risk Factors; D013923:Thromboembolism / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult; D017086:beta-Thalassemia / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*
Hypercoagulable state; Microparticles; Thalassemia intermedia; Thalassemia major