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Classification of Iranian patients with Glanzmann's Thrombasthenia using a flow cytometric method.
- Source :
-
Platelets [Platelets] 2011; Vol. 22 (5), pp. 321-7. Date of Electronic Publication: 2011 Apr 28. - Publication Year :
- 2011
-
Abstract
- Glanzmann's Thrombasthenia (GT) is a rare inherited autosomal recessive platelet disorder caused by a deficiency or dysfunction of the GPIIb-IIIa receptor on platelets, which is characterized by a lack of platelet aggregation in response to multiple physiologic agonists and a life-long bleeding disorder. Flow cytometry is a rapid and highly sensitive method that can detect reduced levels of receptors, as well as absolute deficiency. The aim of this study was to classify Iranian GT patients by a flow cytometric method, and to correlate these findings with the severity of clinical bleeding. The expression of GPIIb-IIIa on the platelet surface was assessed in 123 GT patients using quantitative flow cytometry to determine the most common subtype among these patients. We used a panel of antibodies to detect the expression of glycoproteins GPIb, GPIIb, GPIIIa, as well as Integrin αv. Patients were also interviewed with regard to the severity and frequency of bleeding, according to history and gender, in order to evaluate the nature of their bleeding phenotype, and classify them as mild, moderate or severe bleeders, in accordance with the Glanzmann's Thrombasthenia Italian Team (GLATIT) protocol. In the detailed analysis of the results of our investigation, 95 out of 123 (77.5%) were classified as type I; 20 (16%) as type II with residual GPIIb-IIIa, and eight (6.5%) as GT variants. The variant type was diagnosed by the inability of GPIIb-IIIa to bind fibrinogen, as evidenced by the absence of platelet aggregation in response to physiologic agonists. There was no significant correlation between bleeding severity and different subtypes of GT. This study demonstrates that GT type I is the most common subtype among Iranian patients. There was no correlation between severity of symptoms and cytometric phenotype of the disease. The identification of families at risk may significantly decrease the incidence of the severe form of the disorder if genetic counseling is provided.
- Subjects :
- Adolescent
Adult
Antibodies, Monoclonal metabolism
Case-Control Studies
Child
Child, Preschool
Female
Fibrinogen metabolism
Hemorrhage
Humans
Infant
Integrin alphaV biosynthesis
Iran
Male
Middle Aged
Platelet Glycoprotein GPIIb-IIIa Complex genetics
Platelet Glycoprotein GPIb-IX Complex biosynthesis
Protein Binding
Retrospective Studies
Severity of Illness Index
Blood Platelets metabolism
Flow Cytometry methods
Integrin beta3 biosynthesis
Molecular Typing methods
Platelet Aggregation
Platelet Glycoprotein GPIIb-IIIa Complex biosynthesis
Platelet Membrane Glycoprotein IIb biosynthesis
Thrombasthenia classification
Thrombasthenia diagnosis
Thrombasthenia genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1369-1635
- Volume :
- 22
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Platelets
- Publication Type :
- Academic Journal
- Accession number :
- 21526886
- Full Text :
- https://doi.org/10.3109/09537104.2011.556275