The Diagnostic Value of Thrombopoietin Level Measurements in Thrombocytopenia

1998 ◽  
Vol 79 (06) ◽  
pp. 1101-1105 ◽  
Author(s):  
Leendert Porcelijn ◽  
Claudia Folman ◽  
Bernadette Bossers ◽  
Elly Huiskes ◽  
Marijke Overbeeke ◽  
...  
Keyword(s):  
Diagnostic Value ◽  
Diagnostic Information ◽  
Normal Range ◽  
Autoimmune Thrombocytopenia ◽  
Platelet Destruction ◽  
Total Body Mass ◽  
Platelet Production ◽  
Immune Mediated ◽  
The Mean ◽  
Total Body

SummaryIt has been reported that blood trombopoietin (TPO) levels can discriminate between thrombocytopenia due to increased platelet destruction and decreased platelet production. With our TPO ELISA and a glycocalicin ELISA we analysed a large group of patients in detail and could confirm and amplify the above notion in detail.TPO levels were determined in plasma from 178 clinically and serologically well-defined thrombocytopenic patients: 72 patients with idiopathic autoimmune thrombocytopenia (AITP), 29 patients with secondary AITP, 5 patients with amegakaryocytic thrombocytopenia and 72 patients who suffered from various diseases (46 in whom megakaryocyte deficiency was not and 26 in whom it was expected). In addition, we measured the level of glycocalicin as a marker of total body mass of platelets.In all patients with primary AITP and secondary AITP, TPO levels were within the normal range or in some (n = 7) cases only slightly increased. The level of glycocalicin was not significantly different from that of the controls (n = 95). The patients with amegakaryocytic thrombocytopenia had strongly elevated TPO levels and significantly decreased glycocalicin levels. Similarly, among the 72 thrombocytopenic patients with various disorders, elevated TPO levels were only found in patients in whom platelet production was depressed. The mean level of glycocalicin in these patients was decreased compared to that in controls and patients with AITP, but was not as low as in patients with amegakaryocytic thrombocytopenia.In conclusion, all patients with depressed platelet production had elevated levels of circulating TPO, whereas the TPO levels in patients with an immune-mediated thrombocytopenia were mostly within the normal range. Therefore, measurement of plasma TPO levels provides valuable diagnostic information for the analysis of thrombocytopenia in general.Moreover, treatment with TPO may be an option in AITP.

Mechanism of Thrombocytopenia in Hepatitis C as Determined by the Immature Platelet Fraction.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3199-3199
Author(s):  
Marjorie L. Zucker ◽  
Barry S. Skikne ◽  
Jane M. Rachel ◽  
Carol A. Murphy ◽  
Gregory A. Martinez ◽  
...  
Keyword(s):  
Platelet Count ◽  
Hepatitis C ◽  
Normal Range ◽  
Platelet Destruction ◽  
Platelet Production ◽  
Major Mechanism ◽  
Normal Platelet ◽  
Normal Limits ◽  
Immune Mediated ◽  
Immature Platelet Fraction

Abstract Thrombocytopenia is a frequent complication in patients with hepatitis C. Possible mechanisms include hypersplenism, immune-mediated platelet destruction, and drug-induced impairment of platelet production. The immature platelet fraction (IPF), determined on an automated blood cell analyzer (Sysmex XE-2100), has been shown to be useful in differentiating consumptive and aplastic causes of thrombocytopenia. We studied 31 patients known to have hepatitis C, 21 with thrombocytopenia (platelet count <100,000/uL) and 10 with normal platelet counts (>140,000/uL). None of the patients was taking interferon. Blood samples were drawn for CBC with platelet count, IPF (%), and thrombopoietin (TPO) assay (Quantikine TPO ELISA). The presence or absence of splenomegaly and liver function test results were noted. In the thrombocytopenic group IPF was elevated above the upper limit of the reference range (>7.1%) in 12/21 (57%) patients, suggestive of peripheral platelet consumption. TPO levels (known to correlate inversely with platelet/megakaryocyte mass) were within the normal range (<146pg/mL) in 11/12 (92%) of these patients, implying adequate megakaryocyte mass, which is further evidence of peripheral platelet consumption in this group. Splenomegaly was present in 8 of these 12 patients, suggesting that hypersplenism may be the mechanism for thrombocytopenia in this sub-group. IPF was within normal limits in 9/21 (43%) of the thrombocytopenic patients, implying either decreased platelet production or ineffective thrombopoiesis as the major cause of thrombocytopenia in this group. TPO levels were within the normal range in 8/9 (89%) of these patients, again implying adequate megakaryocyte mass, and suggesting that ineffective or impaired thrombopoiesis, rather than decreased platelet production, may be the major mechanism for thrombocytopenia in this group. Splenomegaly was present in 7 of these 9 patients, thus hypersplenism cannot be ruled out as at least a contributory factor in this sub-group (in spite of normal IPF values). One patient in this group had an elevated TPO level, suggestive of megakaryocyte hypoplasia. In the group of patients with normal platelet counts IPF was within normal limits in 8/10 patients, and minimally elevated in the other 2 patients. TPO levels were within normal limits in this entire group, and no patients in this group had splenomegaly. In conclusion, our findings suggest that peripheral platelet consumption is a major cause of thrombocytopenia in patients with hepatitis C (at least 57% of patients in this study), predominantly secondary to hypersplenism. Other possible causes of peripheral platelet consumption (in those without splenomegaly) include immune-mediated platelet destruction secondary to antibodies, immune complexes or drugs. In the remaining patients (43% in this study) ineffective thrombopoiesis may be the major mechanism of thrombocytopenia, possibly related to the effect of virus, cytokines, drugs or antibodies on thrombopoiesis, in the presence of adequate megakaryocytes in the marrow. Decreased platelet production (megakaryocyte hypoplasia) appears to be an unusual mechanism of thrombocytopenia in these patients.

scholarly journals Standardized MET Value Underestimates the Energy Cost of Treadmill Running in Men

2017 ◽  
Vol 38 (12) ◽  
pp. 890-896
Author(s):  
Helouane Ázara ◽  
Paulo Farinatti ◽  
Adrian Midgley ◽  
Fabrício Vasconcellos ◽  
Patrícia Vigário ◽  
...  
Keyword(s):  
Body Mass ◽  
Energy Cost ◽  
Fat Free Mass ◽  
Treadmill Running ◽  
Metabolic Equivalent ◽  
Total Body Mass ◽  
Healthy Men ◽  
Energy Cost Of Running ◽  
The Mean ◽  
Total Body

AbstractThe main purpose of the present study was to compare the reference metabolic equivalent (MET) value and observed resting oxygen uptake (VO2) for defining cardiorespiratory fitness (VO2max) and characterizing the energy cost of treadmill running. A heterogeneous cohort of 114 healthy men volunteered to participate. In Part 1 of the study, 114 men [mean±SD, age: 24±5 years; height: 177.1±7.9 cm; body mass: 75.0±10.0 kg] visited the laboratory twice for assessment of resting and maximal VO2 values to compare the reference MET value vs. observed resting VO2 and to investigate the association between resting VO2 and VO2max. In Part 2, 14 of the 114 men visited the laboratory once more to perform a 30-min bout of running at 8.0 km∙h−1/8.3 METs. The mean observed resting VO2 of 3.26 mL·kg−1·min−1 was lower than the reference MET value of 3.5 mL·kg−1·min−1 (P<0.001). Resting and maximal VO2 values relative to total body mass and fat-free mass were positively correlated (R=0.71 and 0.60, respectively; P<0.001). The maximal MET and energy cost of treadmill running were consequently underestimated when calculated using the reference MET value only for those with low VO2max (P=0.005 to P<0.001). In conclusion, the reference MET value considerably overestimated observed resting VO2 in men with low VO2max, resulting in underestimations of the maximal MET, exercise intensity prescription, and the energy cost of running.

scholarly journals The Comparison of the Total Body Mass between Pre and Postmenopausal Women in Mosul City

2019 ◽  
pp. 1197-1205
Author(s):  
Khalid Ghanim Majeed ◽  
Husham A Thanon ◽  
Basim Idrees Dhannoon ◽  
Haitham B. Fathi
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Fat Mass ◽  
Mineral Content ◽  
Mineral Density ◽  
Total Body Mass ◽  
Post Menopause ◽  
The Mean ◽  
Total Body

In this research, we discussed bone density for women taking into consideration the method of research, we measure the total body mass of women in premenopausal and comparing it with postmenopausal, since the amount of the bone mineral content and bone mineral density, fat mass and lean mass.A cross sectional study conducted at DXA laboratory, Physiology Department, College of Medicine, University of Ninevah, Mosul-Iraq from Jan. 1 - Dec. 31, 2013. Since 174 healthy women recruited from reviewing of college medical academic center. They were divided into two groups: pre menopause group (n = 42) and post menopause group (n= 130). Detailed anthropometric data were gathered from study subjects. The mean age SD of pre-menopause group was (43.37 7.49) year while the mean age SD postmenopausal group (63.63 9.23) years .The T-score, Z-score, Bone Mineral Density (BMD), Bone Mineral Content (BMC), Fat Mass and Lean Mass were measured in the supine position by the use of DXA bone densitometer scanner type (STRATOS) from (DMS) group, France.Bone Mineral Content (BMC) was significantly lower in arm, rib, and thoracic spines. Bone Mineral Density (BMD) in arm, rib, leg and total were significantly low in postmenopausal women. Non-significant differences were noticed between both groups for lean mass. Postmenopausal women having more fat mass than pre menopause group. Both T-score and Z-score for pre menopause and post menopause groups were from class of osteopenia, but it was significantly lower in post menopause group (p-value =0.001, 0.008 respectively).Postmenopausal women were at higher risk of osteoporosis due to lowered Bone Mineral Density , T & Z scores.

scholarly journals The effects of hypoglycin on glucose metabolism in the rat. A kinetic study in vivo and [U-14C,2-3H]glucose

1978 ◽  
Vol 170 (2) ◽  
pp. 337-342 ◽  
Author(s):  
H Osmundsen ◽  
D Billington ◽  
J R Taylor ◽  
H S A Sherratt
Keyword(s):  
Blood Glucose ◽  
Glucose Metabolism ◽  
Kinetic Study ◽  
Mean Transit Time ◽  
Intravenous Dose ◽  
Total Body Mass ◽  
The Mean ◽  
Total Body ◽  
Kinetics Of

1. The kinetics of glucose metabolism were evaluated in rats deprived of food 15-21 h after the administration of hypoglycaemic doses of hypoglycin (100 mg/kg body wt.) by following changes in the specific radioactivities of 14C and 3H in blood glucose after an intravenous dose of [U-14C,2-3H]glucose [Katz, Rostami & Dunn (1974) Biochem. J. 142, 161-170]. 2. During this time, recycling of glucose through the Cori cycle was virtually abolished, the rate of irreversible disposal of glucose and its total body mass were both decreased by about 70%, whereas there was little effect on the mean transit time for glucose. 3. It was concluded that hypoglycaemia is due to inhibition of gluconeogenesis.

scholarly journals Pathophysiology of Autoimmune Thrombocytopenia: Current Insight with a Focus on Thrombopoiesis

2019 ◽  
Vol 39 (03) ◽  
pp. 227-237 ◽  
Author(s):  
Irene Marini ◽  
Tamam Bakchoul
Keyword(s):  
T Cells ◽  
Cytotoxic T Cells ◽  
The Body ◽  
Additional Contribution ◽  
Autoimmune Thrombocytopenia ◽  
Platelet Destruction ◽  
Platelet Production ◽  
Low Platelet Count ◽  
Underlying Mechanisms ◽  
The Impact

AbstractImmune thrombocytopenia (ITP) is an autoimmune disease characterized by a significant reduction in the number of circulating platelets which is frequently associated with bleeding. The total count of platelets in the body is finely regulated by the balance between platelet production and destruction. Although the pathogenesis of ITP is still not completely elucidated, it is largely recognized that the low platelet count observed in ITP patients is due to alterations of both mechanisms. An abnormal proliferation of autoreactive T cells leading to the breakdown of immune tolerance to platelet antigens is suggested to be responsible for the up-regulated proliferation of autoantibody producing B cells. Consequently, the immune response induces enhanced T cell-mediated cytotoxicity and antibody-mediated platelet destruction through phagocytosis, complement activation and apoptosis. An additional contribution to the pathophysiology of ITP is given by alterations of thrombopoiesis caused by platelet-reactive autoantibodies or cytotoxic T cells leading to impaired megakaryocyte differentiation and platelet production. All these processes involved in ITP pathophysiology account for the complexity and heterogeneity in the clinical manifestation and therapy responsiveness of this disorder. For this reason, a better understanding of the different underlying mechanisms in ITP is necessary to develop more efficient therapeutic treatments in the future. In this review, we will provide an update on the pathophysiology of ITP with a particular focus on the impact of impaired thrombopoiesis.

Platelet Production Rate Predicts the Response to Prednisone Therapy in Patients with Idiopathic Thrombocytopenic Purpura.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1325-1325
Author(s):  
Ewout Houwerzijl ◽  
Henk Louwes ◽  
Wim Sluiter ◽  
Jan Smit ◽  
Edo Vellenga ◽  
...  
Keyword(s):  
Production Rate ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Therapeutic Strategy ◽  
Patient Characteristics ◽  
Platelet Destruction ◽  
Thrombocytopenic Purpura ◽  
Platelet Production ◽  
Prednisone Therapy ◽  
The Mean

Abstract The thrombocytopenia in ITP is predominantly caused by autoantibodies that recognize antigens on platelets and megakaryocytes resulting in accelerated platelet destruction and a decreased platelet production rate (PPR). ITP patients with a predominantly suppressed PPR might respond differently to therapy than patients with predominantly peripheral platelet destruction. Tests and/or patient characteristics that can make a distinction between a reduced platelet half life and a reduced PPR could therefore influence diagnostic and therapeutic strategy in ITP. Therefore, in the present study the predictive value of clinical and platelet kinetic parameter for treatment outcome in idiopathic thrombocytopenic purpura (ITP) was investigated. Seventy-five patients with severe ITP (platelets ≤20 × 109/L) were studied. Median age was 46 (range 16–89) years and 34 (45%) patients were males. Median platelet count was 8 (1–20) × 109/L. The mean platelet life was 1 (0.1–6.5) days, and the PPR 160 (2–4670) × 109/day (normal 223 (100–355) × 109/day, p = 0.7). PPR was decreased (<100 × 109/day), normal (100–355 × 109/day) and increased (>355 × 109/day) in 33%, 48%, and 19% of the patients, respectively. All patients started with prednisone at diagnosis (1 mg/kg/day). Initial complete and partial response (CR/PR) was 84% and a durable CR/PR (defined as CR/PR for ≥6 months without treatment) was attained in 44% of the patients. Apart from a higher proportion of patients with a decreased PPR in the group that responded to prednisone therapy (p=0.03), there were no significant differences regarding clinical and platelet kinetic parameters between responders and nonresponders. A durable CR/PR was noticed in 64% of the patients with a decreased PPR (median follow-up of 81 months (18–92)), compared to 34% of the patients with normal or increased PPR (median follow-up 141 (10–284) months (HR: 0.47 [95% CI (0.24–0.92)], p = 0.03). Splenectomy was performed in 32% of the patients with decreased PPR and in 62% of patients with normal or increased PPR (p = 0.03). In addition, patients with a decreased PPR showed significantly less splenic sequestration and a significantly longer mean platelet life than patients with a normal or increased PPR, which underscores that in these patients peripheral destruction of platelets contributes relatively less to thrombocytopenia than suppressed platelet production. Thirty-nine of 42 nonresponders to prednisone underwent splenectomy. Durable CR/PR postsplenectomy was reached in 74%. There were no significant differences with regard to patient characteristics between responders and nonresponders to splenectomy. In conclusion, ITP patients with suppressed PPR have a significant higher durable CR/PR rate to prednisone therapy and are less frequently exposed to splenectomy, than those with a normal or increased PPR.

scholarly journals POSTURAL PROFILE OF CLASSICAL BALLERINAS FROM THE VALE DO SÃO FRANCISCO REGION OF BRAZIL

2016 ◽  
Vol 15 (3) ◽  
pp. 199-204
Author(s):  
JANNINI NASCIMENTO RIBEIRO ◽  
UILLA ISLANY SOARES DE MOURA ◽  
LARA RABÊLO MENDES ◽  
BRUNA ANGELA ANTONELLI ◽  
PAULO ADRIANO SCHWINGEL ◽  
...  
Keyword(s):  
Body Mass ◽  
Cross Sectional ◽  
Total Body Mass ◽  
Functional Balance ◽  
Pelvic Inclination ◽  
Postural Changes ◽  
Photogrammetric Method ◽  
The Mean ◽  
Classical Ballet ◽  
Total Body

ABSTRACT Objective: The study aimed to determine the association between postural changes and practice of classical ballet among ballerinas from Integrated Administrative Region of Development (RIDE) in Polo Petrolina/PE and Juazeiro/BA. Methods: Cross-sectional observational study with 19 classical ballerinas aged over 15 years and at least 5 years of uninterrupted classical ballet practice. The anthropometric assessment included measurements of total body mass, height and body mass index (BMI). Postural evaluation was performed using the photogrammetric method with help of Posturograma(r) and SAPO(c) software. Results: The mean age was 25.3±11.7 years and the mean BMI was 21.4±2.9 kg/m². Approximately 74% of classical ballerinas had normal anthropometric profile. The postural profile of the classical ballerinas showed inclination and protrusion of the head, trunk rotation, rectification of cervical lordosis, increased thoracic kyphosis, increased lumbar lordosis, pelvic inclination and anteversion. Conclusion: The practice of ballet led to changes in body alignment of the classical ballerinas evaluated. The results points out to the need of postural re-education in order to contribute for the kinetic-functional balance of classical ballet practitioners.

scholarly journals Platelet production and platelet destruction: assessing mechanisms of treatment effect in immune thrombocytopenia

Blood ◽  
2011 ◽  
Vol 117 (21) ◽  
pp. 5723-5732 ◽  
Author(s):  
Sarah J. Barsam ◽  
Bethan Psaila ◽  
Marc Forestier ◽  
Lemke K. Page ◽  
Peter A. Sloane ◽  
...  
Keyword(s):  
Treatment Effect ◽  
Immune Thrombocytopenia ◽  
Inverse Correlation ◽  
Platelet Response ◽  
Platelet Destruction ◽  
Platelet Production ◽  
Immature Platelet Fraction ◽  
The Mean ◽  
The Relationship ◽  
Insight Into

Abstract This study investigated the immature platelet fraction (IPF) in assessing treatment effects in immune thrombocytopenia (ITP). IPF was measured on the Sysmex XE2100 autoanalyzer. The mean absolute-IPF (A-IPF) was lower for ITP patients than for healthy controls (3.2 vs 7.8 × 109/L, P < .01), whereas IPF percentage was greater (29.2% vs 3.2%, P < .01). All 5 patients with a platelet response to Eltrombopag, a thrombopoietic agent, but none responding to an anti-FcγRIII antibody, had corresponding A-IPF responses. Seven of 7 patients responding to RhoD immuneglobulin (anti-D) and 6 of 8 responding to intravenous immunoglobulin (IVIG) did not have corresponding increases in A-IPF, but 2 with IVIG and 1 with IVIG anti-D did. This supports inhibition of platelet destruction as the primary mechanism of intravenous anti-D and IVIG, although IVIG may also enhance thrombopoiesis. Plasma glycocalicin, released during platelet destruction, normalized as glycocalicin index, was higher in ITP patients than controls (31.36 vs 1.75, P = .001). There was an inverse correlation between glycocalicin index and A-IPF in ITP patients (r2 = −0.578, P = .015), demonstrating the relationship between platelet production and destruction. Nonresponders to thrombopoietic agents had increased megakaryocytes but not increased A-IPF, suggesting that antibodies blocked platelet release. In conclusion, A-IPF measures real-time thrombopoiesis, providing insight into mechanisms of treatment effect.

scholarly journals Study on the macrometry of gastrointestinal tract of wild west African Senegal parrot (Poicephalus senegalus versteri)

2017 ◽  
Vol 6 (3) ◽  
pp. 1065-1070
Author(s):  
N Wanmi ◽  
M.H. Sulaiman ◽  
I Gosomji ◽  
S.M. Maidawa ◽  
N Plang
Keyword(s):  
Gastrointestinal Tract ◽  
West African ◽  
Total Body Mass ◽  
Anatomical Features ◽  
In The Wild ◽  
The Mean ◽  
Wild West ◽  
Total Body ◽  
The Right ◽  
Parrot Population

Parrots are ornamental birds that are found in the wild and those in domestication end up in animal units of schools and houses of the wealthy individuals. The wild African Senegal parrot population is at risk of extinction due to its high popularity with urban dweller. Despite their high popularity, there is scanty documentation of the anatomical features of its gastrointestinal tract (GIT). The Wild West African Senegal Parrots were caught around forested area of a farm settlement in Shika, Zaria, Kaduna state, in the Northern part of Nigeria. The mean body weight of the wild Senegal parrot was observed to be 120.50 ± 5.42 g. The mean weights of the GIT with content and without content were 18.01 ±4.80 g and 13.54 ± 5.51 g respectively which accounted for 12.95 % and 10.24 % of the total body mass. The mean weights (small and large intestines) were 2.10 ± 1.09 g and 0.70 ± 0.27 g. The caecum was not noticed and gall bladder had the least mean weight 0.17 ± 0.007 g. while the gizzard the highest of all mean weight 4.28 ± 2.25 g. The mean lengths (GIT, small and large intestines) were; 82. 61 ± 2.36 cm, 41.75 ± 2.97 cm and 18.06 ± 2.01 cm. The glandular area of the proventriculus was longer than the non glandular portion and the left liver was longer compared to the right 3.03 ± 1.53 cm. The ileum is the longest segment of the small intestine which constituted 22.90 ± 2.92 cm.Keywords: Macrometry, Gastrointestinal Tract, Senegal Parrots

scholarly journals Thrombocytopenia and leptospirosis

1990 ◽  
Vol 32 (4) ◽  
pp. 252-259 ◽  
Author(s):  
Antonio Carlos Nicodemo ◽  
Gildo Del Negro ◽  
Vicente Amato Neto
Keyword(s):  
Bone Marrow ◽  
Disseminated Intravascular Coagulation ◽  
Bone Marrow Aspirate ◽  
Contributing Factors ◽  
Platelet Destruction ◽  
Platelet Production ◽  
Intravascular Coagulation ◽  
Dynamic Mechanisms ◽  
Immune Mediated ◽  
Bleeding Episodes

The present study has intended to contribute to the elucidation of the pathogenic mechanisms, involved in the thrombocytopenia and in the bleeding diathesis seen in the course of Leptospirosis. The group of cases included in the present prospective study consisted of 30 patients with Leptospirosis, admitted to the Infectious and Parasitic Diseases Ward, Hospital das Clínicas, Faculty of Medicine, University of São Paulo. The following possible mechanisms of thrombocytopenia have been considered and therefore investigated: platelet consumption, due to disseminated intravascular coagulation; immune-mediated platelet destruction, due to platelet-associated antibodies and an inhibited platelet production in the bone marrow. Thrombocytopenia occurred in 86.6% of 30 patients and did not seem to be immune-mediated by platelet-associated antibodies. Furthermore it did not seem to be due to a disseminated intravascular coagulation consumption. Although there was a statistically-significant correlation between bone marrow platelet production and platelet counts we think that the static microscopic examination of a bone marrow aspirate cannot accurately depict the dynamic mechanisms of platelet production when these cells are being consumed in peripheral blood. Vasculitis should be considered as the most important factor for the pathogenesis of the bleeding disturbances in Leptospirosis. However, we believe that thrombocytopenia, uremia and coagulation disorders, individually or as a group, should be included among the contributing factors that lead to and worsen bleeding episodes, which represent the leading cause of death in this disease.

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