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The Exchangeable Splenic Platelet Pool Studied with Epinephrine Infusion in Idiopathic Thrombocytopenic Purpura and in Patients with. Splenomegaly
Author(s) -
Branehoug Ingmar,
Weinfeld Aleksander,
Roos Bengt
Publication year - 1973
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1973.tb01735.x
Subject(s) - platelet , spleen , thrombocytopenic purpura , splenectomy , medicine , epinephrine , mean platelet volume , scintigraphy , purpura (gastropod) , isotopes of chromium , gastroenterology , endocrinology , biology , ecology
S ummary . The exchangeable splenic platelet pool (ESPP) was studied with epinephrine infusion and platelet labelling with 51 Cr in five healthy students, 10 patients with idiopathic thrombocytopenic purpura (ITP) and 10 patients with splenomegaly. Five of the ITP‐patients were studied after splenectomy. Platelet recovery of infused labelled platelets was calculated in all subjects and also in nine healthy volunteers who had been splenectomized for traumatic rupture of the spleen. Spleen size was determined by gamma camera scintigraphy. It was shown that the spleen is the only site of an exchangeable platelet pool in ITP and that this pool was of the same size in ITP‐patients as in the normal controls, viz ∼30% of the total body platelet mass. In patients with splenomegaly the ESPP was larger than that in controls and ITP‐patients. A highly significant correlation was found between the ESPP and the spleen volume. In splenectomized and in non‐splenectomized ITP‐patients platelet recovery was significantly less than in their respective control groups, indicating that a proportion of the labelled platelets was immediately removed from the circulation after infusion into an ITP recipient and that the recovery of labelled platelets cannot be used as a measure of the ESPP in ITP. It is suggested that the early destruction of platelets may be due to slight damage to the platelets during the labelling procedure. These damaged platelets can survive in a normal recipient, but are destroyed when infused into the‘milieu’ of an ITP‐patient.