Intermediate syndrome of platelet dysfunction
EE Czapek, D Deykin, E Salzman, EC Lian, LJ Hellerstein and CB Rosoff
We studied eight patients with intermittent bleeding episodes usually
following trauma and associated with the ingestion of medicine known to
interfere with platelet function. All patients had a normal or minimally
prolonged baseline bleeding time. All had a normal platelet count, glass
bead retention test, and platelet serotonin content and a variable pattern
of abnormalities in prothrombin consumption and platelet factor 3
availability. However, all showed abnormal platelet aggregation reactions
using epinephrine, adenosine diphosphate, and collagen. Following the
administration of 975 mg aspirin, our patients' bleeding times became
prolonged to a greater extent than the bleeding times of normal controls
(range 13 to greater than 20 min). Review of the literature showed
approximately 5% of "normal" controls had findings similar to those we
report. We believe we are describing a group of individuals with an
intermediate form of platelet dysfunction. Although their bleeding
diathesis is not as severe as that of patients with platelet dysfunction
syndromes previoulsy described, they do bleed significantly when subjected
to trauma following the ingestion of drugs such as aspirin. We propose that
this defect is common and should be screened for. The aspirin tolerance
test is a simple test for detecting these patients.
Volume 52,
Issue 1,
pp. 103-113,
07/01/1978
Copyright © 1978 by The American Society of Hematology
