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Platelet turnover and kinetics in immune thrombocytopenic purpura: results
with autologous 111In-labeled platelets and homologous 51Cr- labeled
platelets differ
P Heyns A du, PN Badenhorst, MG Lotter, H Pieters, P Wessels and HF Kotze
Mean platelet survival and turnover were simultaneously determined with
autologous 111In-labeled platelets (111In-AP) and homologous 51Cr- labeled
platelets (51Cr-HP) in ten patients with chronic immune thrombocytopenic
purpura (ITP). In vivo redistribution of the 111In-AP was quantitated with
a scintillation camera and computer-assisted image analysis. The patients
were divided into two groups: those with splenic platelet sequestration
(spleen-liver 111In activity ratio greater than 1.4), and those with
diffuse sequestration in the reticuloendothelial system. The latter
patients had more severe ITP reflected by pronounced thrombocytopenia,
decreased platelet turnover, and prominent early hepatic platelet
sequestration. Mean platelet life span estimated with 51Cr-HP was
consistently shorter than that of 111In-AP. Platelet turnover determined
with 51Cr-HP was thus over-estimated. The difference in results with the
two isotope labels was apparently due to greater in vivo elution of 51Cr.
Although the limitations of the techniques should be taken into account,
these findings indicate that platelet turnover is not always normal or
increased in ITP, but is low in severe disease. We suggest that this may be
ascribed to damage to megakaryocytes by antiplatelet antibody. The physical
characteristics in 111In clearly make this radionuclide superior to 51Cr
for the study of platelet kinetics in ITP.
Volume 67,
Issue 1,
pp. 86-92,
01/01/1986
Copyright © 1986 by The American Society of Hematology
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