Antiplatelet antibodies contribute to thrombocytopenia associated with chronic hepatitis C virus infection

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http://www.ingentaconnect.com/content/maney/hem/2009/00000014/00000005/art00006

Antiplatelet antibodies contribute to thrombocytopenia associated with chronic

hepatitis C virus infection

Authors: Aref, Salah1; Sleem, Tarek1; El Menshawy, Nadia1; Ebrahiem, Lamiaa1;

Abdella, Dooa1; Fouda, Manal1; Abou Samara, Nashwa1; Menessy, Aymen2;

Abdel-Ghaffar, Hassen1; Bassam, Ansaf2; Wahaab, Mohamed Abdel3

Source: Hematology, Volume 14, Number 5, October 2009 , pp. 277-281(5)

Publisher: Maney Publishing

Abstract:

Thrombocytopenia is one of the most frequent hematological manifestations of

hepatitis Cvirus (HCV) infection; which typically worsens with progression of

the liver disease and can become a major clinical complication. Several

mechanisms have been postulated to explain thrombocytopenia in HCV hepatic

patients, including immune mechanisms. The aim of the present work is to

investigate the role of immune mechanisms as a causative agent of

thrombocytopenia in HCV hepatic patients. The study included 50 hepatic patients

with HCV infection (30 with thrombocytopenia and 20 with normal platelets

counts). Platelets associated glycoprotein specific antibodies were evaluated by

flow cytometry and confirmed by quantitative monoclonal immobilization of

platelet antibodies (MAIPA). The frequency of platelet associated immunoglobulin

(PAIg) in thrombocytopenic HCV positive hepatic patients by FCM was 86·7,

83·3, 46·7 and 33·3% for total PAIg, PAIgG, PAIgM and PAIgA respectively.

MAIPA found platelet specific antibodies in 26/30 (86·7%) of patients. The most

likely target antigen for platelets antibodies were glycoprotein (GP) IIb/IIIa

(30%), followed by GP IIIa (20·5), GP IIb (13·3%), GPIb (13·3%), then GPIa

(10%). The platelets count was inversely correlated to the levels of platelets

GP specific antibodies (r=−0·42, p=0·024), and significantly parallel to

spleen size (p=0·024). Platelet associated glycoprotein specific antibodies

represent a common mechanism inducing thrombocytopenia in patients with chronic

HCV infections.

Document Type: Research article

DOI: 10.1179/102453309X439818

Affiliations: 1: Hematology Unit, Clinical Pathology Department, Mansoura

Faculty of Medicine, Mansoura University, Egypt 2: Internal Medicine Department,

Mansoura Faculty of Medicine, Mansoura University, Egypt 3: Mansoura

gastroenterology Centre, Mansoura Faculty of Medicine, Mansoura University,

Egypt