Acquired Platelet Function Disorders

The common, acquired platelet dysfunction can be caused by aspirin and other NSAIDs and systemic diseases.

Acquired disorders of platelet function are very common. causes are

The common, acquired platelet dysfunction can be caused by aspirin and other NSAIDs and systemic diseases. Acquired disorders of platelet function are very common. Causes include drug therapy Systemic diseases cardiopulmonary bypass If an isolated prolongation of bleeding before and other possible diagnoses are excluded, the diagnosis of acquired platelet dysfunction is provided. Studies on platelet aggregation are not required. Drug therapy acetylsalicylic acid, other NSAIDs, and inhibitors of the platelet P2Y12 ADP receptor (z. B. clopidogrel, prasugrel, ticagrelor) can induce platelet dysfunction. This effect may occur accidentally (z. B. in drugs for the relief of pain or inflammation) and occasionally therapeutically (for. Example, when acetylsalicylic acid or P2Y12 inhibitors for stroke and Koronarthromboseprophylaxe). Aspirin and NSAIDs inhibit the cyclooxygenase-mediated production of thromboxane A2. This effect can last for 5-7 days. Acetylsalicylic acid leads only to a slight strengthening of the blood flow in healthy individuals, but to a significant gain in patients with underlying platelet dysfunction or severe bleeding disorders (eg. As patients receiving heparin treatment, patients with severe hemophilia). Clopidogrel, prasugrel and ticagrelor can significantly affect platelet function and enhance bleeding. Systemic diseases Many diseases (eg. As myeloproliferative and myelodysplastic syndromes, uremia, macroglobulinemia, multiple myeloma, cirrhosis, SLE) can lead to impaired platelet function. Uremia prolongs bleeding time. However, the mechanisms here are based are unknown. When bleeding occurs, the bleeding time can be temporarily shortened by dialysis, administration of cryoprecipitate or desmopressin infusion. If necessary can be reduced by increasing the hemoglobin concentration to> 10 g / dl by transfusion or through a Erythropoetingabe bleeding risks. Cardiopulmonary bypass If blood during cardiopulmonary bypass circulates through a Pumpenoxygenator, the platelets may lose their ability to function, which prolongs the bleeding. This appears to be due to an activation of fibrinolysis on the platelet surface through which there is a loss of glycoprotein Ib – / – IX-binding site for the Von Willebrand Factor is coming. Regardless of the platelet count, patients with severe bleeding after surgery using a heart-lung machine often, the indication for transfusion of platelets. The perioperative administration of aprotinin (a protease inhibitor) can contribute to the preservation of platelet function and therefore to reduce the need for transfusions.

Health Life Media Team

Leave a Reply