Severe ITP, Critical Bleeding, and the Challenge of Platelet Testing – RPTH Journal
RPTH Journal shared a post on LinkedIn about a recent article by Tarun Tyagi et al., adding:
”When standard platelet tests fail: an unconventional approach to severe ITP
In patients with immune thrombocytopenia (ITP) and critically low platelet counts, routine platelet function tests simply cannot be performed. So what do you do when a patient is bleeding and the standard toolkit doesn’t work?
A new case report in RPTH Journal describes an innovative diagnostic approach in a patient with severe ITP and recurrent gastrointestinal bleeding, with platelet counts falling below 10 times 10 to the ninth per liter.
Clinical approach:
A Platelet Mitochondrial Depolarisation Assay using flow cytometry was used to assess platelet apoptosis, before and after bortezomib treatment cycles
A customised ELISA detected circulating antiplatelet autoantibodies (IgG and IgM) targeting glycoprotein Ib and IIb/IIIa receptors
Both assays provided clinically meaningful data despite the extremely low platelet counts
Unexpected, selective changes in antibody profiles were observed in response to bortezomib offering new insights into treatment response
As a proof of concept, this case demonstrates that integrating platelet apoptosis detection with antibody profiling can complement clinical investigation in complex bleeding disorders, even when conventional testing is not an option.”
Title: Real-world investigation of platelet apoptosis for mechanistic insights into severe immune thrombocytopenia and bleeding
Authors: Tarun Tyagi, Kanika Jain, Martin Matthews, Stephanie Halene, John Hwa, Natalia Neparidze
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