Bidot Carlos J, Jy Wenche, Horstman Lawrence L, Ahn Eugene R, Bidot Loreta, Fontana Vincenzo, Ahn Yeon S
Wallace H Coulter Platelet Laboratory, Division of Hematology/Oncology, University of Miami School of Medicine, Miami, FL, 33136, USA.
Hematology. 2005 Dec;10(6):451-6. doi: 10.1080/10245330500226860.
Risk factors for thrombosis (TB) in thrombocythaemia (TC) associated with myeloproliferative disorder (MPD) are not well defined.
We measured antiphospholipid antibodies (APLA) in 35 patients with TC associated with MPD. Fourteen had TB and 21 did not. We assayed IgG and IgM APLA by ELISA for 6 antigens: beta2GP1, cardiolipin (CL), phosphatidylcholine (PC), phosphatidylserine (PS), phosphatidylethanolamine (PE) and FVII/VIIa, together with markers of activation of platelets (CD62P) and endothelium [endothelial microparticles (EMP)].
At least one positive APLA was detected in 66% of TC patients overall. The incidence was significantly higher in the TB subgroup (92.8%) than non-TB (47.6%, p < 0.05). Multiple APLA (positive for more than one antigen) were also more frequent in TB, for both IgG and IgM, for all 6 antigens tested (p < 0.05). However, IgM APLA predominated, being about 2-fold more frequently positive than IgG for all 6 antigens. Platelet CD62P was significantly higher in the TB group (p < 0.05). EMP did not differ between TB and non-TB. The most frequent thrombotic complication was recurring ischemic cerebral vascular accidents (ICVA), leading to progressive cognitive impairment. Venous TB often developed at unusual sites. Recurring and reversible TB were common features in TC.
This study suggests that APLA and platelet activation are risk factors for TB in TC. APLA are prevalent in TC, and IgM APLA predominated over IgG. Activation of platelets but not of endothelium may be consistent with the reversible and recurrent features of TB in TC.
与骨髓增殖性疾病（MPD）相关的血小板增多症（TC）中血栓形成（TB）的危险因素尚不明确。
我们检测了35例与MPD相关的TC患者的抗磷脂抗体（APLA）。其中14例发生了TB，21例未发生。我们通过ELISA法检测了IgG和IgM APLA针对6种抗原：β2糖蛋白1、心磷脂（CL）、磷脂酰胆碱（PC）、磷脂酰丝氨酸（PS）、磷脂酰乙醇胺（PE）和FVII/VIIa，同时检测了血小板活化标志物（CD62P）和内皮标志物[内皮微粒（EMP）]。
总体而言，66%的TC患者检测到至少一种APLA阳性。TB亚组的发生率（92.8%）显著高于非TB亚组（47.6%，p<0.05）。对于所有检测的6种抗原，TB组中多种APLA（一种以上抗原阳性）在IgG和IgM中也更常见（p<0.05）。然而，IgM APLA占主导，所有6种抗原的阳性频率比IgG高约2倍。TB组血小板CD62P显著更高（p<0.05）。TB组和非TB组的EMP无差异。最常见的血栓形成并发症是复发性缺血性脑血管意外（ICVA），导致进行性认知障碍。静脉血栓形成常发生在不寻常的部位。复发性和可逆性血栓形成是TC的常见特征。
本研究表明，APLA和血小板活化是TC中血栓形成的危险因素。APLA在TC中普遍存在，且IgM APLA多于IgG。血小板活化而非内皮活化可能与TC中血栓形成的可逆性和复发性特征一致。
