Elezović I, Mijović A, Rolović Z
Bilt Hematol Transfuz. 1979;7(2-3):165-74.
This report presents the case of a 36 year old woman with an inborn haemorrhagic syndrome, who exhibited a lifelong history of spontaneous bruising, nose bleeding, prolonged bleeding after tooth extraction, and menometrorrhagia. The routine tests of haemostasis were consistent with impaired platelet functions. The diagnosis of the "Aspirin-like defect" was made on the basis of the following findings: the bleeding time was prolonged, whereas the platelet count and morphology were normal; platelet retention in glass bead filters was unmeasurable. ADP-induced platelet aggregation was normal, while it was markedly reduced with collagen and epinephrine. The platelet ADP and ATP content, as well as the ATP/ADP ratio were within normal limits. Aggregation of platelets pre-incubated with aspirin was only slightly reduced when induced by ADP, collagen, or epinephrine. These findings suggest that the thrombocytopathy in our patient is due to an impaired ADP release from the platelet granules containing normal quantities of adenine nucleotides. A similar disorder is observed in normal subjects after aspirin ingestion, and therefore the defect described in this paper is referred to as the "Aspirin-like" defect.
本报告介绍了一名患有先天性出血综合征的36岁女性病例,该患者有终生自发性瘀伤、鼻出血、拔牙后出血时间延长及月经过多的病史。常规止血检查结果与血小板功能受损相符。基于以下发现做出了“阿司匹林样缺陷”的诊断:出血时间延长,而血小板计数和形态正常;玻璃珠滤器中血小板滞留量无法测量。ADP诱导的血小板聚集正常,而胶原和肾上腺素诱导的血小板聚集则明显降低。血小板ADP和ATP含量以及ATP/ADP比值均在正常范围内。用阿司匹林预孵育后的血小板,在ADP、胶原或肾上腺素诱导下,聚集仅略有降低。这些发现表明,我们患者的血小板病是由于含有正常量腺嘌呤核苷酸的血小板颗粒中ADP释放受损所致。正常受试者服用阿司匹林后也观察到类似疾病,因此本文所述缺陷被称为“阿司匹林样”缺陷。