Forster J, Katzikadamos Z, Zinn P
University Children's Hospital, Freiburg, FRG.
Helv Paediatr Acta. 1989 Jun;43(5-6):415-22.
Elevated amounts of platelet-associated serum proteins (PASP) can be detected in idiopathic thrombocytopenic purpura (ITP) and are considered to be of patho-aetiological importance especially in the case of acute ITP, that commonly follows acute febrile illnesses. Using a micro-enzyme-linked immunoassay we examined PASP (IgG, IgM, and C3) in 120 paediatric patients with acute fever caused by viral (n = 45), bacterial (n = 48), or non-detectable agents (n = 27) and compared those values to the levels of PASP of an own paediatric control group (n = 21). Two of the patients presented mild temporary thrombocytopenia without clinical signs in the course of their infectious disease. While having normal platelet counts, the majority of our patients (69.2%) however, showed increased levels of PASP (IgG, IgM, C3; single or combined). Significant differences of PASP levels by discrimination of viral and bacterial diseases could not be demonstrated. Elevated platelet-associated complement was of special interest, because - in the absence of low platelet counts due to platelet-specific antibodies - it must be regarded as an indicator for immune complexes (IC) binding to thrombocyte surface IgG Fc-receptors. Thus we suggest that platelets play a considerable role in the elimination of circulating IC.
在特发性血小板减少性紫癜(ITP)中可检测到血小板相关血清蛋白(PASP)水平升高,尤其在急性ITP病例中,其被认为具有病理病因学重要性,急性ITP通常继发于急性发热性疾病之后。我们采用微酶联免疫分析法检测了120例由病毒(n = 45)、细菌(n = 48)或未检测到病原体(n = 27)引起的急性发热儿科患者的PASP(IgG、IgM和C3),并将这些值与我们自己的儿科对照组(n = 21)的PASP水平进行比较。其中两名患者在感染性疾病过程中出现轻度暂时性血小板减少但无临床症状。然而,在血小板计数正常的情况下,我们的大多数患者(69.2%)显示PASP水平升高(IgG、IgM、C3;单一或联合升高)。通过区分病毒和细菌疾病,未发现PASP水平存在显著差异。血小板相关补体升高特别值得关注,因为——在不存在因血小板特异性抗体导致的血小板计数降低的情况下——它必须被视为免疫复合物(IC)结合到血小板表面IgG Fc受体的一个指标。因此,我们认为血小板在循环IC的清除中起相当重要的作用。