Platelet surface-bound IgG and platelet-specific IgG in plasma in childhood thrombocytopenia

M Donnér, Albert Békássy, Jesper Heldrup, Thomas Wiebe, Stanislaw Garwicz, Lars Holmberg

Research output: Contribution to journalArticlepeer-review

Abstract

Quantification of platelet-bound immunoglobulin is widely used in the evaluation of thrombocytopenia. Several methods have been devised among which labelled ligand-binding assays seem to be most appropriate. In series of adult patients such assays have been shown to be superior in separating immune-thrombocytopenia from thrombocytopenia of non-immune causes. We studied 62 children with thrombocytopenia of various causes, using radiolabelled protein A as a ligand to measure platelet-surface bound IgG. The test was highly sensitive (93%) in detecting immune-thrombocytopenia. The specificity, however, was only 57%, which is less than in published studies of adults. In a number of cases presumed to be non-immune-thrombocytopenia, notably a few patients with leukaemia and bone marrow aplasia, we found increased amounts of platelet surface-bound IgG. The significance of this finding is not clear. An indirect assay measuring platelet-specific IgG in plasma was less sensitive (46%) but highly specific for immune-thrombocytopenia (89%). The measurements of platelet-surface-bound IgG and platelet-specific IgG in plasma are of limited diagnostic value in childhood thrombocytopenia but are useful in following the treatment in chronic ITP.
Original languageEnglish
Pages (from-to)328-334
JournalActa Paediatrica Scandinavica
Volume79
Issue number3
DOIs
Publication statusPublished - 1990

Subject classification (UKÄ)

  • Pediatrics

Keywords

  • thrombocytopenia
  • immune thrombocytopenia
  • childhood
  • platelet

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