Comparison of various diagnostic methods in assessing platelet count in patients with immune thrombocytopenia

Introduction: Accurate platelet count (PLTC) in immune thrombocytopenia is important in order to make therapeutic decisions. The basic method of assessing PLTC is peripheral blood morphology with EDTA or with citrate. The older way of assessing PLTC is measurement under the microscope (FONIO), and the newer way is the fluorescent method. The purpose of this study was to compare PLTC methods, and find the most reliable. Material and methods: PLTC was assessed using five methods in adult patients with previously untreated ITP (EDTA, citrate, FONIO, fluorescent, and immunofluorescent methods). Results: 66 patients were enrolled in the study. The median age was 56 and 56% were men. Median PLTC in EDTA was 69 G/L, in citrate 69 G/L, in fluorescence 69 G/L, in FONIO 90 G/L, and in immunofluorescence 83 G/L. A significant difference in PLTC was observed in comparing EDTA to immunofluorescence (53% ±123%), followed by FONIO (51% ±91%). PLTC from immunofluorescence differed from the fluorescent method by 40% ±78%. Conclusions: The most valuable method for obtaining PLTC is the immunofluorescent method. These findings are especially important in helping to make therapeutic decisions during a challenging time for accessing medical care like a pandemic

In seeking diagnostic tool for laboratory monitoring of FXII-targeting agents, could assessment of rotational thromboelastometry (ROTEM) in patients with factor XII deficiency be useful?

Introduction: Targeting factor XII (FXII) is a new concept for safe thrombosis prophylaxis. Global hemostasis tests offer promise in terms of the laboratory monitoring of FXII inhibition. The present study examines selected parameters of rotational thromboelastometry (ROTEM) in patients with FXII deficiency. The objective of this study was to assess the impact of FXII deficiency on selected parameters of ROTEM, which can be significant in the laboratory monitoring of FXII inhibition. Material and methods: The study included 20 patients with FXII deficiency ≤40% and 21 volunteers free of it. Clotting time (CT), clot formation time (CFT), alpha angle (α), maximum clot firmness (MCF), and maximum lysis (ML) were recorded in ROTEM. Results: For the INTEM test, CT and CFT readings were markedly higher in FXII deficient patients than in controls. No marked differences in relation to MCF and ML were found. Conclusion: The results of ROTEM show that FXII deficiency has a great impact on the initiation and amplification of coagulation. This was confirmed by a number of marked correlations between FXII activity and certain ROTEM parameters. ROTEM tests merit further investigation as treatment control strategies in the context of FXII inhibition