Chapter 128 : Autoimmune Thrombocytopenia

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A chronic form of autoimmune thrombocytopenia exists and is the clinical course most often seen in adults. With characterization of the immunopathological features of autoimmune thrombocytopenia, a variety of methods have been developed to measure the antiplatelet autoantibodies that mediate the immune destruction of platelets in this disorder. The risk of chronicity increases with increased age of the child; otherwise, there are no prognostic features, either clinical or laboratory, that will predict whether a child with acute immune thrombocytopenia will recover spontaneously. The pathogenic factor present in the plasma reacted with normal and autologous platelets and could be isolated and removed from the gamma fraction of plasma by adsorption with platelets. Patients with chronic autoimmune thrombocytopenia typically present with petechiae and mucosa bleeding. Symptoms may be present for months, or some patients may experience more acute manifestations. Quantitative measurements based on antiglobulin consumption give falsely high values for platelet-associated immunoglobulin because antiglobulin binds differently to membrane-bound immunoglobulin G (IgG) than to the IgG in the solution used to calibrate the standard curve.

Citation: Kickler T. 2006. Autoimmune Thrombocytopenia, p 1132-1135. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch128
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Image of FIGURE 1

Platelet autoantibody assays. In the solid-phase assay, a microtiter well or plastic bead is coated with a monoclonal antibody (MoAB) to a specific platelet glycoprotein, such as GPIIb-IIIa or Ib-IX. Platelets from a patient with idiopathic thrombocytopenia purpura are washed, solubilized with detergent, and added to the coated surface to allow capture by platelet glycoprotein complex and bound autoantibody (AutoAb). The autoantibody is measured using labeled antihuman IgG. The MAIPA is similar, except that the murine monoclonal antiplatelet glycoprotein antibody is added to the autoantibody-sensitized platelets and the immune complex composed of platelet glycoprotein, mouse monoclonal antibody, and human immunoglobulin is captured with an anti-mouse antibody.

Citation: Kickler T. 2006. Autoimmune Thrombocytopenia, p 1132-1135. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch128
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1. Berchtold, P., and , M. Wenger. 1993. Autoantibodies against platelet glycoproteins in autoimmune thrombocy-topenic purpura: their clinical significance and response to treatment. Blood 81: 12461255.
2. George, J. 1990. Platelet immunoglobulin G: its significance for the evaluation of thrombocytopenia and for understanding the origin of alpha granule proteins. Blood 76: 859870.
3. George, J. N.,, M. A. El-harangue, and , G. E. Rasion. 1995. Chronic idiopathic thrombocytopenia purpura. N. Engl. J. Med. 331: 12071211.
4. Harrington, W. J.,, V. Minnich,, J. W. Hollingsworth, and , C. V. Moore. 1951. Demonstration of a thrombocytopenic factor in the blood of patients with thrombocytopenic purpura. J. Lab. Clin. Med. 38: 110.
5. He, R.,, D. M. Reid,, C. E. Jones, and , N. R. Shulman. 1994. Spectrum of Ig classes, specificities and titers of serum antiplatelet glycoproteins in chronic idiopathic thrombocytopenia purpura. Blood 83: 10241032.
6. Herman, J. H.,, T. S. Kickler, and , P. M. Ness. 1986. The resolution of platelet serologic problems using western blotting. Tissue Antigens 28: 257268.
7. Kickler, T. S. 1994. Platelet immunology, p. 304315. In K. L. Anderson and , P M. Ness (ed.), Scientific Basis of Transfusion Medicine. The W. B. Saunders Co., Philadelphia, Pa.
8. Kiefel, V.,, M. S. Santoso,, E. Kaufmann, and , C. Mueller Eckhardt. 1991. Autoantibodies against platelet glycopro-tein lb/IX: a frequent finding in autoimmune thrombocytopenic purpura. Br. J. Haematol. 79: 256262.
9. Kiefel, V.,, M. S. Santoso,, M. Weisheit, and , C. Mueller Eckhardt. 1987. Monoclonal antibody-specific immobilization of platelet antigens (MAIPA): a new tool for the identification of platelet reactive antibodies. Blood 70: 17221726.
10. Kim, H. O.,, S. D. Kennedy, and , T. S. Kickler. 1995. Studies using immobilized platelet glycoproteins for detection of platelet alloantibodies. Am. J. Clin. Pathol. 104: 258263.
11. LoBuglio, A. E.,, W. S. Court,, L. Vinocur,, G. Maglott, and , G. M. Shaw. 1983. Use of a 125I labeled antihuman IgG monoclonal antibody to quantify platelet bound IgG. N. Engl. J. Med. 309: 459463.
12. McMillan, R. 1990. Antigen-specific assays in immune thrombocytopenia. Transfus. Med. Rev. 14: 136143.
13. McMillan, R.,, P. Tani, and , E. Millard. 1987. Platelet associated and plasma antiglycoprotein autoantibodies in chronic ITP Blood 70: 10401045.
14. Mueller-Eckhardt, C, and , V. Kiefel. 1989. Laboratory methods for the detection of platelet antibodies and identification of antigens, p. 436453. In T. J. Kunicki and , J. N. George (ed.), Platelet Immunobiology. J. B. Lippincott, Philadelphia, Pa.
15. Rosse, W. E.,, D. V. Devine, and , R. Ware. 1984. Reactions of immunoglobulin G-binding ligands with platelets and platelet-associated immunoglobulin G. J. Clin. Investig. 73: 489496.
16. Shulman, N. R.,, V. J. Marder,, M. C. Hiller, and , E. M. Collier. 1964. Platelet and leukocyte isoantigens and their antibodies: serologic, physiologic and clinical studies, p. 222304. In Progress in Hematology, 4th ed. Grune and Stratton, New York, N.Y.
17. Smith, J. W.,, C. P. M. Hayward,, T. E. Warkentin,, P. Horsewood, and , J. G. Kelton. 1993. Investigation of human platelet alloantigens and glycoproteins using non-radioactive immunoprecipitation. J. Immunol. Methods 158: 7785.
18. Tsubakio, T.,, P. Tani,, V. L. Woods, and , R. McMillan. 1987. Autoantibodies against platelet GPIIb/IIIa in chronic ITP react with different epitopes. Br. J. Haematol. 67: 345348.
19. van Leeuwen, E. F.,, J. T. M. van der Ven,, C. P. Engelfriet, and , A. E. G. von dem Borne. 1982. Specificity of autoantibodies in autoimmune thrombocytopenia. Blood 59: 2326.
20. Woods, V. L.,, E. H. Oh,, D. Mason, and , R. McMillan. 1984. Autoantibodies against the platelet glycoprotein IIb/IIIa complex in patients with chronic ITP Blood 64: 368375.

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