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Overproduction of platelet microparticles in cyanotic congenital heart disease with polycythemia

Hitoshi Horigome, MD^*,*, Yuji Hiramatsu, MD, Osamu Shigeta, MD, Toshiro Nagasawa, MD and Akira Matsui, MD^*

^* Department of Pediatrics, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
Department of Cardiovascular Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
Department of Hematology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan

View larger version (14K): [in a new window]   Figure 1 Relationship between platelet count and hematocrit. There is a significant negative correlation between the platelet count and hematocrit. Solid circles = cyanotic congenital heart disease group; open circles = acyanotic congenital heart disease group.

View larger version (13K): [in a new window]   Figure 2 Relationship between platelet aggregation to adenosine 5"-diphosphate (ADP) and hematocrit (Hct). There is a significant negative correlation between the platelet aggregation response to ADP and Hct. Solid circles = cyanotic congenital heart disease group; open circles = acyanotic congenital heart disease group.

View larger version (13K): [in a new window]   Figure 3 Relationship between platelet microparticles (MPs) and hematocrit (Hct). There is a significant correlation between platelet MPs and Hct in the cyanotic congenital heart disease (CCHD) group. In particular, platelet MPs increased markedly at Hct values above 60% in the CCHD group. The regression line was drawn based on the values of the CCHD group. Solid circles = CCHD group; open circles = acyanotic congenital heart disease group.

View larger version (31K): [in a new window]   Figure 4 Detection of platelet microparticles (MPs) by flow cytometry. Dot plots in the left lower area of the scatter (area R1) represent platelet MPs; those in the right upper area (area R2) represent normal-sized platelets. The hematocrit values are 34.0% (A) and 70.9% (B). Note overproduction of MPs in B. FSC = front scatter; SSC = side scatter.

View larger version (14K): [in a new window]   Figure 5 Effect of phlebotomy on platelet count and microparticles (MPs) in two patients. Microparticles (solid triangles) were reduced and the platelet count (solid circles) was increased at 6 h after phlebotomy, and these effects were maintained over several days.