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

Acta Paediatr Scand. 1990 Mar;79(3):328-34. doi: 10.1111/j.1651-2227.1990.tb11465.x.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, Surface / analysis
  • Blood Platelets*
  • Child
  • Diagnosis, Differential
  • Epitopes
  • Evaluation Studies as Topic
  • Humans
  • Immunoglobulin G / analysis*
  • Purpura, Thrombocytopenic / blood*
  • Purpura, Thrombocytopenic / diagnosis
  • Purpura, Thrombocytopenic / epidemiology
  • Radioligand Assay / standards*
  • Sensitivity and Specificity
  • Staphylococcal Protein A

Substances

  • Antigens, Surface
  • Epitopes
  • Immunoglobulin G
  • Staphylococcal Protein A