Quantification of platelet-associated IgG for differential diagnosis of patients with thrombocytopenia

Thromb Haemost. 2000 Nov;84(5):779-83.

Abstract

Immune thrombocytopenia is due to platelet destruction by circulating glycoprotein-specific antibodies and is found in various disorders. Methods for the detection of platelet-associated IgG (PAIgG) are generally sensitive but unspecific, whereas glycoprotein-specific assays are highly specific but less sensitive. Usefully, a sensitive screening method for PAIgG detection would also provide information for differential diagnosis. We developed a quantitative direct Platelet Immunofluorescence Test (PIFT) by flow cytometry and studied 79 thrombocytopenic patients with immune thrombocytopenia and other disorders. The sensitivity of the assay was 94%, its specificity 66% for the detection of a clinically obvious immune thrombocytopenia. PAIgG levels of patients with immune thrombocytopenia differed significantly from those of other patients with low platelet counts (p <0.001). The quantitative PIFT proved to be a sensitive method for PAIgG detection and should therefore be used as a screening method. In addition, it could be helpful for differential diagnosis in marked thrombocytopenia where a MAIPA is not feasible.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Blood Platelets / immunology*
  • Diagnosis, Differential
  • Female
  • Flow Cytometry
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin G / immunology*
  • Male
  • Middle Aged
  • Purpura, Thrombocytopenic, Idiopathic / blood
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis*
  • Purpura, Thrombocytopenic, Idiopathic / immunology

Substances

  • Autoantibodies
  • Immunoglobulin G