著者

小竹 要 大江 国広 長谷田 恭子 吉野 公明 万見 新太郎 黒田 満彦 松田 保 竹田 亮祐 村上 元孝

出版者

一般社団法人 日本血液学会

雑誌

臨床血液 (ISSN:04851439)

巻号頁・発行日

vol.15, no.5, pp.487-494, 1974

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Studies on platelet functions of 21 patients with renal insufficiency have been preformed. Platelet counts were significantly decreased in uremic patients, although severe thrombocytopenia less than 100&times;10³ platelets/mm³ was detected only in two patients. Platelet adhesiveness to glass was remarkably decreased in uremic patients. Platelet factor-3 availability was impaired in some of these patients, while platelet factor-3 activity was not decreased. Clot retraction was slightly defective in few patients. The significant correlation was not found between platelet adhesiveness and BUN, creatinine, uric acid or inorganic phosphate level in the serum of these patients. The abnormalities of platelet functions were partially corrected after dialysis.<br>In vitro, urea at high concentration showed an inhibitory effect on platelet aggregation. Guanidinosuccinic acid had less inhibitory effect on platelet aggregation, and creatinine had no inhibitory effect.

著者

山崎 義亀与 松田 保 黒田 満彦 内田 健三 嶋田 千恵子 大谷 逸子 村上 元孝 北川 正信

出版者

一般社団法人 日本血液学会

雑誌

臨床血液 (ISSN:04851439)

巻号頁・発行日

vol.14, no.1, pp.81-87, 1973

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A 25-year-old male was admitted because of dark-red urine, jaundice and purpura. 5 days prior to admission, the patient noticed that the urine color became dark red, and purpuric rash and jaundice were noted by his wife.<br>Examination revealed scleral icterus, pallor, numerous petechiae and an ecchymosis. The sensorium was clear. The neurologic examination was normal.<br>The patient had hemolytic anemia, thrombocytopenic purpura, fever and proteinuria. Shortly after admission, fluctuating neurologic symptoms developed, and the patient was diagnosed as thrombotic thrombocytopenic purpura.<br>He was treated with prednisolone and heparin without benefits, and expired on the 14 th hospital day.<br>Hyaline thromboses of the vessels of liver and kidney were demonstrated by the examination of the specimens obtained by post mortem needle puncture.<br>Coagulation studies disclosed that partial thromboplastin time and prothrombin time were slightly prolonged, however, factor V activity and fibrinogen titre were not low. Fibrinogen degradation products determined by tanned red cell hemagglutination inhibition immunoassay were markedly increased, although euglobulin lysis time was not shortened.<br>Immunological analysis of serum proteins showed the increase of acute phase reactants, the decrease of &beta;₁-AC and haptoglobin, and the appearance of fibrinogen degradation products.<br>These results were discussed in relation to the pathogenesis of the disease.