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Snow TAC, Abdul-Kadir RA, Gomez K, England A. Platelet storage pool disorder in pregnancy: Utilising thromboelastography to guide a risk-based delivery plan. Obstet Med 2021; 15:133-135. [DOI: 10.1177/1753495x20980254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/30/2020] [Accepted: 11/22/2020] [Indexed: 11/16/2022] Open
Abstract
We present a case of a 33-year-old woman in her third pregnancy diagnosed with platelet storage pool disorder who had previously suffered two postpartum major obstetric haemorrhages. Platelet storage pool disorder is a rare bleeding disorder where the platelet count is normal but platelet function is impaired due to deficiency of dense granules. A peripartum plan devised by an extensive multi-disciplinary team using principles for managing other bleeding and platelet function disorders helped minimise her risk of major haemorrhage. We also describe how point-of-care thromboelastography can help guide management and enable an individualised risk-benefit discussion with the woman about her anaesthetic choices.
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Affiliation(s)
- Timothy AC Snow
- Department of Anaesthesia, Royal Free Hospital, London, UK
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Rezan A Abdul-Kadir
- Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital, London, UK
- Maternity Services, Royal Free Hospital, London, UK
- Institute for Women’s Health, University College London, London, UK
| | - Keith Gomez
- Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital, London, UK
| | - Adrian England
- Department of Anaesthesia, Royal Free Hospital, London, UK
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2
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Karch C, Masser‐Frye D, Limjoco J, Ryan SE, Fletcher SN, Corbett KD, Johnsen JM, Thornburg CD. The odds and implications of coinheritance of hemophilia A and B. Res Pract Thromb Haemost 2020; 4:931-935. [PMID: 32685904 PMCID: PMC7354394 DOI: 10.1002/rth2.12345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/04/2020] [Accepted: 03/19/2020] [Indexed: 11/21/2022] Open
Abstract
We report 2 patients with coinheritance of the X-linked bleeding disorders hemophilia A and hemophilia B. We describe the family pedigrees, clinical features, and genotyping. The case report addresses the key clinical questions of how to manage patients with both hemophilia A and B and how to counsel families regarding recurrence risk. The patients with coinherited hemophilia A and B require a combination of factor VIII and factor IX replacement to achieve hemostasis. We calculated the estimated genomic meiotic recombination frequency between F8 and F9 to be 38%. The findings in these cases are consistent with this calculation. These findings provide critical information for management of families with coinherited hemophilia A and B.
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Affiliation(s)
- Corinne Karch
- Virginia Commonwealth University School of MedicineRichmondVirginiaUSA
| | | | | | | | | | - Kevin D. Corbett
- Department of Cellular and Molecular MedicineUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Jill M. Johnsen
- Bloodworks NorthwestSeattleWashingtonUSA
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Courtney D. Thornburg
- Rady Children’s Hospital San DiegoSan DiegoCaliforniaUSA
- Department of PediatricsUniversity of California San DiegoLa JollaCaliforniaUSA
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Pillai SA, Ishrat N, Al-Khabori M, Al Shukri MN, Vaidyanathan G. Successful Management of Endometriosis, In Vitro Fertilization, Pregnancy, and Postpartum Recovery in a Woman with Glanzmann's Thrombasthenia. J Gynecol Surg 2019. [DOI: 10.1089/gyn.2019.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Silja Arumugham Pillai
- Department of Obstetrics and Gynecology, Sultan Qaboos University College of Medicine and Health Science, Al Koudh, Muscat Governorate, Oman
- Department of Obstetrics and Gynecology, and Sultan Qaboos University Hospital, Al Koudh, Muscat Governorate, Oman
| | - Noreen Ishrat
- Department of Obstetrics and Gynecology, Sultan Qaboos University College of Medicine and Health Science, Al Koudh, Muscat Governorate, Oman
- Department of Obstetrics and Gynecology, and Sultan Qaboos University Hospital, Al Koudh, Muscat Governorate, Oman
| | - Murtadha Al-Khabori
- Department of Haematology, Sultan Qaboos University College of Medicine and Health Science, Al Koudh, Muscat Governorate, Oman
- Department of Haematology, Sultan Qaboos University Hospital, Al Koudh, Muscat Governorate, Oman
| | - Maryam Nasser Al Shukri
- Department of Obstetrics and Gynecology, Sultan Qaboos University College of Medicine and Health Science, Al Koudh, Muscat Governorate, Oman
- Department of Obstetrics and Gynecology, and Sultan Qaboos University Hospital, Al Koudh, Muscat Governorate, Oman
| | - Gowri Vaidyanathan
- Department of Obstetrics and Gynecology, Sultan Qaboos University College of Medicine and Health Science, Al Koudh, Muscat Governorate, Oman
- Department of Obstetrics and Gynecology, and Sultan Qaboos University Hospital, Al Koudh, Muscat Governorate, Oman
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4
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Wihadmadyatami H, Röder L, Berghöfer H, Bein G, Heidinger K, Sachs UJ, Santoso S. Immunisation against αIIbβ3 and αvβ3 in a type 1 variant of Glanzmann’s thrombasthenia caused by a missense mutation Gly540Asp on β3. Thromb Haemost 2018; 116:262-71. [DOI: 10.1160/th15-12-0982] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 04/09/2016] [Indexed: 01/21/2023]
Abstract
SummaryTreatment of bleeding in patients with Glanzmann’s thrombasthenia (GT) can be hampered by iso-antibodies against the αIIbβ3 integrin, which cause rapid clearance of transfused donor platelets. Type 1 GT patients with a total absence of αIIbβ3 from the platelet surface are known to be susceptible to form such isoantibodies. In this study, we describe a type 1 GT patient with a missense mutation (Gly540Asn) located in the EGF3 domain of the β3 integrin subunit. Cotransfection analysis in CHO cells demonstrates total absence of αIIbβ3 from the surface, based on inappropriate αIIb maturation. The patient’s serum was reactive with αIIbβ3 and αvβ3 integrins in a capture assay, when platelets and endothelial cells were used. Two specificities could be isolated from the patient’s serum, anti-αIIbβ3 and anti-αvβ3 isoantibodies. Both specificities did not interfere with platelet aggregation. In contrast, isoantibodies against αvβ3, but not against αIIbβ3, were able to disturb endothelial cell adhesion onto vitronectin, triggered endothelial cell apoptosis and interfered with endothelial tube formation. This intriguing finding may explain more recently observed features of fetal/neonatal iso-immune thrombocytopenia in children from type 1 GT mothers with intracranial haemorrhage, which could be related to anti-endothelial activity of the maternal antibodies. In conclusion, we give evidence that two isoantibody entities exist in type 1 GT patients, which are unequivocally different, both in an immunological and functional sense. Further research on the clinical consequences of immunisation against αvβ3 is required, predominantly in GT patients of childbearing age.Supplementary Material to this article is available online at www.thrombosis-online.com.
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5
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Prabhudesai A, Shanbhag S, Mirgal D, Kawankar N, Shetty S. A de novo factor VIII mutation in a haemophilia B family leading to combined deficiency of factor VIII and IX. Haemophilia 2017; 23:e477-e479. [PMID: 28750473 DOI: 10.1111/hae.13307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 11/28/2022]
Affiliation(s)
- A Prabhudesai
- Department of Haemostasis and Thrombosis, National Institute of Immunohaematology (ICMR), Parel, Mumbai, India
| | - S Shanbhag
- Department of Haemostasis and Thrombosis, National Institute of Immunohaematology (ICMR), Parel, Mumbai, India
| | - D Mirgal
- Department of Haemostasis and Thrombosis, National Institute of Immunohaematology (ICMR), Parel, Mumbai, India
| | - N Kawankar
- Department of Haemostasis and Thrombosis, National Institute of Immunohaematology (ICMR), Parel, Mumbai, India
| | - S Shetty
- Department of Haemostasis and Thrombosis, National Institute of Immunohaematology (ICMR), Parel, Mumbai, India
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6
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Poon MC, Di Minno G, Zotz R, d’Oiron R. Glanzmann’s thrombasthenia: strategies for identification and management. Expert Opin Orphan Drugs 2017. [DOI: 10.1080/21678707.2017.1341306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Man-Chiu Poon
- Cumming School of Medicine, University of Calgary, Calgary, Canada
- Southern Alberta Rare Blood and Bleeding Disorders Comprehensive Care Program, Foothills Medical Centre, Alberta Health Services, Calgary, Canada
| | - Giovanni Di Minno
- Department of Clinical Medicine and Surgery, Regional Reference Center for Coagulation Disorders, Federico II University, Naples, Italy
| | - Rainer Zotz
- Institute for Laboratory Medicine, Blood Coagulation and Transfusion Medicine (LBT), Düsseldorf, Germany
- Department of Haemostasis, Haemotherapy and Transfusion Medicine, Heinrich Heine University Medical Centre, D-40225 Düsseldorf, Germany
| | - Roseline d’Oiron
- Centre for Haemophilia and Rare Congenital Bleeding Disorders, University Hospitals Paris-Sud, Le Kremlin-Bicêtre, France
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Wijemanne A, Watt-Coote I, Austin S. Glanzmann thrombasthenia in pregnancy: Optimising maternal and fetal outcomes. Obstet Med 2016; 9:169-170. [PMID: 27829878 DOI: 10.1177/1753495x16655021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 05/25/2016] [Indexed: 11/16/2022] Open
Abstract
Glanzmann thrombasthenia is a rare autosomal recessive haemorrhagic disorder. The risks of miscarriage, antepartum and postpartum haemorrhage, and neonatal complications are all increased in individuals presenting with the disease in pregnancy. Some individuals may develop antibodies to platelet glycoproteins; the presence of these antibodies is a rare cause of neonatal alloimmune thrombocytopenia and potential intracranial haemorrhage. Multidisciplinary care is paramount for ensuring optimal fetal and maternal outcomes in such cases. We report a case of neonatal alloimmune thrombocytopenia secondary to maternal Glanzmann thrombasthenia in pregnancy.
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Affiliation(s)
- A Wijemanne
- Department of Obstetrics and Gynaecology, St George's Hospital, UK
| | - I Watt-Coote
- Department of Obstetrics and Gynaecology, St George's Hospital, UK
| | - S Austin
- Department of Haematology, St George's Hospital, UK
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8
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Bozkurt N, Guler I, Ozturk M, Utkan ZE, Yalcin MM, Karakaya C. Live birth following an intracytoplasmic sperm injection in a patient with Glanzmann thrombasthenia. J OBSTET GYNAECOL 2015; 36:273-4. [PMID: 26466915 DOI: 10.3109/01443615.2015.1060198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- N Bozkurt
- a Department of Obstetrics and Gynaecology , Gazi University School of Medicine , Ankara , Turkey
| | - I Guler
- a Department of Obstetrics and Gynaecology , Gazi University School of Medicine , Ankara , Turkey
| | - M Ozturk
- a Department of Obstetrics and Gynaecology , Gazi University School of Medicine , Ankara , Turkey
| | - Z E Utkan
- a Department of Obstetrics and Gynaecology , Gazi University School of Medicine , Ankara , Turkey
| | - M M Yalcin
- b Department of Haematology , Gazi University School of Medicine , Ankara , Turkey
| | - C Karakaya
- c Embryologist, Division of IVF Unit, Gazi University School of Medicine , Ankara , Turkey
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9
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Nurden AT, Pillois X, Nurden P. Understanding the genetic basis of Glanzmann thrombasthenia: implications for treatment. Expert Rev Hematol 2014; 5:487-503. [PMID: 23146053 DOI: 10.1586/ehm.12.46] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Alan T Nurden
- Plateforme Technologique et d'Innovation Biomédicale, Hôpital Xavier Arnozan, Pessac, France.
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