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Lyster AL, Biørn SH, Kjeldsen AD, Nielsen C, Lange B, Fialla AD, Vinholt PJ. The bleeding diathesis in patients with hereditary haemorrhagic telangiectasia is not due to impaired platelet function. Orphanet J Rare Dis 2023; 18:354. [PMID: 37964294 PMCID: PMC10648329 DOI: 10.1186/s13023-023-02968-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/06/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Patients with the rare disease; Hereditary haemorrhagic telangiectasia (HHT) often bleed from telangiectatic lesions in mucosal surfaces. Studies suggest that impaired platelet function may also play a role in their bleeding tendency. The aim of the present study was to investigate whether HHT-patients with epistaxis have impaired platelet function. METHOD We conducted a case-control study based on a sample size calculation and included 22 HHT-patients (inclusion criteria: epistaxis severity score ≥ 4, no intake of medicine affecting platelet function the last 5 days, HHT-type 1 or 2, age ≥ 18 years) and 20 controls. We assessed the platelet function with standard haemostasis parameters, flow cytometry (platelet function and micro aggregation), rotational thromboelastometry and Platelet Function Analyzer 200. RESULTS We found no significant difference in mean platelet volume and immature platelet fraction and no difference in platelet activation as measured by exposure of CD62P, CD63P and PAC1 binding. Nor did we find a significant difference in platelet aggregation response in HHT-patients compared with the control group for all agonists (thrombin receptor activating peptide, adenosine diphosphate and collagen-related peptide). The PFA-200 analysis was without difference between the two groups and thromboelastometry showed no impairment of global haemostasis. CONCLUSION Reduced platelet function is unlikely to contribute to the frequent and long bleeding episodes that HHT-patients suffer from. We propose that further studies should focus on whether patients with HHT have hypercoagulability.
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Affiliation(s)
- Anne Lørup Lyster
- Department of Clinical Biochemistry, Odense University Hospital, Winsløws Vej 4, 5000, Odense C, Denmark.
- Department of Clinical Research, University of Southern Denmark (SDU), Campusvej 55, 5230, Odense M, Denmark.
- Department of Gastroenterology, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark.
- Department of Oto-Rhino-Laryngology, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark.
- OPEN, Patient Data Explorative Network, J.B. Winsløws Vej 9A, Third Floor, 5000, Odense C, Denmark.
| | - Signe Hedengran Biørn
- Department of Clinical Biochemistry, Odense University Hospital, Winsløws Vej 4, 5000, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark (SDU), Campusvej 55, 5230, Odense M, Denmark
| | - Anette Drøhse Kjeldsen
- Department of Clinical Research, University of Southern Denmark (SDU), Campusvej 55, 5230, Odense M, Denmark
- Department of Oto-Rhino-Laryngology, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark
- Member of VASCERN (The European Reference Network of Rare Multisystemic Vascular Diseases, Paris), The HHT-Centre at Odense University Hospital, 5000 Odense C, Denmark
| | - Christian Nielsen
- Department of Clinical Immunology, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark
| | - Bibi Lange
- Department of Oto-Rhino-Laryngology, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark
| | - Annette Dam Fialla
- Department of Clinical Research, University of Southern Denmark (SDU), Campusvej 55, 5230, Odense M, Denmark
- Department of Gastroenterology, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark
- Member of VASCERN (The European Reference Network of Rare Multisystemic Vascular Diseases, Paris), The HHT-Centre at Odense University Hospital, 5000 Odense C, Denmark
| | - Pernille Just Vinholt
- Department of Clinical Biochemistry, Odense University Hospital, Winsløws Vej 4, 5000, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark (SDU), Campusvej 55, 5230, Odense M, Denmark
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