Sticky Platelet Syndrome
| Classification according to ICD-10 | |
|---|---|
| D68.8 | Other specified coagulopathies |
| ICD-10 online (WHO version 2019) | |
The sticky platelet syndrome ( syndrome of the sticky platelets ) is a platelet hyperaggregation syndrome from the group of hereditary thrombophilia . Excessive reactivity of the blood platelets with one another leads to strong clumping ( platelet aggregation ), which increases the risk of vascular occlusions .
root cause
Due to the frequent familial occurrence of the syndrome , a genetic cause with an autosomal dominant inheritance is assumed. The exact cause is not yet known.
frequency
The syndrome often occurs in combination with other thrombophilias, such as a factor V Leiden mutation or hyperhomocysteinemia . It can often be diagnosed in people with deep vein thrombosis , peripheral arterial disease, coronary artery disease, transitory ischemic attack (TIA) and in over half of all patients with occlusions of the retinal vessels in the eye.
Diagnosis
The examination for sticky platelet syndrome is only possible if the patient is currently not using a platelet aggregation inhibitor such as B. ASA is treated. If this requirement is met, the syndrome can be determined or excluded within the first three and a half to four hours after a blood sample has been taken by means of a functional analysis of the blood platelets as part of a platelet aggregation test ( platelet aggregometry ). The diagnosis of a hyperreactivity of the platelets with a disproportionately accelerated maximum aggregation when using the stimulants L- epinephrine and adenosine diphosphate is meaningful .
consequences
People with sticky platelet syndrome have an increased risk of venous, arterial and cerebrovascular occlusion ( thromboembolism ).
There is also evidence that anginal pain in angiographically normal coronary arteries can often be attributed to the syndrome.
If sticky platelet syndrome is present, thromboembolic complications can occur during therapy with Marcumar , so that treatment must be continued with a combination therapy of Marcumar and a platelet aggregation inhibitor.
Family planning can lead to impairments such as miscarriages or involuntary childlessness.
After a kidney transplant , if the patient has sticky platelet syndrome, an increased risk of transplant dysfunction and thromboembolic complications must be expected.
treatment
Sticky platelet syndrome is treated with antiplatelet drugs. Acetylsalicylic acid (ASA) is usually used in low doses , which leads to a dampening of the hyperaggregability and thus prevents excessive clumping.
A further platelet aggregation test should be carried out about one month after the start of therapy in order to check the success of the treatment and, if necessary, to adjust the dosage of the drug.
history
The syndrome was first described in 1983 from a scientific point of view by Eberhard F. Mammen and others.
literature
- EF Mammen: Sticky Platelet Syndrome. In: Seminars Thromb Hemost. 1999; 25, pp. 361-365.
- EF Mammen: Ten Years Experience with the Sticky Platelet Syndrome. In: Clin Appl Thrombosis Hemostasis. 1995; 1, pp. 66-72.
- A. Gehoff: Recurrent strokes under anticoagulation therapy: Sticky platelet syndrome combined with a patent foramen ovale. In: J Cardiovasc disease res. 2011; 1, pp. 68-70.
