BACKGROUND: Reticulated platelets (RP) are young platelets with a high mRNA that are newly produced from the bone marrow. Thiazole orange (TO) has been a RNA staining fluorescent dye for reticulocyte, and used for RP recently. The increased percentage of RP (RP%) reflects immaturity and hematopoietic activity of platelets, therefore it may be useful for the diagnosis of idiopathic thrombocytopenic purpura (ITP). METHODS: To assess the usefulness of RP in diagnosing ITP, we compared with RP%s of 50 ITP patients, 35 thrombocytopenic patients due to impaired production and 87 heathly normal controls. Platelets were stained with TO dye, followed by flowcytometric analysis. Platelet associated IgG (PAIgG) was also measured with the same samples. The standard gate was used as a reference with the unstained sample from a normal subject and the RP% was expressed as the percentage of TO positive cells of platelets. RESULTS: The RP% of patients with ITP was significantly higher than those of thrombocytopenia due to impaired platelet production and healthy controls (24.4+/-14.3% vs 8.6+/-5.2% and 8.0+/-5.1%, respectively). There was negative correlation between the platelet count and RP%, and positive correlation between MPV and RP%. In diagnosing for ITP, the sensistivity and specificity of RP% were 81% and 92%, respectively, and more valuable than those of PAIgG test. Using RP% and PAIgG at the same time, the diagnostic efficiency for ITP was not improved. The RP% of an ITP patient was changed to correspond with the disease progression, and that of an AML patient following chemotherapy was increased to precede the rising of the platelet count. CONCLUSION: It suggest that the measurement of reticulated platelets is a very useful test for diagnosis of ITP, furthermore it can be used to estimate the thrombopoietic activity before bone marrow examination.
Blood Platelets ; Bone Marrow ; Bone Marrow Examination ; Citrus sinensis* ; Diagnosis ; Disease Progression ; Drug Therapy ; Flow Cytometry ; Humans ; Immunoglobulin G ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Reticulocytes ; RNA ; RNA, Messenger ; Sensitivity and Specificity ; Thrombocytopenia

BACKGROUND: Idiopathic thrombocytopenic purpura (ITP) is a condition that often develops in young women and, consequently, physicians should frequently manage and monitor pregnant patients with this disorder. METHODS: We reviewed the charts of 30 women with chronic ITP delivered in 31 pregnancies from January 1995 to December 2003. RESULTS: Fifteen patients were diagnosed with ITP before pregnancy and sixteen patients were diagnosed during pregnancy. The mean platelet counts before pregnancy, during pregnancy, and at delivery were 70, 040/mm3, 83, 960/mm3, and 62, 680/mm3, respectively. The symptoms of hemostatic impairment were not noted in most of the pregnancies (77%, 24/31). During pregnancy and at delivery, most of the women (61%, 19/31) received various kinds of treatment to raise platelet counts. At delivery, the most commonly used therapy was platelet transfusion (48.4%, 15/31). Seven pregnancies (22.6%) were treated with corticosteroids during pregnancy and at delivery. Five pregnancies (16.1%) were treated with IV IgG during pregnancy and at delivery. Fifteen deliveries (51.7%) were performed by cesarean section and fourteen (48.3%) with vaginal delivery. Bleeding was uncommon at delivery. There were no cases of infants with any clinical signs of hemorrhage. CONCLUSION: Our current results suggest that ITP in pregnancy can proceed safely with low hemorrhagic risk in both infants and mothers, and that mothers with ITP can deliver healthy infants without serious hemorrhagic complications.
Adult ; Chronic Disease ; Comparative Study ; *Delivery, Obstetric/methods ; Female ; Glucocorticoids/therapeutic use ; Humans ; Immunoglobulin G/administration & dosage/therapeutic use ; Immunoglobulins, Intravenous/therapeutic use ; Infant, Newborn ; Platelet Count ; Platelet Transfusion ; Pregnancy ; *Pregnancy Complications, Hematologic/blood/diagnosis ; *Pregnancy Outcome ; *Purpura, Thrombocytopenic, Idiopathic/blood/diagnosis/therapy ; Retrospective Studies