OBJECTIVE: To analyze the occurrence of arterial events and platelet parameters in patients with polycythemia vera (PV) and essential thrombocythemia (ET), and to explore the characteristics of platelet parameters in patients with PV and ET and their relationship with arterial complications. METHODS: The clinical and laboratory data of newly diagnosed PV and ET patients who visited the Department of Hematology, Beijing Anzhen Hospital, Capital Medical University from August 2017 to August 2022 were retrospectively analyzed. RESULTS: 86 MPN patients (46 males and 40 females) were enrolled, including 44 PV patients and 42 ET patients, with an median age of 61(23-83) years. The mutation rate of JAK2V617F gene, the number of megakaryocytes in bone marrow, the incidence of splenomegaly, and the levels of white blood cell count (WBC), hemoglobin (HGB), hematocrit (HCT), platelet distribution width (PDW), mean platelet volume (MPV), platelet-large cell ratio (P-LCR) in PV patients were significantly higher than those in ET patients (P < 0.05), while the levels of PLT and PCT were significantly lower than those in ET patients (P < 0.01). 22 cases (50%) of PV patients were complicated with arterial events, of which 12 had arterial stenosis in≥2 locations. Among arterial events, the PDW of PV patients with ischemic stroke was greater than that of PV patients without ischemic stroke (P =0.003), and the PDW of PV patients with arterial stenosis in≥2 locations was greater than that of PV patients with arterial stenosis in≤1 location (P =0.037). 23 cases (54.8%) of ET patients were complicated with arterial events, and 7 cases had arterial stenosis in≥2 locations. In arterial events, the PCT of ET patients complicated with ischemic stroke was greater than that of ET patients without ischemic stroke (P =0.037), and the PCT of ET patients with≥2 locations of arterial stenosis was greater than that of ET patients with≤1 location of arterial stenosis (P =0.049). The binary logistic regression analysis showed that elevated PDW and PCT were risk factors for ischemic stroke in PV and ET patients, respectively (P < 0.05). CONCLUSION The platelet parameters of PV and ET patients exhibit significantly different characteristics. Elevated PDW and PCT can predict a higher risk of ischemic stroke in PV and ET patients, respectively.
Humans ; Middle Aged ; Female ; Male ; Aged ; Retrospective Studies ; Adult ; Thrombocythemia, Essential/blood* ; Myeloproliferative Disorders/complications* ; Aged, 80 and over ; Polycythemia Vera/blood* ; Blood Platelets ; Platelet Count ; Young Adult ; Mean Platelet Volume

OBJECTIVE: To analysis the specific protein markers of essential thrombocythemia (ET) based on proteomics technology, to explore and verify the differential protein related to platelet activation. METHODS: Blood samples were obtained from ET patients and healthy people and a certain protein mass spectrometry was detected using label-free quantitative technology. The proteins relative abundance increased or down-regulated by 1.3 times in the disease group compared with the control group, and the protein abundance in the two groups t test P＜0.05 were defined as differential proteins. Bioinformatics analysis of the differential proteins was performed using GO and KEGG. The difference in the average protein abundance between the two groups was analyzed by t test and P＜0.05 was considered statistically significant. Differential proteins were selected for verification by parallel reaction monitoring (PRM) technology. RESULTS: A total of 140 differential proteins were found, of which 72 were up-regulated and 68 were down-regulated. KEGG enrichment showed that the differential protein expression was related to the platelet activation pathway. The differential proteins related to platelet activation were GPV, COL1A2, GP1bα, COL1A1 and GPVI. Among them, the expressions of GPV, GP1bα and GPVI were up-regulated, and the expressions of COL1A2 and COL1A1 were down-regulated. PRM verification of COL1A1, GP1bα, GPVI and GPV was consistent with LFP proteomics testing. CONCLUSION Differential proteins in ET patients are related to platelet activation pathway activation.Differential proteins such as GPV, GPVI, COL1A1 and GP1bα can be used as new targets related to ET platelet activation.
Blood Platelets/metabolism* ; Humans ; Platelet Activation ; Platelet Membrane Glycoproteins/metabolism* ; Technology ; Thrombocythemia, Essential

OBJECTIVE: To detect the levels of microparticles (MP) in plasma of patients with esseutial thrombo-cythermia(ET) and analyze the relationship between the JAK2V617F mutant and MP in ET patients. METHODS: The numerical values of MPs were analysed by using flow cytometry. Venous blood of 56 ET patients and 28 healthy persons was collected in the morning and anticoagulated with sodium citrate (1∶9). The RMP, PMP, TF RESULTS: The detection results showed that the MP levels in ET group were higher than those in normal control group: RMP (157.2±304.9/μl vs 21.3±18.4/μl), PMP (1378.9±2454/μl vs 113.8±97.1/μl), TF CONCLUSION The numerical values of MP detected are more in ET patients than those in healthy controls. The number of MP is higher in patients with thrombus than that without thrombus, so do in patients with splenomegaly and without splenomegaly. Patients with JAK2V617F mutation show higher number of TF
Blood Platelets ; Cell-Derived Microparticles ; Endothelial Cells ; Humans ; Mutation ; Patients ; Thrombocythemia, Essential/genetics*

OBJECTIVE: Myeloproliferative neoplasm (MPN) is considered as one of the risk factors of ischemic stroke. Some MPN patients manifest stroke as their first symptom. Our purpose was to assess diagnostic rate of MPN in newly diagnosed acute ischemic stroke patients. METHODS: This study was performed using National Health Insurance Service Ilsan Hospital dataset. Data retrieving was performed by defining by defining the patient with coding of acute ischemic stroke from January 2013 to June 2017. We selected only the patients who had checked brain magnetic resonance imaging and complete blood cell count (CBC) in emergency room or on admission. Among the results of CBC finding, hemoglobin and platelet count were analyzed. Erythrocytosis was defined >16.5 g/dL (male), >16 g/dL (female) according to revised World Health Organization (WHO) classification of polycythemia vera (PV) criteria. Thrombocytosis was >450,000/µL according to revised WHO classification of essential thrombocythemia (ET). RESULTS: Total number of newly diagnosed acute ischemic stroke was 1,613 patients. Seven patients (0.43%) were diagnosed MPN (ET=2, PV=5) after ischemic stroke. Patients who had thrombocytosis and erythrocytosis were 18 and 105, respectively. Three patients who had thrombocytosis were diagnosed MPN (ET=2, PV=1). Two patients with erythrocytosis were diagnosed MPN (PV=2). Two patients had both thrombocytosis and erythrocytosis, and two of them were diagnosed PV. Seventy-one patients who had erythrocytosis were normalized in follow-up period. Six patients who had thrombocytosis and 30 patients who had erythrocytosis did not further evaluate. CONCLUSION: CBC has to be carefully read and MPN can be suspected. Diagnosis must be confirmed by hematologist to initiate appropriate treatment. It is important to recognized suspected MPN patients to prevent stroke.
Blood Cell Count ; Brain ; Classification ; Clinical Coding ; Dataset ; Diagnosis ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; National Health Programs ; Platelet Count ; Polycythemia ; Polycythemia Vera ; Risk Factors ; Stroke ; Thrombocythemia, Essential ; Thrombocytosis ; World Health Organization

We report a case that a 68-year-old man taking hydroxyurea for essential thrombocythemia produced milky urine during propofol infusion. Under microscopic analysis, the cloudy urine sample was revealed to comprise uric acid crystals. Postoperatively, kidney function such as urine output and blood urea nitrogen to creatinine ratio showed no abnormality. We suggest that the cloudy urine may be due to the increased excretion of uric acid after administration of propofol. Although this rare case of cloudy milky urine is resolved on its own, we need to consider the possibility of such urine color changes. It is particularly important to understand that medication, preoperative serum uric acid level, urine pH, and the hypothermal operating room can change the color of urine through the presence of uric acid crystals.
Aged ; Anesthesia, Intravenous* ; Blood Urea Nitrogen ; Creatinine ; Humans ; Hydrogen-Ion Concentration ; Hydroxyurea* ; Kidney ; Operating Rooms ; Propofol* ; Thrombocythemia, Essential ; Uric Acid

Essential thrombocytosis (ET) is a myeloproliferative disorder characterized by an anomalous increase in platelet production. Many patients with ET are asymptomatic. Few studies have reported ET-associated thromboembolism in large vessels such as the aorta. We report a patient with ET who presented with peripheral embolism from an abdominal aortic thrombus and developed acute limb ischemia. The patient underwent aortic replacement successfully. The patient’s platelet count was controlled with hydroxyurea, and no recurrence was noted over 2 years of follow-up.
Aorta ; Aorta, Abdominal* ; Blood Platelets ; Embolism ; Extremities ; Follow-Up Studies ; Humans ; Hydroxyurea ; Ischemia ; Myeloproliferative Disorders ; Platelet Count ; Recurrence ; Thrombocythemia, Essential ; Thrombocytosis ; Thromboembolism* ; Thrombosis

No abstract available.
Adult ; Biomarkers, Tumor/genetics ; Bone Marrow/pathology ; Calreticulin/genetics ; Erythropoietin/blood ; Female ; Fusion Proteins, bcr-abl/*genetics ; Hematocrit ; Hemoglobins/analysis ; Humans ; Janus Kinase 2/genetics ; Male ; Middle Aged ; Mutation ; Myeloproliferative Disorders/*diagnosis/genetics ; Polycythemia Vera/*diagnosis/genetics ; Receptors, Thrombopoietin/genetics ; Thrombocythemia, Essential/diagnosis ; World Health Organization

Aspirin ; administration & dosage ; therapeutic use ; Blood Cell Count ; Blood Platelets ; drug effects ; physiology ; C-Reactive Protein ; analysis ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Hydroxyurea ; administration & dosage ; therapeutic use ; Interferons ; administration & dosage ; therapeutic use ; Platelet Count ; Thrombocythemia, Essential ; blood ; diagnosis ; therapy

BACKGROUND/AIMS: Antiphospholipid antibodies (aPL) have been detected in various proportions of patients with primary immune thrombocytopenia (ITP), but the clinical significance of this is debatable. The present study aimed to determine the frequency and clinical implications of elevated aPL in adult patients with ITP. METHODS: We prospectively studied newly diagnosed adult patients with ITP who were enrolled between January 2003 and December 2008 at Chungnam National University Hospital. They were evaluated for the presence of lupus anticoagulant (LA) and anticardiolipin antibodies (aCL) at diagnosis and were followed for the development of thrombosis. RESULTS: Seventy consecutive patients with ITP (median age, 48 years; range, 18 to 79) were enrolled. Twenty patients (28.5%) were positive for aPL at the time of diagnosis: aCL alone in 15 (75%), aCL and LA in two (10%), and LA alone in three (15%). Patients who had platelet counts < 50,000/microL were administered oral prednisolone with or without intravenous immune globulin. No difference was found between the aPL-positive and -negative groups regarding gender, initial platelet count, and response to the therapy. After a median follow-up of 20 months (range, 2 to 68), two of 20 patients who were aPL-positive (10%) developed thrombosis, whereas no thrombotic event was found among those who were aPL-negative. CONCLUSIONS: Our data suggest that aPL levels should be determined at the initial presentation of ITP and that patients found to be aPL-positive should receive closer follow-up for thrombotic events.
Adolescent ; Adult ; Aged ; Antibodies, Anticardiolipin/*blood ; Antibodies, Antiphospholipid/blood ; Chi-Square Distribution ; Female ; Glucocorticoids/therapeutic use ; Humans ; Lupus Coagulation Inhibitor/*blood ; Male ; Middle Aged ; Prednisolone/therapeutic use ; Prospective Studies ; Purpura, Thrombocytopenic, Idiopathic/*blood/drug therapy ; Thrombocythemia, Essential/*blood/drug therapy ; Thrombosis ; Young Adult

Acute ischemic stroke is often the first manifestation of essential thrombocythemia (ET). We report two cases of acute ischemic stroke in patients with ET who suffered acute thrombus formation in a large cerebral artery with related cortical infarction. We suggest that platelet aggregation and its distal embolization may occur in large intracranial arteries in patients with ET.
Arteries ; Blood Platelets ; Cerebral Arteries ; Humans ; Infarction ; Platelet Aggregation ; Stroke ; Thrombocythemia, Essential ; Thrombosis