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Thromb Haemost 1995; 73(02): 210-214
DOI: 10.1055/s-0038-1653752
Original Article
Clinical Studies
Schattauer GmbH Stuttgart

Platelet Consumption in Thrombocythemia Complicated by Erythromelalgia: Reversal by Aspirin

Perry J J Van Genderen
1   The Department of Hematology Hospital Dijkzigt, The Netherlands
,
Jan J Michiels
1   The Department of Hematology Hospital Dijkzigt, The Netherlands
,
Roel Van Strik
2   The Institute of Epidemiology and Biostatistics, Erasmus University, The Netherlands
,
Jan Lindemans
3   The Department of Clinical Chemistry, University Hospital, Rotterdam, The Netherlands
,
Huub H D M Van Vliet
1   The Department of Hematology Hospital Dijkzigt, The Netherlands
› Author Affiliations
Further Information

Publication History

Received 01 July 1994

Accepted after resubmission 26 October 1994

Publication Date:
09 July 2018 (online)

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Summary

The involvement of platelets in the pathogenesis of erythromelalgia, a frequent and characteristic microvascular thrombotic manifestation in patients with primary thrombocythemia and polycythemia rubra vera, was investigated by measuring the survival and turnover of 51Cr labeled autologous platelets in 10 patients with thrombocythemia complicated by erythromelalgia, in 10 asymptomatic thrombocythemia patients and in 6 subjects with reactive thrombocytosis. The mean platelet survival time of the erythromelalgia patients was 4.2 ± 0.2 days, which is significantly decreased as compared with asymptomatic thrombocythemia patients (6.6 ± 0.3 days, p <0.001) and patients with reactive thrombocytosis (8.0 ± 0.4 days, p <0.001). The mean platelet survival time of asymptomatic thrombocythemia patients was significantly decreased (p <0.01) as compared with reactive thrombocytosis patients. Treatment of erythromelalgia with aspirin increased the mean platelet survival time from 4.0 ± 0.3 days to 6.9 ± 0.4 days (p <0.001) and was associated with an elevation of the platelet count of 216 ± 30 × 109 platelets per liter (p <0.001). Coumadin failed to improve platelet survival or symptoms caused by erythromelalgia. The increased platelet consumption in erythromelalgia is attributed to the formation of platelet thrombi in the arterial microvasculature. This conclusion is supported by the ability of aspirin to interrupt platelet consumption and clinical features of erythromelalgia.

 

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