Acquired platelet dysfunction with eosinophilia: Study of platelet function in 62 cases

Abstract

Sixty two children age 19 months to 11 years who had recurrent ecchymosis coagulation defect, were studied for epistaxis without thrombocytopenia or platelet functions. All children were in good health and no history of any drug ingestion was detected. All of these patients had eosinophilia ranging from 3% to 69% and various intestinal parasites were detected in 58% of cases. Platelet function studied included Ivy's bleeding time, clot retraction, platelet adhesiveness, platelet factor 3 release and platelet aggregation to ADP, thrombin, collagen and ristocetin. It was found that every patient had normal platelet count and normal clot retraction, but 67.1% of cases had prolonged bleeding time. Abnormal platelet adhesiveness was found in 63.03% of cases, while platelet factor 3 release was abnormal in 50%. Platelet aggregation to ADP, thrombin, collagen and ristocetin were abnormal in 67%, 79.6%, 87.1% and 75% respectively. The clinical course of this bleeding syndrome is usually mild with spontaneous remission within 6 months to one year without specific treatment. However, in the cases with severe bleeding, platelet concentrate is necessary to stop bleeding. When the patients had recovered from bleeding symptoms, all abnormal platelet functions returned to normal in every case. No abnormalities of platelet function could be detected in children who had only eosinophilia or intestinal parasites without purpura. The possible interrelationship of intestinal parasites, host defense mechanism and abnormal platelet function is postulated.