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Platelets from patients with several bleeding disorders (congenital afibrinogenemia, Glanzmann's thrombasthenia, gray platelet syndrome, and Hermansky-Pudlak syndrome) were evaluated for both platelet-bound and platelet-free hemagglutination activities. Thrombin and A23187 activated afibrinogenemic, Hermansky-Pudlak, and thrombasthenic platelets had normal platelet-bound hemagglutination activity. Gray platelets activated by the same agents had deficient platelet-bound hemagglutination activity. In contrast, thrombin-activated afibrinogenemic, gray, and thrombasthenic platelets lacked platelet-free hemagglutination activity. Only thrombin-activated Hermansky-Pudlak platelets had a normal level of platelet-free hemagglutination activity. On the basis of these results and the distinguishing characteristics of the defective platelets, it is concluded that the alpha-granules are the origin of the enhanced hemagglutination activity. Furthermore, it is suggested that the insufficiency of the platelet-bound agglutinin may be the cause of the inability of gray platelets to aggregate normally in response to thrombin.
Gartner et al. (1981) studied this question.