Highlights a paradox in myeloproliferative disorders where impaired in-vitro platelet aggregation may coexist with severe in-vivo thrombosis due to disseminated intravascular platelet aggregation.
Suggests caution interpreting in-vitro aggregation for thrombosis risk in myeloproliferative disorders; hypothesis-generating case leaves open prospective validation.
A patient with features of a myeloproliferative disorder developed an acute multisystems illness and died. In-vitro platelet aggregation was imparied, but necropsy revealed widespread platelet-rich thromboemboli and multiple organ infarctions. It is suggested that platelets are damaged during disseminated intravascular platelet aggregation (DIPA) and that disaggregation of platelet thrombi and recirculation of platelets give rise to their subsequent hypofunction when tested in vitro.
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Boughton et al. (1977) studied this question.
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