Key result
Light transmission aggregometry diagnosed platelet aggregation defects in 40% of children with bleeding tendency, and abnormal LTA was significantly associated with a bleeding score ≥2 (P=0.04).
Why the study?
Are LTA and PFA-100 useful for diagnosing platelet function disorders in pediatric patients with bleeding tendency?
Observational (n=137)
No
Are LTA and PFA-100 useful for diagnosing platelet function disorders in pediatric patients with bleeding tendency?
p-value: p=0.04
LTA is a valid diagnostic tool for evaluating platelet function disorders in children with bleeding tendency, whereas PFA-100 closure time lacks sensitivity as a screening tool.
Supports LTA in pediatric bleeding assessment; leaves open whether it guides therapy or outperforms PFA-100.
Platelet function disorders (PFDs) are a common cause of mild bleeding tendency. However, they cannot be recognized by standard screening studies. The gold standard test for PFD is platelet aggregation, performed by light transmission aggregometry (LTA). A newer and less validated method is the closure time (CT), performed by the platelet function Analyzer 100 (PFA-100). Data regarding the validity of these tests in children are limited. The aim of this study was to evaluate the usefulness of LTA and PFA-100 for the diagnosis of pediatric patients with bleeding tendency. This retrospective study included patients one month-18 year old that had LTA tests performed at the coagulation laboratory of Rabin Medical Center between the years 2006-2015. Bleeding severity was assessed using a pediatric bleeding score. Patients were excluded from analysis if they had thrombocytopenia, thrombocytosis or coagulation factors deficiencies. One hundred and thirty-seven (137) patients were included in the analysis. The median age was 7.5 years (range one month-18 years). Most patients (93%) had a bleeding score of 2 or more. Abnormal LTA was found in 40% and prolonged CT in 23% of the patients. Abnormal LTA was significantly more common in patients with a bleeding score of 2 or more compared to patients with a lower bleeding scores (P = 0.04). No significant correlation was found between the bleeding severity and the number of agonists which induced abnormal responses (p = 0.52) or the CT (p = 0.35). Furthermore, no correlation was found between abnormal LTA and prolonged CT. To conclude, we were able to diagnose 40% of children who presented with bleeding tendency with platelet aggregation defects by LTA. Abnormal LTA was significantly more prevalent in patients with a bleeding score of 2 and above. In contrast, CT was not found to be sensitive as a screening tool for PFD. Therefore, our data extend the validity of the use of LTA for the evaluation of pediatric patients with bleeding tendency.
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Tanous et al. (2017) conducted an observational in Bleeding tendency (n=137). Light transmission aggregometry (LTA) and PFA-100 closure time (CT) was evaluated on Abnormal LTA and prolonged CT (p=0.04). Light transmission aggregometry diagnosed platelet aggregation defects in 40% of children with bleeding tendency, and abnormal LTA was significantly associated with a bleeding score ≥2 (P=0.04).
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