Platelet antibodies in bilharzial Hepatosplenomegaly

ABSTRACT

This study was conducted on forty subjects, thirty male patients with bilharzial hepatosplenomegaly and ten healthy control subjects matched for age and sex. Platelets were studied quantitatively and platelet functions were assessed by bleeding time, clot retraction, platelet adhesion and aggregation. Immunological investigations including determination of serum immunoglobulins [IgG, IgM, and IgA], serum complement [C3c and C4], circulating immune complexes [CICs], as well as clot retraction test for detection of platelet antibodies. There was a significant reduction of platelet count and a negative correlation between the platelet count and the platelet antibodies in patients group. Diminished platelet functions were demonstrated by decreased platelet adhesion, decreased clot retraction, and impaired adenosine diphosphate [ADP] aggregation. No statistical correlation was found between the impairment of aggregation and the degree of inhibition of clot retraction. On the contrary, and inverse correlation was demonstrated between clot retraction and platelet antibodies. Significant higher levels of IgG and IgM in patients' group were detected whereas serum IgA levels showed no statistical difference. Significantly increased levels of serum C3c were demonstrated and there was an inverse correlation between C3c levels and platelet count, however, there was no correlation between serum C3c and platelet antibodies. Serum levels of C4 were not significantly deviated from normal levels. Serum levels of CICs were higher in patients' group and a significant positive correlation was found between these complexes and serum IgG levels. In conclusion, the present study proved the presence of platelet antibodies in patients with bilharzial hepatosplenomegaly. The observed quantitative and qualitative platelet defects in those patients had been correlated to the presence of platelet antibodies and the concomitant immunological disturbances