Use of the Sysmex XT-4000i hematology analyzer in the differentiation of cerebrospinal fluid cells in children.

BACKGROUND: Routine analysis of pleocytosis and cellular composition of cerebrospinal fluid (CSF) is carried out with a phase-contrast microscope. The use of hematological analyzers seems to be an alternative to the manual method. The aim of the study was to assess the usefulness of the automated technique for counting and differentiating CSF cells in children. METHODS: The study group consisted of 59 children (28 girls and 31 boys) aged from 4 to 17 years suffering from viral and bacterial meningitis. Children were divided into three subgroups according to CSF cell count: 1st group had a pleocytosis of 6-50 cells/µL, 2nd group-51-100 cells/µL, and 3rd group->100 cells/µL. A reference group involved 32 children (17 girls and 15 boys) aged from 2 to 18 years with a normal range of 0-5 cells/µL. Examination of CSF was performed in parallel by two different method, manual and automated. RESULTS: The analysis of pleocytosis revealed that the values obtained by the manual method were statistically significantly lower in relation to the values obtained by automated technique in subgroups I and II. The number of mononuclear and polymorphonuclear cells in subgroups I, II, and III determined by both manual and automated methods was comparable. CONCLUSION: We conclude that automated method cannot fully replace the previously used manual method and some of the dubious cases, such as samples with low pleocytosis rates or abnormal cells indicated by the analyzer, will still require microscopic examination.

[Subpopulation of CD14+CD16+ monocytes in the children with acute lymphoblastic leukemia treated with filgrastim]. / Subpopulacja monocytów CD14+CD16+ u dzieci chorych na ostra bialaczke limfoblastyczna po leczeniu filgrastimem.

UNLABELLED: It is well known that patients with leucopenia are susceptible to life-threatening infections due to chemotherapy. The number of neutrophils and monocytes is increasing after administration filgrastim (G-CSF) in patients with the acute lymphoblastic leukemia. CD16 expression was analyzed in order to determine whether monocytes function is also impaired by chemotherapy CD16. The aim of study was to compare the percentage of CD14+CD16+ monocytes in the group of children with the acute lymphoblastic leukemia after administration filgrastim with the group of children with inflammatory state and the group of the healthy children. MATERIALS AND METHODS: The cell surface expression of CD16 was analyzed by flow cytometry. The percentage of CD16 expression and the mean intensity fluorescence rate of CD16 receptor was studied. RESULTS: Monocytes showed increased CD16 expression in the group of the children with the acute lymphoblastic leukemia in comparison to the other two groups. There were no differences in the mean fluorescence intensity of the CD16 monocytes between groups. CONCLUSIONS: The present study demonstrated that G-CSF increased the percentage of monocytes with the CD16 expression, which could be beneficial to the immunological response of the children with the acute lymphoblastic leukemia.

[The estimation of the number of platelets by different methods]. / Ocena liczby plytek róznymi metodami pomiarowymi.

UNLABELLED: The commonly available and accurate platelet counts play an important role in the evaluation of haemorrhagic status and in assessing the need for platelet transfusions. We evaluated platelet counting performance by the Sysmex XT-2000i haematology analyser and by the Coulter EPICS XL cytometry using optical, impedance and immunological methods in trombocytopenic patients. Hematology analysers display the high precision and the accuracy of the measurement of the number of platelets in whole blood. However, the measurement of number of platelets can be disturbed by the presence of interference factors such as: microcytic erytrocytes, schizocytes, cryoglobulins, microplatelets and immunological clumps. THE AIM OF THE STUDY: The comparison of impedance, optical and immunological enumeration methods of platelets by the Sysmex XT-2000i haematology analyser and by the Coulter EPICS XL cytometer. RESULTS: The platelet count of all considered methods showed good correlation with the cytometric method. CONCLUSIONS: Only cytometric method with using anti-CD41 monoclonal antibody allowed to verify the results of enumeration methods of platelets.

Association among Fas expression in leucocytes, serum Fas and Fas-ligand concentrations and hepatic inflammation and fibrosis in chronic hepatitis C.

BACKGROUND: Replication of the hepatitis C virus (HCV) in peripheral blood mononuclear cells (PBMC) may impair immune functions and establish persistent infection. The aim of this study was to assess the influence of HCV on PBMC and their susceptibility to apoptosis in relation to liver inflammation and fibrosis. METHODS: Eighty-one patients with chronic hepatitis C (CHC) were enrolled in this study. Flow cytometry was used to determine the amount of T cells (CD4(+), CD8(+)), B cells (CD19(+)), monocytes (CD14(+)) and natural killer cells (CD16(+)) in the peripheral blood and the expression of CD95(+) (CD95/APO-1) in each subset. Serum concentrations of sFas and sFasL were assessed by the enzyme-linked immunosorbent assay method. RESULTS: An increased expression of Fas was observed in CD4(+) and CD8(+) cells in CHC. There was a more prominent expression of Fas on CD4(+) cells in HCV genotype 1b in contrast to 3a. Increased Fas expression on CD4(+) cells was seen in advanced stages of liver disease. Fas expression on monocytes was lower in advanced stages of liver inflammation and fibrosis. Serum sFas concentration was higher in CHC compared with the control group. There was an association between sFasL concentration and inflammatory activity in the liver. Serum sFasL concentration correlated positively with the mean intensity of fluorescence of the Fas receptor in CD4(+) and CD8(+) cells, granulocytes and monocytes. CONCLUSION: These findings indicate that there is an increased susceptibility of PBMC to apoptosis, which can be attributed to the constant contact of leucocytes with the inflamed liver tissue, or from direct HCV influence.

[Expression of chosen chemokine receptors on the Th lymphocytes in children with hypertrophied adenoids with otitis media with effusion]. / Ekspresja wybranych receptorów chemokin na limfocytach Th przeroslych migdalków gardlowych w wysiekowym zapaleniu ucha srodkowego.

INTRODUCTION: Chemokine receptors play a crucial role in the recruitment of leucocytes into inflamed tissue from secondary lymphoid organs. AIM OF THIS STUDY: was evaluation of the percentage Th (CD4+) lymphocytes with expression of chemokine receptors: CCR3, CCR4, and CCR5 in hypertrophied adenois tissue in children with otitis media with effusion. MATERIAL AND METHODS: 36 children with otitis media with effusion and 25 children with hypertrophied adenoids were tested. Expression of chemokine receptors CCR3, CCR4 and CCR5 on T CD4 lymphocytes of hypertrophied adenoid's tissue was estimated by flow cytometry method. RESULTS: Average percentage of T CD4+ lymphocytes with expression CCR4 in hypertrophied adenoid in children group with otitis media with effusion (OME = 64.11%) was significantly higher than in comparative group with hypertrophied adenoid (HA = 75.05%, p < 0.04). We showed statistically lower percentage of CD3+CD4+ cells with expression CCR3 in examinated group (OME = 47.19%) than HA group (62.66%; p < 0.003). CONCLUSION: Results suggests that intensify of humoral immunological answer in hypertrophied adenoid depends on Th2 lymphocytes with expression CCR3 and CCR4 chemokine receptors in course of inflammatory state in middle ear.

[Cytometric evaluation of immaturity granulocytes in infections]. / Cytometryczna ocena odmlodzenia granulocytów obojetnochlonnych w przebiegu infekcji.

UNLABELLED: The leukocyte differential count is one of the most useful and frequency requested tests in the clinical laboratory. Conventional blood cell counting instruments can enumerate only the WBCs normally found in the peripheral blood, i.e., neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Nevertheless, there are other cells not normally found in the peripheral blood, such as immature granulocyte. They are indicators of different disease states. We haven't got still references of automatic method to good evaluation of enumeration of the immature granulocyte. AIM OF THE STUDY: The aim of this study was compare count immature granulocytes by manual microscopy method with flow cytometric method. Flow cytometric method enumeration of immature granulocyte was performed using monoclonal antibody: anti-CD45, anti-CD11b and anti-CD16. RESULTS: A comparison of flow cytometry count with the manual count of promyelocytes, myelocytes, and metamyelocytes using linear regression revealed a correlation coefficient of 0,85 for percentage counts. CONCLUSIONS: Our results indicate that the flow cytometric immature granulocyte count can replace the manual morphology count for the laboratory work.

[Atypical lymphocytes]. / Limfocyty atypowe.

Atypical lymphocytes or reactive are cells that become large as a result of antigen stimulation. This cells usually are associated with viral illnesses, however they can also be present as result of drug reactions, immunisations, humoral diseases and auto-immune disorders.

[Expression Fas and FasL antigen protein of lymphocytes T and B in hypertrophied adenoid in children with otitis media with effusion]. / Ekspresja antygenu Fas i FasL na limfocytach T i B w przeroslych migdalkach gardlowych u dzieci chorych na wysiekowe zapalenie ucha.

INTRODUCTION: Apoptosis of lymphocytes can be induced by different factors mainly however the activation of antigen Fas (CD95) and his ligand FasL (CD95L) route. Apoptosis induced by Fas-FasL has large significance in elimination of lymphocytes T in final phase immune response designate AICD (activation induced cell death). Lymphocytes B undergo apoptosis induced by Fas-FasL in germinal center, which has special meaning in elimination of cells about low specificity and weak affinity of receptor BCR ( B-cell antigen receptor). AIM OF STUDY: The aim of this study was evaluation of percentage of apoptotic lymphocytes and expression of Fas and FasL in CD4+, CD8+, CD19+ lymphocytes in hypertrophied adenoid and hypertrophied adenoid and otitis media with effusion. METHODS: CD4+Fas+, CD8+Fas+, CD19+Fas+CD4+FasL+, CD8+FasL+, CD19+FasL+ cells subpopulation were identified using monoclonal antibodies and flow cytometry method. RESULTS: The percentage of lymphocytes CD4+ Fas+, CD8+Fas+, CD19+Fas+ was higher in hypertrophied adenoid and otitis media with effusion compored to the control group. Their was no significant difference the percentage CD4+ Fas+, CD8+Fas+, CD19+Fas+CD4+FasL+, CD8+FasL+, CD19+FasL+ in hypertrophied adenoid and otitis media with effusion then the control group. The percentage of apoptotic lymphocytes was higher in hypertrophied adenoid and otitis media with effusion compored to the control group. CONCLUSIONS: The susceptibility the individual subpopulation of lymphocytes in hypertrophied adenoid seems to influence on change of relations of quantitative lymphocytes and upset the immunological function of tonsils which can influence on course otitis media with effusion at children.

[Fetal activin A in labor complicated by meconium-stained amniotic fluid]. / Plodowa aktywina A w porodzie powiklanym obecnoscia smólki w plynie owodniowym.

OBJECTIVE: During pregnancy the placenta and the fetal membranes are the main sources of activin A. An increased level of activin A has been found in the serum of women with preeclampsia, diabetes mellitus and intrauterine growth restriction. Meconium is the predictor for adverse perinatal outcome, such as meconium aspiration syndrome or brain damage. The aim of our study was to evaluate the levels of fetal activin A in labors complicated by meconium-stained amniotic fluid. MATERIAL AND METHODS: Cord blood samples were collected from 65 full-term neonates from single pregnancies. In each case, the hematological parameters of cord blood and activin A (ELISA--Oxford Bio-Innovation Activin A Assay Kit) were assessed. RESULTS: There were no significant differences in the concentration of activin A in cord blood between the group with and the group without meconium-stained amniotic fluid. The mean count of nucleated erythrocytes and white blood cells as well as the percentage of reticulocytes was significantly higher in the meconium group. There were no significant differences between concentration of fetal activin A in a vaginal delivery (0.58 +/- 0.38 ng/ml) and cesarean section after labor (0.44 +/- 0.32 ng/ml) or elective cesarean section (0.62 +/- 0.47 ng/ml) groups. There were also no correlations between the levels of activin A and the parameters of fetal acid base status or cord blood hematological values. CONCLUSIONS: Fetal activin A has a limited significance for diagnosing fetal hypoxia in labors complicated by meconium-stained amniotic fluid. There were no correlations between the parameters of fetal acid base status and fetal activin A. The levels of fetal activin A do not depend on the mode of the delivery. Meconium-stained amniotic fluid resulted in significant changes of the hematological variables in cord blood.

Increase in expression of monocytic tissue factor (CD142) with monocytes and blood platelet activation in liver cirrhosis.

Tissue factor (TF) is one of the proteins that participate in hemostatic and inflammatory processes. Activated monocytes present in the liver increase expression of TF, and while accumulating in the organ they can intensify inflammation. The aim of the present study was to evaluate the expression of TF on monocytes in advanced liver cirrhosis with regard to other activation markers. The flow cytometric analysis of TF (CD142), CD14, adhesive molecules CD11b and CD11c, costimulatory molecules CD40, CD80 and CD86, and HLA-DR on monocytes was carried out in 45 patients with postalcoholic liver cirrhosis (Child Pugh B, 20 patients; Child Pugh C, 25 patients) and in 25 healthy persons. The positive correlation between monocytic TF expression and monocyte [soluble CD14 (sCD14), CD11b, monocyte aggregates] activation, the expression of costimulatory molecules on monocytes (CD40, CD80), blood platelet (soluble P-selectin, microplatelets) activation, the level of tumor necrosis factor-alpha, biochemical parameters of liver damage (alanine aminotransferase, aspartate aminotransferase, alkaline phosphate, gamma-glutamyltransferase, and bilirubin) as well as coagulation disorders were observed in the study. In conclusion, the study revealed that the activation of monocytes and blood platelets is accompanied by the elevation of monocytic TF expression in advanced liver cirrhosis. The monocytic TF is a significant link connecting clotting processes and inflammatory and immunological phenomena in liver cirrhosis.

ICAM-1 expression on conjunctival epithelial cells in patients with cystic fibrosis.

BACKGROUND: Cystic fibrosis is one of the most common lethal genetic conditions. The defect is due to mutations in a gene on chromosome 7, named the cystic fibrosis transmembrane regulator (CFTR), which functions as a chloride channel in epithelial membranes It is presumed that the disease affects all secretory epithelia including the eye. The objective of this study is to investigate the expression of intercellular adhesion molecule-1 (ICAM-1) by conjunctival epithelial cells of patients with cystic fibrosis and the correlation between of the expression of ICAM-1 and the grade of cystic fibrosis severity. METHODS: Impression cytology specimens were collected in 24 patients with cystic fibrosis. Cells were processed for flow cytometry, by using monoclonal antibodies to ICAM-1. RESULTS: A significant increase of ICAM-1 expression on epithelial cells was found in patients with cystic fibrosis when compared with normal eyes. A positive correlation between the ICAM-1 expression and severe clinical status of CF patients was also observed. CONCLUSIONS: Our findings suggest that the inflammation appears to have a role in the pathogenesis of the ocular surface changes in patients with cystic fibrosis. ICAM-1 expression on conjunctival epithelial cells may be a marker of the inflammatory status in cystic fibrosis patients. The method described here reveal good repeatability and reliability for the analysis of the inflammatory markers on conjunctival epithelial cells and can be a useful tool in evaluating of the ocular findings and treatment interventions in patients with cystic fibrosis.

[Biophysical and biochemical intrapartum fetal assessment in relation to hematological varaiables in umbilical cord blood]. / Sródporodowa biochemiczna i biofizyczna ocena stanu plodu, a parametry hematologiczne krwi pepowinowej.

UNLABELLED: The analysis of the hematological variables of umbilical cord blood can be useful in broadening our knowledge of both physiological and pathological processes undergoing during prenatal period. OBJECTIVES: The aim of our study was to evaluate the hematological parameters of umbilical cord blood in cases of either the abnormal fetal heart rate or the confirmed fetal acidosis. MATERIAL AND METHODS: A study group consisted of 458 neonates, live-born term of 38 to 41 completed weeks of single gestation. In each case, the hematological cord blood parameters were assessed. Fetal acidosis was diagnosed when the umbilical cord blood pH was below 7,15. Fetal heart rate (FHR) was assessed according to FIGO criteria. Statistical analysis was conducted using Mann-Withney tests, analysis of variance, p-value < 0.05 was considered as significant. RESULTS: The values of WBC (16,5 vs. 13,8x109), NRBC (25,1 vs. 7,3 /100 WBC) and HCT (51,8 vs. 46,5%) were higher in cases of fetus acidosis compare to non-acidemic fetuses. The significant differences in RBC, PLT, NRBC, HCT, HG were observed between group with abnormal and normal FHR. CONCLUSIONS: Fetal distress resulted in significant changes of the hematological variables in umbilical cord blood. Fetal hemopoetic system responds in specific manner to asphyxia. A precise analysis of fetal hematological variables may help to establish an exact onset and degree of fetal hypoxia.

[The evaluation of the expression of intercellulare adhesion molecule (ICAM-1) by conjunctival epithelial cells of patients with cystic fibrosis]. / Ocena ekspresji miedzykomórkowej czasteczki adhezyjnej-1 na komórkach nablonka spojówki w przebiegu mukowiscydozy u dzieci i mlodziezy.

PURPOSE: To investigate the expression of intercellulare adhesion molecule (ICAM-1) by conjunctival epithelialcells of patients with cystic fibrosis. MATERIAL AND METHODS: 15 patients with cystic fibrosis and 15 control subjects were included in this study. Impression cytology specimens were collected and analyzed by flow cytometry and analyzed by flow cytometry. RESULTS: A significant increase of ICAM-1 expression by epithelial cells was found in patients with cystic fibrosis compared with normal eyes. CONCLUSIONS: Increase of ICAM-1 expression by epithelial cells in cystic fibrosis patients suggests, that the inflammation appears to have a role in the pathogenesis of the ocular surface changes and may be a marker of the inflammatory status in cystic fibrosis.

Expression of beta2-integrin on leukocytes in liver cirrhosis.

AIM: To analyze beta2-integrin expression on blood leukocytes in liver cirrhosis. METHODS: In 40 patients with liver cirrhosis and 20 healthy individuals, the evaluation of expression of CD11a (LFA-1alpha), CD11b (Mac-1alpha), CD11c (alphaX) and CD49d (VLA-4alpha) on peripheral blood leukocytes was performed using flow cytometry. The analysis was carried out in groups of patients divided into B and C according to Child-Pugh's classification. RESULTS: An increased CD11a, CD11b, CD11c and CD49d integrin expression was observed on peripheral blood leukocytes in liver cirrhosis. The integrin levels were elevated as the advancement of liver failure progressed. The highest expression of integrins occurred predominantly on monocytes. A slight expression of VLA-4 was found on lymphocytes and granulocytes and it increased together with liver failure. A positive correlation was noted between median intensity of fluorescence (MIF) expression on polymorphonuclear cells of CD11a and CD11c and CD49d (r = 0.42, P < 0.01; r = 053, P < 0.01, respectively) in liver cirrhosis stage C. However, no correlation was observed between integrin expression on leukocytes. The concentrations of sICAM-1, sVCAM-1, and TNFalpha, were significantly elevated in liver cirrhosis. CONCLUSION: beta2-integrin expression on leukocytes increases in liver cirrhosis decompensated as the stage of liver failure increases, which is a result of permanent activation of leukocytes circulating through the inflamed liver environment. beta2-integrin expression on circulating leukocytes can intensify liver cirrhosis.

[Platelet satellitism]. / Satelityzm plytkowy.

Platelet satellitism is an infrequent phenomenon of platelet adhesion to leucocytes. Twelve-month-old patient was hospitalized because of bronchopneumonia. In peripheral blood smear prepared from EDTA-anticoagulated blood sample taken from this patient platelet satellitism was observed. As time went by, a gradual, small decrease of platelet count was observed. Cytometric analysis showed the following proportions of platelet aggregates: with granulocytes--88,7%, with monocytes--5,0%, with lymphocytes--17,0%. In spite of using modern hematological analyzers still microscopic assessment of peripheral blood sample is necessary. Microscopic examination of blood smear is necessary not only to assess erythrocytes and leucocytes systems but also blood platelets.

[Inflammatory mediators and hematological parameters in cord blood in labor complicated by meconium-stained amniotic fluid]. / Mediatory zapalenia oraz parametry hematologiczne krwi plodu w porodzie powiklanym obecnoscia smolki w plynie owodniowym.

OBJECTIVE: Meconium-stained amniotic fluid at term gestation is a predictor for adverse perinatal outcome and is associated with increased peripartum infections, independent of other risk factors. The aim of our study was to evaluate concentrations of inflammatory mediators (such as cytokine IL-6 and intracellular adhesion molecule ICAM-1) and values of hematological parameters of cord blood in presence or absence of meconium in amniotic fluid in term labor. MATERIAL AND METHODS: Cord blood samples were obtained from 66 term normal neonates immediately after birth, Soluble ICAM-1 and IL-6 concentrations were measured with ELISA R&D Systems kits. The umbilical blood specimen was analyzed using an automated hematology cell analyzer. Blood films were stained using May-Grünwald-Giemsa method. RESULTS: There were no difference in concentrations of ICAM-1 and IL-6 in cord blood in groups with or without meconium-stained amniotic fluid. The mean count of umbilical nucleated red blood cells and white blood cells was significantly higher in meconium group. There was no correlation between the cord blood hematological values and ICAM-1 or IL-6. There was also no correlation between IL-6 and ICAM-I and duration of labor. The mode of delivery influenced cord blood IL-6 levels. CONCLUSIONS: There was no influence of meconium-stained amniotic fluid on cord blood IL-6 and ICAM-1 levels. Changes in hematological parameters in cord blood in meconium passage can suggest either fetus hypoxia or infection. Significant differences of concentrations of fetal IL-6 were associated with the mode of delivery.

[Expression Bcl-2 protein of lymphocytes T and B in hypertrophied adenoid in children with otitis media with effusion]. / Ekspresja bialka Bcl-2 na limfocytach T i B w przeroslych migdalkach gardlowych u dzieci chorych na wysiekowe zapalenie ucha.

INTRODUCTION: The quantity of lymphocytes in adenoid and their cooperation in immunological processes is dependent on proliferation process and their migration to the effectory places. The most important process provide for equilibrium between lymphocytes of tonsils is apopotosis. Special meaning in induction this process has Bcl-2 family proteins with can be divided into pro-apoptotic and anti-apoptotic. An investigation was executed in hypertrophied adenoids with or without otitis media with effusion. MATERIAL AND METHODS: By flow cytometry percentage of lymphocytes CD4+, CD8+, CD19+ and percentage of these lymphocytes with expression Bcl-2 proteins in hypertrophied adenoid and hypertrophied adenoid and otitis media with effusion was analyzed. RESULTS: The percentage of lymphocytes CD4+Bcl-2+, CD8+Bcl-2+, CD19+Bcl-2+ was lower in hypertrophied adenoid and otitis media with effusion compared to the control group. CONCLUSIONS: Tendency to lowered percentage of lymphocytes T and B with expression Bcl -2 protein in adenoids reflects likely the local immunity alterations.

Expressions of selected adhesion molecules on peripheral blood leukocytes in patients with aggressive periodontitis.

INTRODUCTION: Aggressive forms of periodontitis lead to rapid bone destruction resulting in extensive losses in children's and young adults' dentition. Adhesion molecule deficiency syndrome and abnormalities in the expression of various adhesion molecules on peripheral blood leukocytes can be observed in prepubertal and aggressive periodontitis (AP) patients. The aim of the study was thus to assess the expression of selected cell adhesion molecules (CAMs; CD11a, CD11b, CD11c, CD54, and CD62L) on monocytes, neutrophils, and lymphocytes of the peripheral blood in patients with AP. MATERIAL/METHODS: The study involved 16 patients with AP and a control group of 13 generally healthy subjects with healthy periodontium. CAM expressions were determined by flow cytometry and presented as mean fluorescence intensity (MFI) and percentage of cells showing expression of the assessed adhesion molecules. RESULTS: Neutrophil CAM expressions in AP patients were comparable with those of the control group. MFI of CD62L on monocytes in AP patients was significantly lower than that of the controls. Lymphocytes showed increased CD11b expression compared with the control group. The percentage of leukocytes showing CAM expression in both groups was similar. Only the percentage of lymphocytes with CD11b in AP patients was significantly higher than in healthy controls. CONCLUSIONS: Because of the evident lack of differences between patients and controls and the great amount of individual dispersion of the results, the above CAMs on peripheral blood leukocytes in generally healthy patients with AP do not seem to be characteristic markers of this disease.

Blood platelet and monocyte activations and relation to stages of liver cirrhosis.

AIM: Blood platelets (plt) and monocytes are the cells that play a crucial role in the pathogenesis of liver damage and liver cirrhosis (LC). In this paper, the analysis of mutual relationship between platelets and monocytes activation in LC was conducted. METHODS: Immunofluorescent flow cytometry was used to measure the percentage of activated platelet populations (CD62P, CD63), the percentage of plt-monocyte aggregates (pma) (CD41/CD45), and activated monocytes (CD11b, CD14, CD16) in the blood of 20 volunteers and 40 patients with LC. Platelet activation markers: sP-selectin, platelet factor 4 (PF4), beta-thromboglobulin (betaTG) and monocyte chemotactic peptide-1 (MCP-1) were measured and compared in different stages of LC. RESULTS: Platelet activation with the increase in both betaTG serum concentration and elevation of plt population (CD62P and CD63 as well as MIF CD62P and CD63) is elevated as LC develops and thrombocytopenia rises. There is a positive correlation between medial intensity of fluorescence (MIF) CD62P and MIF CD63 in LC. We did not show any relationship between monocyte activation and pma level. SP-selectin concentration correlates positively with plt count and pma, and negatively with stage of plt activation and MIF CD62P and MIF CD63. There was no correlation between MCP-1 concentration and plt, monocyte activation as well as pma level in LC. CD16 monocytes and MIF CD16 populations are significantly higher in the end stage of LC. A positive correlation occurs between the value of CD11b monocyte population and MIF CD14 and MIF CD16 on monocytes in LC. CONCLUSION: Platelet and monocyte activation plays an important role in LC. Platelet activation stage does not influence monocyte activation and production of plt aggregates with monocytes in LC. With LC development, thrombocytopenia may be the result of plt consumption in platelet-monocyte aggregates.