A diagnosis you can trust
Platelets have essential roles in primary hemostasis. Patients with either hereditary or acquired platelet disorders usually have bleeding diathesis, which can potentially be life threatening. A reliable laboratory diagnosis of a platelet disorder can significantly impact patients' and, potentially, their family members' clinical management and outcome.
Platelet Transmission Electron Microscopic Study (PTEM)
Considered the gold standard test for diagnosing dense granule deficiencies in Hermansky-Pudlak syndrome, alpha-delta platelet storage pool deficiency, Paris-Trousseus-Jacobsen syndrome, Wiskott-Aldrich syndrome, TAR (thrombocytopenia, absent radii) syndrome, Chediak-Higashi syndrome, and more. PTEM has been an essential tool for laboratory diagnosis of various hereditary platelet disorders since it was first used to visualize fibrin-platelet clot formation in 1955. PTEM employs 2 main methods to visualize platelet ultrastructure, whole mount (WM) TEM and thin section (TS) TEM.
Which test should I order?
Platelet Surface Glycoprotein
Exposed collagen at a vascular damage site can activate platelets via collagen receptor GPVI and GPIa and bind shear-stretched multimeric VWF proteins, which subsequently interact with the platelet surface receptor, GPIb-V-IX. Upon full activation, platelets can aggregate by binding to fibrinogen through activated GPIIb-GPIIIa receptors. Deficiency of platelet surface glycoproteins can cause bleeding diathesis.
Platelet flow cytometric analysis is the preferred method to assess hereditary platelet disorders due to quantitative surface glycoprotein (GP) deficiencies. GP expression levels can be measured by using fluorescent-conjugated GP-specific antibodies and their fluorescent intensities can be compared to normal ranges of various glycoproteins.
Platelet Transmission Electron Microscopy and Flow Cytometry
Laboratory diagnosis of hereditary platelet disorders requires a systematic approach. It begins with elucidating a complete personal and family bleeding history, then effectively utilizing both routine and esoteric laboratory tests.
Learn more about how to order these evaluations at your institution.