Page 263 - Haematologica Atlas of Hematologic Cytology

CHAPTER 32 - Immune thrombocytopenia
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Figure 3 Rare abnormali es of of of platelet platelet size and and shape A A very limited number of of of platelets larger than red cells similar to those of of of of MYH9-related disease and and biallelic Bernard-Soulier syndrome may be be be observed in in some ITP ITP pa pa ents (A) Thus iden ca ca on on of of of single giant platelets platelets does not exclude ITP ITP ITP Although li li li li le le le le le le a
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en en en en en on on has been paid so so far to the the shape shape of of platelets platelets in in in in in in in ITP ITP ITP our experience indicates that the the the abnormali es es es es in in in in in in in platelet platelet platelet shape shape shape we described for inherited throm- bocytopenias may be be be be observed in in in in in in in ITP ITP The sausage-shaped giant elements elements shown in in in in in in in (B) and (C) can be be be be iden ed ed ed ed ed ed ed ed as as the the the precursors of platelets platelets platelets platelets platelets named preplatelets while the the the elongated barbell-shaped elements elements in in in in (D-F) look like proplatelets which are expected to to to undergo ssion into platelets platelets platelets platelets platelets platelets (see “Inherited thrombocytopenias”) As for for giant platelets platelets platelets platelets platelets platelets also the the the the presence of these elements elements therefore does not exclude ITP Interes ngly elements elements resembling proplatelets may be ob- served also in in in thrombo c c c c c c c c c c c c c c microangiopathies microangiopathies (see “Thrombo c c c c c c c c c c c c c c microangiopathies”) So we are tempted to conclude that the the the the the presence of of of late late late precursors of of of platelets in in blood may be be the the the the the consequence of of of either an an an accelerated platelet platelet turnover or or a
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gene c c c c c c c c c c c c defect that that a
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ects megakaryocytes Given the the the the the the the the very limited knowledge on on on this topic we believe that that at at at at at at at the the the the the the the the moment it it is is not possible to to to a
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ribute any diagnos c c c c c c value to to to the the the the the observa on on of these elements in the the the the the peripheral blood 250