CHANGES OF PLATELET MORPHOLOGY IN PATIENTS WITH ACUTE PANCREATITIS
Keywords:
pancreatitis, hemostasis, plateletsAbstract
Importance. Acute pancreatitis is the inflammation of the pancreas and the parapancreatic fat tissue. Like any inflammation, it is associated with changes of hemostasis, where platelets play and important part, as they are a component of blood clotting, and most enzymatic hemostasis reactions occur on the surface of platelets. The purpose of this study was to investigate the changes in platelet morphology and functional condition in patients with acute pancreatitis. Material and methods. We have assessed 18 patients (8 female, 10 male) who had been admitted into Lviv Regional Clinical Hospital because of moderate acute pancreatitis [5] between 2010 and 2015. In 10 cases acute pancreatitis was caused by cholelitiasis and microlithiasis, in 4 patients — alcohol, while 4 patients presented with idiopatic pancreatitis. All patient were treated according to the generally accepted guidelines [1–3, 6, 7]. We utilize microscopy of platelets and assess the changes in platelet shape following spontaneous platelet activation after the drawing of sample. The method is based upon Fromovik et Milton technique (1982). [4]. Results. Decreased count of intact platelets (71.4±1.1 р<0,05) and increased count of activated cells was noted on the third day of disease, indicating early activation of platelet phase of blood clotting. The total fraction of active platelets on the third day of disease was 23.8 % (N=7.9–17.7 %). Increase of the count of intact platelets was observed only on the 10th day of the course of moderate acute pancreatitis. The total fraction of active platelets on that day was 15.6 %. Conclusions. Our data on the change of shape of platelets following stimulation indicate that these parameters may be used in conditions associated with impaired hemostasis. Intravascular activation of platelets is caused by numerous factors, including changes in vascular wall, tissue damage, etc. Many clinical studies have shown that morphological changes of platelets are early indicators of platelet activation.
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