Here is a message sent last week by Prof. Bernadette (Bunny) Rodak, chief editor of Hematology; Clinical Principles and Applications, Elsevier, Inc, and of  Clinical Laboratory Science, the journal of the American Society for Clinical Laboratory Science. This is from her niece, Susan O'Neill, The Baltimore Life Companies, Owings Mills, MD.

Hi Bunny,
My father-in-law was recently diagnosed with sticky platelet syndrome. He has been taking aspirin for 30 years and Plavix for the past year, and he is now starting on Coumadin. He has a history of two TIAs and one stroke and he has a hole in his heart. All of which, I think, have something to do with the platelets. When I look it up online, I can't understand what the heck it means. Can you put it in laymen's terms for me? Thanks, Susie

About four times a year Path residents and Heme-Path fellows rotate through Special Coagulation at UAB and I get the opportunity to provide a few lectures. Thursday I lectured on platelet aggregometry, but I didn't prepare quite enough handouts. Here is the handout as a 6-per page PDF for those who need it, and of course, any Fritsma Factor members. Geo.

Here's a new message from Kim Kinney at Clarian in Indianapolis:

 Hi George, I have a question in regards to platelet aggregation and the effects of plavix and aspirin.  We have had several patients where just the AA, ADP and collagen are abnormal but we have had a few where the ristocetin is also abnormal!  Do you know what the mechanism could be?  Thanks, we are awaiting our CAP inspection and everyone is on alert!

Kim

Alice Runge at City of Angels Hemostasis Thrombosis Laboratory in Los Angeles wrote:

I have been searching the literature for a good article on sticky platelet syndrome (SPS).  Do you  have a recent article that has a procedure and interpretation for SPS?

Here is a new stumper from Kim Kinney at Clarian in Indianapolis:

Hi, George. We perform many PFA-100s on both adults and children.  We have started seeing a pattern only in children.  Approximately six times in the past few months, we have seen abnormal EPI and ADP closure times with totally normal platelet aggregations.  We check all of our abnormal PFAs for platelet count, hematocrit and hemolysis.  All of these cases have had no abnormalities.  On a few cases, we have also done von Willebrand antigen, ristocetin cofactor and factor VIII levels.  All of these have been normal.  Could these be cases of mild von Willebrand disease that we cannot pick up with our traditional methods, but the PFA is picking up the abnormality?

Kim, thank you for the question, and let's look for some answers from other PFA-100 users. Geo.