Context :Acute pancreatitis constitutes a systemic inflammatory process which is often accompanied by thrombosis and bleeding disorders. The role of platelets in the pathophysiology of the disease remains to be elucidated. Objective :In the present study, we evaluated the alterations of platelet function in patients suffering from acute edematous pancreatitis using the recently developed platelet function analyzer PFA-100TM. Design :A cohort study with one end-point (difference between patients with acute edematous pancreatitis and normal controls concerning at least one PFA-100TM closure time at the P0.01 level of statisical significance). Main outcome measure: The hemostatic capacity of platelets was tested in citrated blood and standard cartridges containing collagen-ADP or collagen-epinephrine. Patients :We studied 16 patients (6 women and 10 men, mean age 62.1 years) with acute edematous pancreatitis, who had been admitted to our Internal Medicine Department, along with 32 normal controls of similar age and having the same woman-man ratio. Results :The mean closure time using collagen-ADP cartridges was 69.6 s (95% CI: 60.4-78.7 s) in patients and 96.1 s (95% CI: 93.0-99.3 s) in normal controls (t-value: 7.2; P0.001). The mean closure time using collagen-epinephrine cartridges was 110.7 s (95% CI: 100.1-121.3 s) in patients and 119.7 s (95% CI: 114.6-124.8 s) in normal cotrols (t-value: 1.8; P=0.078). The hematocrit in all patients was less than the upper reference value. Conclusions: The PFA-100TM represents a simple and easy to use test for investigating primary hemostasis. Although the method has been widely used in hemorrhagic conditions, this is the first time it has been applied in the prethrombotic model of acute pancreatitis, suggesting increased platelet adhesiveness and aggregation.
Konstantinos Mimidis, Vassilios Papadopoulos, Vassilios Tsatlidis, Georgios Kartalis, Zafiris Kartasis, Maria Baka, Georgios Bourikas