Platelet storage pool deficiency explained

Platelet storage pool deficiency is a family of clotting disorders characterized by deficient granules in platelets. Individuals with these disorders have too few or abnormally functioning alpha granules, delta granules, or both alpha and delta granules and are therefore unable to form effective clots, which leads to prolonged bleeding.^{[1] [2]} Platelet storage pool deficiency can be acquired or inherited.

Symptoms and signs

The symptoms individuals with platelet storage pool deficiency may experience include the following:

• Easy bruising
• Nose bleeds
• Bleeding from gums
• Heavy or prolonged menstrual bleeding (menorrhagia) or bleeding after childbirth
• Abnormal bleeding after surgery, circumcision, or dental work

Severity can vary widely from person to person, and individuals with platelet storage pool deficiency may not experience all of the above symptoms.

Cause

Platelet storage pool deficiency can be acquired or inherited. Inheritance may be autosomal dominant or autosomal recessive, depending on the specific disorder.

Some of the causes of platelet storage pool deficiency when acquired are:^[3]

• Hairy-cell leukemia

• Cardiovascular bypass

Mechanism

In terms of the pathophysiology of platelet storage pool deficiency one must consider several factors including the human body's normal function prior to such a deficiency, such as platelet alpha-granules one of three types of platelet secretory granule.

Platelet α–granules are important in platelet activity. α–granules connect with plasma membrane. This in turn increases the size of the platelet. Platelet α–granules have an important role in hemostasis as well as thrombosis. SNARE accessory proteins control the secretion of α–granule.^[4]

Diagnosis

The diagnosis of this condition can be done via the following:^[5]

• Flow cytometry
• Bleeding time analysis
• Platelet aggregation function study:

Types

This condition may involve the alpha granules or the dense granules.^[6] Some common inherited disorders associated with each include the following:

• Platelet alpha-granules
  • Gray platelet syndrome^[7]
  • Quebec platelet disorder^[8]
• Dense granules
  • δ-Storage pool deficiency^[9]
  • Hermansky–Pudlak syndrome^[10]
  • Chédiak–Higashi syndrome^[11]

Treatment

Platelet storage pool deficiency usually requires no daily treatment, although many individuals with heavy menstrual bleeding take hormonal contraceptives to reduce menstrual symptoms.^[12] However, management of uncontrolled bleeding consists of antifibrinolytic medications or transfusion of normal blood products. Additionally, caution should be taken with usage of NSAIDS, since they thin the blood and further impair clotting.^{[5] [13]}

See also

• Hypocoagulability
• Hypercoagulability

Further reading

• Sandrock. Kirstin. Zieger. Barbara. Current Strategies in Diagnosis of Inherited Storage Pool Defects. Transfusion Medicine and Hemotherapy. 2010. 37. 5. 248–258. 10.1159/000320279. 1660-3796. 2980509. 21113247.
• Book: Gresele. Paolo. Fuster. Valentin. Lopez. Jose A.. Page. Clive P.. Vermylen. Jos. Platelets in Hematologic and Cardiovascular Disorders: A Clinical Handbook. 2007. Cambridge University Press. 9781139468763. 26 November 2017. en.

External links

• PubMed

Notes and References

1. Web site: Platelet Storage Pool Deficiency . 2 September 2024 . National Hemophilia Foundation.
2. Web site: Platelet Function Disorders . 2024-09-02 . health.ucdavis.edu.
3. Konkle . Barbara . 10 December 2011 . Acquired disorders of platelet function . Hematology Am Soc Hematol Educ Program . 2011 . 1 . 391–396 . 10.1182/asheducation-2011.1.391 . 22160063 . Ash Publications.
4. Blair. Price. Flaumenhaft. Robert. Platelet alpha-granules: basic biology and clinical correlates. Blood Reviews. 2009. 23. 4. 177–189. 10.1016/j.blre.2009.04.001. 1532-1681. 19450911. 2720568.
5. Web site: Alpha Delta Granule Deficiency . 2017-10-28 . rarediseases.info.nih.gov . en.
6. Book: William B. Coleman. Gregory J. Tsongalis. Molecular pathology: the molecular basis of human disease. 2 November 2010. 2009. Academic Press. 978-0-12-374419-7. 258–.
7. Web site: Gray platelet syndrome . 2017-10-29 . Orphanet . en.
8. Web site: OMIM Entry - # 601709 - Quebec Platelet Disorder . www.omim.org. 29 October 2017. en-us.
9. Kaushansky K, Lichtman M, Beutler E, Kipps T, Prchal J, Seligsohn U. (2010; edition 8: pages 1946–1948) Williams Hematology. McGraw-Hill.
10. Book: https://www.ncbi.nlm.nih.gov/books/NBK1287/. GeneReviews. Huizing. Marjan. Malicdan. May Christine V.. Gochuico. Bernadette R.. Gahl. William A.. 1993. University of Washington, Seattle. Adam. Margaret P.. Seattle (WA). 20301464. Ardinger. Holly H.. Pagon. Roberta A.. Wallace. Stephanie E.. Bean. Lora J.H.. Mefford. Heather C.. Stephens. Karen. Amemiya. Anne. Ledbetter. Nikki. Hermansky-Pudlak Syndrome. update 2017
11. Web site: Chédiak Higashi syndrome . 29 October 2017 . Orphanet . en.
12. Web site: More Than a Bloody Nose: Platelet Storage Pool Deficiency . 2024-09-02 . Children's Hospital of Philadelphia . en.
13. Kirchmaier. Carl Maximilian. Pillitteri. Daniele. Diagnosis and Management of Inherited Platelet Disorders. Transfusion Medicine and Hemotherapy. October 2010. 37. 5. 237–246. 10.1159/000320257. 1660-3796. 2980508. 21113246.