抄録
Case 1. 60-year-old female with history of three times' hematemesis. Received esohageal transection and splenectomy for Banti's syndrome. Postoperatively developed thrombophlebitis of right leg and was administered heparin. Two months later admitted for posttransfusion hepatitis. Main laboratory findings on admission are T. Bilirubin 4.1mg/dl, GOT 156u., GPT 126u. Characteristic finding is hypercoagulability. Reduction in r and k and increase in ma on thromboelastogram were conspicuous. Spontaneous platelet aggregation of platelet rich plasma (PRP) containing 30×104 platelets/ml without an addition of ADP by Evans' aggregometer was most characteristic.
Electronmicroscopic examination of the platelets showed unremarkable change of internal structure but formation of chracteristic pseudopodia which may explain morphological alterations suggesting an abnormality of platelet release reaction. ADP in patient's platelets was definitely increased. High activity of ATPase in platelets was also demonstrated. This spontaneous aggregation disappeared 4 hours after administration of 0.5g aspirin.
From the above results it can be said that main causes of spontaneous aggregation of this particular case are sought in an acceleration of energy generation system in metabolic pool of the platelets as well as an increase in ADP content of the storage pool.
Case 2. 25-year-old female with liver cirrhosis. Also showed spontaneous platelet aggregation. Same mechanism as Case 1 was considered.
