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Interpretive Handbook

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Test 8538:
Platelet Antibody, Serum

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Platelet antibodies may be allo- or autoantibodies and may be directed to a wide range of antigenic "targets" carried on platelet cytoplasmic membranes.

 

Platelet alloantibodies are involved in several clinical situations such as alloimmune platelet refractoriness (APR), neonatal alloimmune thrombocytopenic purpura (NATP), and posttransfusion purpura (PTP). In these settings, the antibodies, usually HLA Class I in the case of APR, and platelet-specific antibodies eg, HPA-1a (PLA1) in the case of NATP or PTP, are found in the patient's plasma and are detected by tests performed on serum.

 

In contrast, conditions such as idiopathic thrombocytopenic purpura (ITP), systemic lupus erythematosus (SLE), or sepsis are associated with the presence of excessive platelet associated immunoglobulin usually IgG. Testing for cell bound platelet antibody is indicated for the diagnosis of these autoimmune conditions. In some cases of ITP, platelet antibodies can also be found in the patient's serum but with less frequently than cell bound antibody.

Useful For Suggests clinical disorders or settings where the test may be helpful

Evaluating cases of immune platelet refractoriness, post-transfusion purpura, or neonatal alloimmune thrombocytopenic purpura

Interpretation Provides information to assist in interpretation of the test results

Presence of reactivity to some glycoproteins has no clearly established clinical significance.

 

Results are based on clinical situation as well as test results.

 

Serum platelet antibody testing by solid-phase enzyme-linked immunoassay offers more than a positive/negative result. When the patient's serum is positive, the specific platelet glycoprotein will be identified as well as the probable specificity. The platelet glycoproteins reported are: IIb/IIIa, Ia/IIa, GPIb/IX. Specificities include the following: HPA-1a (PL[a1]), HPA-1b (PL[a2]), HPA-3a (BAK[a]/LEK[a]), HPA-3b (BAK[b]), HPA-5b (Br[a]), HPA-5a (Br[b]). Those specificities listed in parenthesis refer to old nomenclature. In addition, this assay screens for HLA Class I antibodies, but specificity is not determined.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

An interpretive report will be provided.

Clinical References Provides recommendations for further in-depth reading of a clinical nature

1. Kiefel V, Santoso S, Weisheit M, et al: Monoclonal antibody-specific immobilization of platelet antigens (MAIPA): A new tool for the identification of platelet-reactive antibodies. Blood 1987;70:1722-1726

2. Moore SB, DeGoey SR: Serum platelet antibody testing: evaluation of solid-phase enzyme immunoassay and comparison with indirect immunofluorescence. Am J Clin Pathol 1998;109:190-195