PB1070 - Whole Blood Impedance Aggregometry Is Inferior to Lumiaggregometry in the Diagnosis of Platelet Function Defects Amongst Women With Menorrhagia Referred for Surgical Intervention

Tuesday, July 12, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Alison Delaney, MBBS

Haematology Specialty Registrar
Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
Sheffield, England, United Kingdom

Co-Author(s)

MM

Michael Makris

Honorary Consultant Haematologist
Sheffield Haemophilia and Thrombosis Centre, Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield, England, United Kingdom
EK

Evangelos Kritsotakis

School of Health and Related Research, University of Sheffield; School of Medicine, University of Crete, Greece
Rhona Maclean, MB ChB, FRCP, FRCPath

Sheffield Haemophilia Comprehensive Care Centre Director
Sheffield Teaching Hospitals NHS Trust
Sheffield, England, United Kingdom
Kevin Horner, BSc (Hons) MSc

Routine Coagulation Scientific Lead
Coagulation Department Sheffield Teaching Hospitals
Sheffield, England, United Kingdom
Steve Kitchen, PhD

Lead Scientist
Sheffield Haemophilia and Thrombosis Centre
sheffield, England, United Kingdom
JS

Jennifer Sedcole

Specialty Registrar
Department of Obstetrics & Gynaecology, Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield, England, United Kingdom
TB

Ted Baxter

Consultant Gynaecologist
Department of Obstetrics & Gynaecology, Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield, England, United Kingdom
CS

Clare Samuelson

Consultant Haematologist
Sheffield Haemophilia and Thrombosis Centre, Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield, England, United Kingdom

Background: There is clinical interest in alternative diagnostic methodology for platelet function disorders in contrast to the time consuming and labour intensive “gold standard” of light transmission or lumiaggregometry.

Aims: Within this prospective study, we aimed to determine the sensitivity of whole blood impedance aggregometry (WBIA) with the Multiplate® analyser (Roche) in detecting platelet function abnormalities amongst women referred for surgical management of severe menorrhagia.

Methods: Women aged ≥18 referred for surgical management of menorrhagia at our tertiary gynaecology centre were eligible for inclusion. Anti-thrombotic therapy, known bleeding disorder or pelvic malignancy were exclusion criteria. After providing informed consent, participants underwent standardised ISTH-BAT scoring and laboratory testing, including platelet function testing with both lumiaggregometry and WBIA (Multiplate® analyser, Roche). Those with abnormal lumiaggregometry results underwent repeated testing by both methods and were also referred for specialist haematology review.

Results: Fifty patients were recruited and underwent testing. Eight women (16%) were identified as having a platelet function defect based on reproducible abnormalities on lumiaggregometry. Of these, 3/8 had results consistent with a storage pool disorder; medication was suspected to be a contributory factor in a further 3/8 cases. WBIA results were normal in 3/8 women (37.5%) in whom lumiaggregometry detected platelet dysfunction, 2 of whom had a storage pool disorder. Only 2 patients with a platelet function abnormality detected on lumiaggregometry had persistently abnormal WBIA analysis, giving a test sensitivity of only 25%. Five patients had abnormal WBIA results despite normal lumiaggregometry results.

Conclusion(s): In conclusion, WBIA with the Multiplate® analyser (Roche) has poor sensitivity and specificity in comparison to gold standard lumiaggregometry in the detection of platelet function disorders amongst women with severe menorrhagia referred for surgical intervention.
This study was supported by a grant from the Platelet Society and received local ethical approval.