JAMES N. ATKINS, M.D.
To the editor: the interesting article by Dr. Kelton and colleagues (1) concerning the detection of platelet-aggregating factor in thrombotic thrombocytopenic purpura raises two questions that I hope they will clarify.
First, when they evaluated aggregation, did they control for isoagglutins? Their article indicated that when they pooled platelets they used ABO-compatible donors, but did the aggregation studies use ABO-compatible platelets with ABO-appropriate serum and cryoprecipitate?
Second, why did they use an endpoint of visible agglutination rather than using phase microscopy to look for agglutination or using an aggretometer as Dr. Lain and colleagues (2) did in their study? Visible
ATKINS JN. Platelet-Aggregating Factor in Thrombotic Thrombocytopenic Purpura. Ann Intern Med. ;102:560–561. doi: 10.7326/0003-4819-102-4-560
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Published: Ann Intern Med. 1985;102(4):560-561.
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