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Thrombasthenic-Thrombopathic Thrombocytopenia with Giant, "Swiss-Cheese" Platelets: A Case Report

THOMAS P. SMITH, M.D.; W. JEAN DODDS, D.V.M.; and ANTHONY P. TARTAGLIA, MD.
[+] Article and Author Information

Grant support: HL09902, National Heart and Lung Institute, U.S. Public Health Service.

▸Requests for reprints should be addressed to Anthony P. Tartaglia, M.D., Division of Hematology, Albany Medical College, Albany, NY 12208.


Albany, New York


Ann Intern Med. 1973;79(6):828-834. doi:10.7326/0003-4819-79-6-828
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A patient, studied over a 5-year period, had presented with a mild bleeding diathesis and chronic, mild, nonimmunologic thrombocytopenia. He had giant, bizarre, vacuolated platelets; functional platelet abnormalities characteristic of more than one specific platelet disorder; and a documented shortened platelet survival. The initial platelet defect was most consistent with thrombasthenia because platelet aggregation with exogenous ADP was markedly decreased. During and after corticosteroid therapy, however, the thrombocytopenia improved, and the disorder evolved into a primary platelet release defect, more consistent with thrombopathia. The accurate classification of qualitative platelet disorders is difficult. Whether this case represents an overlap of two specific platelet disorders or an evolution from one defect to another remains unresolved.

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