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Annals of Clinical & Laboratory Science 39:283-288 (2009)
© 2009 Association of Clinical Scientists

Flow Cytometric Detection of Platelet-Associated Immunoglobulin in Patients with Immune Thrombocytopenic Purpura and Nonimmune Thrombocytopenia

Hee Jin Huh1,*, Chan Jeoung Park1, Sang We Kim2, Sang Hee Han1, Seongsoo Jang1 and Hyun Sook Chi1
1 Departments of Laboratory Medicine and 2 Oncology, College of Medicine, University of Ulsan and Asan Medical Center, Seoul, Korea

Address correspondence to Chan Jeoung Park, M.D. Dept. of Laboratory Medicine, Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, South Korea; tel 82 2 3010 4508; fax 82 2 478 0884; e-mail cjpark{at}amc.seoul.kr.

We increased the specificity of flow cytometric detection of platelet-associated immunoglobulin (PAIg) by a combination of platelet gating and cutoff for positivity determined by the use of receiver operating characteristic (ROC) curve analysis, and we evaluated the significance of elevated PAIg in non-immune thrombocytopenic purpura (ITP) patients. Blood samples from 118 patients with a platelet count <100 x 109/L were used in this study. Flow cytometric detection of PAIg was performed. To obtain the cutoff of the surface-bound immunoglobulin for the discrimination of ITP and non-ITP, ROC curve analysis was used. The sensitivity of a positive PAIgG and PAIgM test for ITP in thrombocytopenic patients was 74.6%; the specificity was 79.7%; the positive predictive value 78.6%; and the negative predictive value 75.8%. Among 3 patients with myelodysplastic syndrome, 2 showed increased PAIg. Six of 20 patients with benign disease showed positivity for PAIg. Among these patients, 4 with elevated PAIg were diagnosed with liver disease. This study demonstrates that flow cytometric detection of PAIg combined with ROC curve analysis is a convenient, sensitive, and specific test, compared to previous methods, and it is useful for the differential diagnosis of thrombocytopenic patients.

Keywords: platelet associated immunoglobulin, flow cytometry, immune thrombocytopenic purpura






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