Research Article| Volume 81, ISSUE 1, P64-76, January 1973

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Thrombokinetic studies in alcohol-related thrombocytopenia

  • Dale H. Cowan
    Reprint requests: Dr. Dale H. Cowan, Department of Medicine, Cleveland Metropolitan General Hospital, 3395 Scranton Rd., Cleveland, Ohio 44109.
    From the Department of Medicine, Case Western Reserve University School of Medicine at Cleveland Metropolitan General Hospital, Cleveland, Ohio U.S.A.
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      Thrombokinetic studies were done in 5 folate-deficient and 3 folate-replete alcoholic subjects to evaluate the mechanism of alcohol-related thrombocytopenia. Measurements were done during abstinence and during a period of supervised alcohol ingestion on a metabolic ward. Thrombocytopenia developed during alcohol ingestion in 3 of the 5 folate-deficient and 2 of the 3 folate-replete subjects. Total thrombopoiesis, determined from the total mass of megakaryocytes, increased 1.5 to 3.0-fold in the folate-deficient thrombocytopenic patients with alcohol ingestion. No change and a 1.6-fold increase in total thrombopoiesis were observed in the 2 folate-replete thrombocytopenic patients. Platelet life-span during alcohol-related thrombocytopenia was 2.2 to 3.8 days as compared to 8.0 to 9.0 days during abstinence; effective thrombopoiesis, determined from the platelet turnover, decreased 30 to 50 per cent. During ingestion, total thrombopoiesis in the folate-deficient and folate-replete thrombocytopenic patients was, respectively, 4.7 and 2.7 times greater than effective thrombopoiesis. With alcohol ingestion unaccompanied by thrombocytopenia (3 patients), changes in megakaryocytes were variable, platelet life-span was 50, 75, and 100 per cent of control, effective thrombopoiesis was increased 1.1 to 1.5-fold, and the ratio of total to effective thrombopoiesis was unchanged or decreased. Survival of normal homologous platelets in a thrombocytopenic alcoholic recipient was 25 per cent below normal. Platelet counts during intravenous ethanol administration varied from 82 to 109 per cent of pre-infusion values. The results indicate that alcohol-related thrombocytopenia is characterized by a reduced platelet life-span and an inability of the marrow to compensate appropriately for the premature removal of the platelets from the bloodstream.
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      1. Haut MJ and Cowan DH: The effect of ethanol on hemostatic properties of human blood platelets. Submitted for publication.