Advances in Clinical and Experimental Medicine
2018, vol. 27, nr 9, September, p. 1279–1283
Publication type: original article
Elevated beta-thromboglobulin and mean platelet volume levels may show persistent platelet activation in systemic lupus erythematosus patients
1 Department of Internal Medicine, University of Health Science, Antalya Training and Research Hospital, Turkey
2 Department of Internal Medicine, University of Health Science, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
3 Department of Rheumatology, University of Health Science, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
4 Bezmialem Vakıf University Faculty of Medicine, Internal Medicine Clinic, Istanbul, Turkey
Background. Patients with systemic lupus erythematosus (SLE) have an increased risk of thrombotic events. Platelets become more active and they enlarge to release proteins from alpha granules for aggregation during the plaque formation period. Beta-thromboglobulin is one of the proteins released from alpha-granules when platelets are activated and used as a marker of platelet activation in vivo.
Objectives. The aim of this study was to evaluate the plasma levels of beta-thromoglobulin and mean platelet volume as markers of the presence of platelet activation in systemic lupus erythematosus patients compared with healthy controls.
Material and Methods. Thirty-seven SLE patients with a mean disease duration of 4.96 years and without any organ involvement as well as 30 healthy volunteers were included in the study. All patients were in remission of SLE.
Results. The mean beta-thromboglobulin level was 97.36 ±55.8 ng/mL in the SLE group and 72.67 ±33.5 ng/mL in the control group (p = 0.029). The mean platelet volume level was 8.27 ±1.68 fL in the SLE group and 9.16 ±1.52 fL (p = 0.031) in the controls.
Conclusion. Elevated beta-thromboglobulin levels in systemic lupus erythematosus patients may be associated with platelet activation in the early stages of disease, whereas lower mean platelet volume levels in the same population may be due to the effects of hydroxychloroquine and the inactivity of SLE.
systemic lupus erythematosus, mean platelet volume, β-thromboglobulin
- Afeltra A, Vadacca M, Conti L, et al. Thrombosis in systemic lupus erythematosus: Congenital and acquired risk factors. Arthritis Rheum. 2005;53(3):452–459.
- Nowak B, Szmyrka-Kaczmarek M, Durazińska A, et al. Anti-ox-LDL antibodies and anti-ox-LDL-B2GPI antibodies in patients with systemic lupus erythematosus. Adv Clin Exp Med. 2012;21(3):331–335.
- Cervera R, Khamashta MA, Font J, et al. Morbidity and mortality in systemic lupus erythematosus during a 10-year period: A comparison of early and late manifestations in a cohort of 1,000 patients. Medicine (Baltimore). 2003;82(5):299–308.
- Mok CC, Tang SS, To CH, et al. Incidence and risk factors of thromboembolism in systemic lupus erythematosus: A comparison of three ethnic groups. Arthritis Rheum. 2005;52(9):2774–2782.
- Kaiser R, Li Y, Chang M, et al. Genetic risk factors for thrombosis in systemic lupus erythematosus. J Rheumatol. 2012;39(8):1603–1610.
- Kaplan KL, Owen J. Plasma levels of beta-thromboglobulin and platelet factor 4 as indices of platelet activation in vivo. Blood. 1981;57(2): 199–202.
- Endler G, Klimesch A, Sunder-Plassmann H, et al. Mean platelet volume is an independent risk factor for myocardial infarction but for coronary artery disease. Br J Haematol. 2002;117(2):399–404.
- Yazici S, Yazici M, Erer B, et al. The platelet indices in patients with rheumatoid arthritis: Mean platelet volume reflects disease activity. Platelets. 2010;21(2):122–125.
- Bai M, Xing L, Feng J, et al. Mean platelet volume as a possible marker for monitoring the disease activity in ulcerative colitis. Int J Lab Hematol. 2016. https://doi.org/10.1111/ijlh.12495
- Pyo JS, Sohn JH, Kang G. Diagnostic and prognostic roles of the mean platelet volume in malignant tumors: A systematic review and meta-analysis. Platelets. 2016;9:1–7.
- Lippi G, Danese E, Montagnana M, et al. Mean platelet volume is significantly associated with serum levels of thyroid-stimulating hormone in a cohort of older euthyroid subjects. Endocr Res. 2015;40(4): 227–230.
- Karatoprak C, Uyar S, Abanonu GB, et al. The levels of β-throm-boglobulin in femalerheumatoid arthritis patients as activation criteria. Rheumatol Int. 2013;33(5):1229–1232.
- Abanonu GB, Daskin A, Akdogan MF, et al. Mean platelet volume and β-thromboglobulin levels in familial Mediterranean fever: Effect of colchicine use? Eur J Intern Med. 2012;23(7):661–664.
- Yamamoto T, Chikugo T, Tanaka Y. Elevated plasma levels of beta-thromboglobulin and platelet factor 4 in patients with rheumatic disorders and cutaneous vasculitis. Clin Rheumatol. 2002;21(6):501–504.
- Vrij AA, Rijken J, Van Wersch JW, et al. Platelet factor 4 and beta-thromboglobulin in inflammatory bowel disease and giant cell arteritis. Eur J Clin Invest. 2000;30(3):188–194.
- Ekdahl KN, Bengtsson AA, Andersson J, et al. Thrombotic disease in systemic lupus erythematosus is associated with a maintained systemic platelet activation. Br J Haematol. 2004;125(1):74–78.
- Tam LS, Fan B, Li EK, et al. Patients with systemic lupus erythematosus show increased platelet activation and endothelial dysfunction induced by acute hyperhomocysteinemia. J Rheumatol. 2003;30(7):1479–1484.
- Turner-Stokes L, Jones D, Patterson KG, et al. Measurement of haematological indices of chronic rheumatic disease with two newer generation automated systems, the H1 and H6000 (Technicon). Ann Rheum Dis. 1991;50:583–587.
- Delgado-García G, Galarza-Delgado DÁ, Colunga-Pedraza I, et al. Mean platelet volume is decreased in adults with active lupus disease. Rev Bras Reumatol. 2016;56(6):504–508.
- Joseph JE, Harrison P, Mackie IJ, et al. Increased circulating platelet–leucocyte complexes and platelet activation in patients with antiphospholipid syndrome, systemic lupus erythematosus and rheumatoid arthritis. Br J Haematol. 2001;115(2):451–459.
- Bäck J, Lood C, Bengtsson AA, et al. Contact activation products are new potential biomarkers to evaluate the risk of thrombotic events in systemic lupus erythematosus. Arthritis Res Ther. 2013. doi: 10.1186/ar4399
- Tan E, Cohen A, Fries J, et al. The 1982 revised criteria for the classification of systemic lupus erythematosis. Arthritis Rheum. 1982;25:1271–1277.
- Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40(9):1725.
- Chang ER, Pineau CA, Bernatsky S, et al. Risk for incident arterial or venous vascular events varies over the course of systemic lupus erythematosus. J Rheumatol. 2006;33(9):1780–1784.
- Safak S, Uslu AU, Serdal K, et al. Association between mean platelet volume levels and inflammation in SLE patients presented with arthritis. Afr Health Sci. 2014;14(4):919–924.
- Yolbas S, Yildirim A, Gozel N, et al. Hematological indices may be useful in the diagnosis of systemic lupus erythematosus and in determining disease activity in Behçet’s disease. Med Princ Pract. 2016; 25(6):510–516.
- Belizna C. Hydroxychloroquine as an anti-thrombotic in antiphospholipid syndrome. Autoimmun Rev. 2015;14(4):358–362.
- Gasparyan AY, Ayvazyan L, Pretorius E, et al. Platelets in rheumatic diseases: Friend or foe? Curr Pharm Des. 2014;20(4):552–566.