Disorders of platelet function: evaluation and treatment
Joel S. Bennett, MDAddress reprint requests to J.S.B., Hematology-Oncology Section, Department of Medicine, School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104-4183.
Platelet function involves adhesion, aggregation, secretion, and elaboration of procoagulant activity. Compromise of any of these functions due to an inherited or acquired defect in primary hemostasis can result in bleeding diatheses. Acquired disorders are related to drugs, systemic disease, or hematologic disease. Although laboratory tests are available to evaluate platelet function, the history is of prime importance in the diagnostic workup. Plasmapheresis, dialysis, transfusion of normal platelets, administration of cryoprecipitate, and administration of corticosteroids are all acceptable treatment protocols in specific situations. The drug of choice for treating mild hemostatic abnormalities due to platelet function defects is desmopressin acetate, which may be administered by several routes, produces few, if any, side effects, and carries no risk of infectious disease transmission.