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Zum Problem des Nachweises antithrombocytärer Autoantikörper

Vergleichende Untersuchungen an thrombocytopenischen und nichtthrombocytopenischen Patienten mit dem Antiglobulin-Konsumptionstest und dem Fluorescenz-Antiglobulintest

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Zusammenfassung

Blutproben von 161 Patienten (davon 63 Patienten mit einer Thrombocytopenie unter 90000/mm3 und 98 Patienten mit normalen Thrombocytenzahlen) wurden mit dem direkten und/oder indirekten Antiglobulin-Konsumptionstest (AGKT) und dem direkten und/oder indirekten Fluorescenz-Antiglobulintest (FT) under Verwendung von Thrombocyten untersucht. Ohne Berücksichtigung der klinischen Diagnose wurde gefunden, daß thrombocytopenische Patienten in 37% einen positiven dir. AGKT, in 18% einen positiven dir. FT, in 27% einen positiven indir. AGKT und in 28% einen positiven indir. FT aufwiesen. Bei Patienten ohne Thrombocytopenie betrug der Anteil positiver Ergebnisse für den dir. AGKT 30%, für den dir. FT 16%, für den indir. AGKT 7%, für den indir. FT 9%. — Mit Thrombocyten von gesunden Blutspendern waren die Ergebnisse fast ausnahmslos negativ. — Unsere Untersuchungen lassen vermuten, daß der Ausfall der Tests zum Nachweis von antithrombocytären Autoantikörpern stark von nicht-immunologischen Faktoren beeinflußt wird. Beziehungen zu den Plasmaeiweißverhältnissen spielen dabei wahrscheinlich eine wichtige Rolle.

Summary

The blood of 161 patients with different internal diseases was investigated with the direct and/or the indirect antiglobulin consumption test (AGCT) and with the direct and/or indirect fluorescence antiglobulin test (FT) on platelets. 63 patients revealed thrombocytopenia (platelets less than 90000 per mm3) in the course of various diseases, the remainder had normal platelet counts.

Irrespective of clinical diagnosis positive results were found in the thrombocytopenic group in 37% with the direct AGCT, in 18% with the direct FT, in 27% with the indirect AGCT and in 28% with the indirect FT. Patients with normal platelet numbers showed positive tests in 30% (direct AGCT), in 16% (direct FT), in 7% (indirect AGCT) and in 9% (indirect FT). Control examinations on thrombocytes of healthy blood donors were almost regularly negative under the same conditions.

These results suggest that the tests used for the detection of antiplatelet „autoantibodies“ are severely influenced by non-immunologic factors. There seem to exist correlations between the results of the tests and the level of gammaglobulins in the plasma.

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  1. Medizinische Kliniken und Polikliniken der Justus Liebig-Universität Gießen, Germany

    Ch. Mueller-Eckhardt & H. Boehm

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  1. Ch. Mueller-Eckhardt
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  2. H. Boehm
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Mueller-Eckhardt, C., Boehm, H. Zum Problem des Nachweises antithrombocytärer Autoantikörper. Klin Wochenschr 46, 986–991 (1968). https://doi.org/10.1007/BF01745587

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