International Journal of Colorectal Disease

, Volume 22, Issue 12, pp 1429–1435 | Cite as

Reticulated platelet levels in patients with ulcerative colitis

  • Hasan KayahanEmail author
  • Mesut Akarsu
  • Mehmet Ali Ozcan
  • Serdal Demir
  • Halil Ates
  • Belkis Unsal
  • Hale Akpinar
Original Article


Background and aims

In this study, we investigated whether reticulated platelets (RP) would be useful markers in the evaluation of ulcerative colitis (UC) activity and also aimed to gain indirect information about the platelet kinetics.

Materials and methods

Complete blood count, C-reactive protein, erythrocyte sedimentation rate, and proportion of RP were measured in 16 active, 21 inactive UC patients, and 20 healthy blood donors. UC activity was assessed by Truelove–Witts criteria.


Mean platelet count was increased in patients with active compared to inactive UC (p = 0.008) or healthy donors (p = 0.000). Mean platelet volume (MPV) was significantly decreased in patients with active compared to inactive (p = 0.015) and healthy donors (p = 0.001). RP values was significantly decreased in active and inactive UC groups compared to healthy donors (p = 0.000, p = 0.000, respectively), while there was no significant difference between active and inactive UC patients (p = 0.980). Significant negative correlation between platelet count and MPV in patients with active UC (r = −0.542, p = 0.030) was observed.


RP values is reduced in active and inactive UC patients compared to healthy donors. To our knowledge, this is the first study about proportion of RP with UC in literature. However, the role of low RP values have not been determined clinically. Further studies are needed to evaluate the role of platelet abnormalities and changes in megakaryopoiesis caused by inflammatory state on low MPV and RP values during the course of UC.


Reticulated platelets Ulcerative colitis Mean platelet volume 


  1. 1.
    Danese S, de la Motte C, Fiocchi C (2004). Platelets in inflammatory bowel disease: clinical, pathogenic, and therapeutic implications. Am J Gastroenterol 99(5):938–945CrossRefPubMedGoogle Scholar
  2. 2.
    Collins CE, Rampton DS (1995) Platelet dysfunction: a new dimension in inflammatory bowel disease. Gut 36(1):5–8CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Collins CE, Cahill MR, Newland AC, Rampton DS (1994) Platelets circulate in an activated state in inflammatory bowel disease. Gastroenterology 106(4):840–845CrossRefPubMedGoogle Scholar
  4. 4.
    Webberley MJ, Hart MT, Melikian V (1993) Thromboembolism in inflammatory bowel disease: role of platelets. Gut 34(2):247–251CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Papa A, Danese S, Piccirillo N, Toriani-Terenzi C, Bartolozzi F, Piscaglia AC, Grillo A, Leone G, Gentiloni-Silveri N, Gasbarrini G, Gasbarrini A (2003) Thrombopoietin serum levels in patients with inflammatory bowel disease with and without previous thromboembolic events. Hepatogastroenterology 50(49):132–135PubMedGoogle Scholar
  6. 6.
    Kapsoritakis AN, Koukourakis MI, Sfiridaki A, Potamianos SP, Kosmadaki MG, Koutroubakis IE, Roussomoustakaki MI, Manousos ON, Kouroumalis EA (2001) Mean platelet volume: a useful marker of inflammatory bowel disease activity. Am J Gastroenterol 96(3):776–781CrossRefPubMedGoogle Scholar
  7. 7.
    Jaremo P, Sandberg-Gertzen H (1996) Platelet density and size in inflammatory bowel disease. Thromb Haemost 75(4):560–561PubMedGoogle Scholar
  8. 8.
    Ingram M, Coopersmith A (1969) Reticulated platelets following acute blood loss. Br J Haematol 17(3):225–229CrossRefPubMedGoogle Scholar
  9. 9.
    Harrison P, Robinson MSC, Mackie IJ, Machin SJ (1997) Reticulated platelets. Platelets 8:379–383CrossRefPubMedGoogle Scholar
  10. 10.
    Kienast J, Schmitz G (1990) Flow cytometric analysis of thiazole orange uptake by platelets: a diagnostic aid in the evaluation of thrombocytopenic disorders. Blood 75(1):116–121PubMedGoogle Scholar
  11. 11.
    Rinder HM, Bonan JL, Anandan S, Rinder CS, Rodrigues PA, Smith BR (1994) Noninvasive measurement of platelet kinetics in normal and hypertensive pregnancies. Am J Obstet Gynecol 170(1 Pt 1):117–122CrossRefPubMedGoogle Scholar
  12. 12.
    Stiegler G, Stohlawetz P, Brugger S, Jilma B, Vierhapper H, Hocker P, Panzer S (1998) Elevated numbers of reticulated platelets in hyperthyroidism: direct evidence for an increase of thrombopoiesis. Br J Haematol 101(4):656–658CrossRefPubMedGoogle Scholar
  13. 13.
    Nakamura T, Uchiyama S, Yamazaki M, Okubo K, Takakuwa Y, Iwata M (2002) Flow cytometric analysis of reticulated platelets in patients with ischemic stroke. Thromb Res 106(4–5):171–177CrossRefPubMedGoogle Scholar
  14. 14.
    Rinder HM, Schuster JE, Rinder CS, Wang C, Schweidler HJ, Smith BR (1998) Correlation of thrombosis with increased platelet turnover in thrombocytosis. Blood 91(4):1288–1294PubMedGoogle Scholar
  15. 15.
    Robinson MS, Harrison C, Mackie IJ, Machin SJ, Harrison P (1998) Reticulated platelets in primary and reactive thrombocytosis. Br J Haematol 101(2):388–389CrossRefPubMedGoogle Scholar
  16. 16.
    Ryningen A, Apelseth T, Hausken T, Bruserud O (2006) Reticulated platelets are increased in chronic myeloproliferative disorders, pure erythrocytosis, reactive thrombocytosis and prior to hematopoietic reconstitution after intensive chemotherapy. Platelets 17(5):296–302CrossRefPubMedGoogle Scholar
  17. 17.
    Ault KA (1993) Flow cytometric measurement of platelet function and reticulated platelets. Ann N Y Acad Sci 677:293–308CrossRefPubMedGoogle Scholar
  18. 18.
    Ault KA, Rinder HM, Mitchell J, Carmody MB, Vary CP, Hillman RS (1992) The significance of platelets with increased RNA content (reticulated platelets). A measure of the rate of thrombopoiesis. Am J Clin Pathol 98(6):637–646CrossRefPubMedGoogle Scholar
  19. 19.
    Slupsky JR, Kalbas M, Willuweit A, Henn V, Kroczek RA, Muller-Berghaus G (1998) Activated platelets induce tissue factor expression on human umbilical vein endothelial cells by ligation of CD40. Thromb Haemost 80(6):1008–1014PubMedGoogle Scholar
  20. 20.
    Lindmark E, Tenno T, Siegbahn A (2000) Role of platelet P-selectin and CD40 ligand in the induction of monocytic tissue factor expression. Arterioscler Thromb Vasc Biol 20(10):2322–2328CrossRefPubMedGoogle Scholar
  21. 21.
    Srirajaskanthan R, Winter M, Muller AF (2005) Venous thrombosis in inflammatory bowel disease. Eur J Gastroenterol Hepatol 17(7):697–700CrossRefPubMedGoogle Scholar
  22. 22.
    Twig G, Zandman-Goddard G, Szyper-Kravitz M, Shoenfeld Y (2005) Systemic thromboembolism in inflammatory bowel disease: mechanisms and clinical applications. Ann N Y Acad Sci 1051:166–173CrossRefPubMedGoogle Scholar
  23. 23.
    Collins CE, Rampton DS, Rogers J, Williams NS (1997) Platelet aggregation and neutrophil sequestration in the mesenteric circulation in inflammatory bowel disease. Eur J Gastroenterol Hepatol 9(12):1213–1217PubMedGoogle Scholar
  24. 24.
    Kayo S, Ikura Y, Suekane T, Shirai N, Sugama Y, Ohsawa M, Adachi K, Watanabe K, Nakamura S, Fujiwara Y, Oshitani N, Higuchi K, Maeda K, Hirakawa K, Arakawa T, Ueda M (2006) Close association between activated platelets and neutrophils in the active phase of ulcerative colitis in humans. Inflamm Bowel Dis 12(8):727–735CrossRefPubMedGoogle Scholar
  25. 25.
    Danese S, de la Motte C, Sturm A, Vogel JD, West GA, Strong SA, Katz JA, Fiocchi C (2003). Platelets trigger a CD40-dependent inflammatory response in the microvasculature of inflammatory bowel disease patients. Gastroenterology 124(5):1249–1264CrossRefPubMedGoogle Scholar
  26. 26.
    Danese S, Katz JA, Saibeni S, Papa A, Gasbarrini A, Vecchi M, Fiocchi C (2003). Activated platelets are the source of elevated levels of soluble CD40 ligand in the circulation of inflammatory bowel disease patients. Gut 52(10):1435–1441CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Vrij AA, Rijken J, Van Wersch JW, Stockbrugger RW (2000) Platelet factor 4 and beta-thromboglobulin in inflammatory bowel disease and giant cell arteritis. Eur J Clin Investig 30(3):188–194CrossRefGoogle Scholar
  28. 28.
    Morowitz DA, Allen LW, Kirsner JB (1968) Thrombocytosis in chronic inflammatory bowel disease. Ann Intern Med 68(5):1013–1021CrossRefPubMedGoogle Scholar
  29. 29.
    Talstad I, Rootwelt K, Gjone E (1973) Thrombocytosis in ulcerative colitis and Crohn’s disease. Scand J Gastroenterol 8(2):135–138PubMedGoogle Scholar
  30. 30.
    Heits F, Stahl M, Ludwig D, Stange EF, Jelkmann W (1999) Elevated serum thrombopoietin and interleukin-6 concentrations in thrombocytosis associated with inflammatory bowel disease. J Interferon Cytokine Res 19(7):757–760CrossRefPubMedGoogle Scholar
  31. 31.
    Kapsoritakis AN, Potamianos SP, Sfiridaki AI, Koukourakis MI, Koutroubakis IE, Roussomoustakaki MI, Manousos ON, Kouroumalis EA (2000) Elevated thrombopoietin serum levels in patients with inflammatory bowel disease. Am J Gastroenterol 95(12):3478–3481CrossRefPubMedGoogle Scholar
  32. 32.
    Wang C, Smith BR, Ault KA, Rinder HM (2002) Reticulated platelets predict platelet count recovery following chemotherapy. Transfusion 42(3):368–374CrossRefPubMedGoogle Scholar
  33. 33.
    Macchi I, Chamlian V, Sadoun A, Le Dirach A, Guilhot J, Guilhot F, Brizard A (2002) Comparison of reticulated platelet count and mean platelet volume determination in the evaluation of bone marrow recovery after aplastic chemotherapy. Eur J Haematol 69(3):152–157CrossRefPubMedGoogle Scholar
  34. 34.
    Tassies D, Reverter JC, Cases A, Escolar G, Villamor N, Lopez-Pedret J, Castillo R, Ordinas A (1995) Reticulated platelets in uremic patients: effect of hemodialysis and continuous ambulatory peritoneal dialysis. Am J Hematol 50(3):161–166CrossRefPubMedGoogle Scholar
  35. 35.
    Takubo T, Yamane T, Hino M, Ohta K, Koh KR, Tatsumi N (2000). Clinical significance of simultaneous measurement of reticulated platelets and large platelets in idiopathic thrombocytopenic purpura. Haematologia (Budap) 30(3):183–192CrossRefGoogle Scholar
  36. 36.
    Robinson MS, Mackie IJ, Khair K, Liesner R, Goodall AH, Savidge GF, Machin SJ, Harrison P (1998) Flow cytometric analysis of reticulated platelets: evidence for a large proportion of non-specific labelling of dense granules by fluorescent dyes. Br J Haematol 100(2):351–357CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Hasan Kayahan
    • 1
    Email author
  • Mesut Akarsu
    • 1
  • Mehmet Ali Ozcan
    • 2
  • Serdal Demir
    • 3
  • Halil Ates
    • 2
  • Belkis Unsal
    • 3
  • Hale Akpinar
    • 1
  1. 1.Department of Internal Medicine, Division of GastroenterologyDokuz Eylul University Medical SchoolInciralti/IzmirTurkey
  2. 2.Department of Internal Medicine, Division of HaematologyDokuz Eylul University School of MedicineInciralti/IzmirTurkey
  3. 3.Department of GastroenterologyAtaturk Training and Research HospitalInciralti/IzmirTurkey

Personalised recommendations