Autoantibodies against platelet glycoproteins in critically ill patients with thrombocytopenia

Am J Med. 2000 May;108(7):554-60. doi: 10.1016/s0002-9343(00)00332-6.


Purpose: The aim of the study was to investigate immunologic causes of thrombocytopenia in critically ill patients, especially causes that were related to platelet-associated IgG antibodies.

Subjects and methods: All patients admitted to two intensive care units between May 1 and October 30, 1997, who developed thrombocytopenia (less than 100 x 10(9) platelets/L) were studied prospectively. We measured platelet-associated IgG with a radioimmunoassay using I(125)-labeled polyclonal antihuman IgG. Characterization of platelet-associated IgG was assessed with a monoclonal antibody immobilization of platelet antigen. Circulating immune complexes were also assayed.

Results: Of the 61 patients with thrombocytopenia, elevated platelet-associated IgG was found in 18 (30%). Associated antiplatelet autoantibodies (glycoprotein IIb/IIIa) were detected in 4 patients, circulating autoantibodies (glycoprotein Ib/IX) were detected in sera from 2 patients, and circulating immune complexes were detected in 3 patients. The nature of the platelet-associated IgG could not be determined in 10 patients. Elevated platelet-associated IgG was associated with sepsis and previous cardiopulmonary bypass. Thrombocytopenic patients with elevated platelet-associated IgG had a lower nadir platelet count (58 +/- 27 x 10(9)/L vs 74 +/- 24 x 10(9)/L, P = 0.03).

Conclusion: Elevated platelet-associated IgG, some of which are platelet autoantibodies, is frequent in thrombocytopenic patients with sepsis or after cardiopulmonary bypass.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal
  • Autoantibodies / blood*
  • Cardiopulmonary Bypass / adverse effects
  • Critical Illness*
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Male
  • Middle Aged
  • Platelet Membrane Glycoproteins / immunology*
  • Radioimmunoassay
  • Risk Factors
  • Sepsis / immunology
  • Thrombocytopenia / immunology*


  • Antibodies, Monoclonal
  • Autoantibodies
  • Immunoglobulin G
  • Platelet Membrane Glycoproteins