혈소판감소증 환자에서 혈소판 항체 검출을 위한 Modified Antigen Capture ELISA 방법의 적용 - Thrombomatch EIA, Flow cytometry 검사 방 법과의 비교 -

Abstract

Background : There have been several recent reports on autoantibodies to glycoprotein(GP) Ⅱb/Ⅲa and GP Ib/IX, but there are few reports in Korea. In this study, antiplatelet antibodies against anti-GP Ⅱb/Ⅲa and anti-GP Ib/IX were assayed by using a modified antigen capture ELISA(MACE) in 63 patients with thrombocytopenia. Methods : We studied sera obtained between February, 1994 and July, 1995 from 63 patients with thrombocytopenia. Three Methods were performed for the detection of platelet antibodies, ie. MACE, immunofluorescent assay using flow cytometry, and enzyme immunoassay using Thrombomatch EIA test kit(Biotest AG, Germany). Results : Thrombomatch EIA test detected all anti-PIAI in the seven sera confirmed by MACE. The detection rate was 32% by MACE, 30% by Thrombomatch EIA, and 14% by flow cytometry in sera collected from the 63 patients with thrombocytopenia. Among 63 thrombocytopenic patients, 5 had anti-GP Ⅱb/Ⅲa ; 4 had anti-GP Ib/IX ; and 11 had both. The concordance rate was 70% between MACE and thrombomatch EIA. Conclusion : All three Methods have their advantages and disadvantages. MACE identified the glycoprotein specific antibodies, but the method was too complex to routinely use. Thrombomatch EIA is simple to use, but nonspecific reactions were noted. The detection rate of flow cytometry was the lowest among three Methods, but this method appears to more useful for the analysis of platelets than sera. Our Results suggest that none of the three Methods is sufficient to stand alone and that they should be used together in the analysis of platelet antibodies.