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To the Editor.—
Drs Ballard and Marcus (136:316-319, 1976) reported on impaired platelet aggregation in response to adenosine diphosphate (ADP) in 12 of 24 patients with Laënnec cirrhosis. They found no correlation between this abnormality and other tests of hemostasis, like fibrinogen-fibrin split product levels.We studied hemostasis in nine patients with biopsy-proven liver cirrhosis (seven had Laënnec, one had postnecrotic, and one had cryptogenic cirrhosis). In five patients, the spleen was enlarged, as judged by isotope scanning.Results of blood coagulation tests showed no great disturbances, except for the invariably prolonged thrombin time. Platelet aggregation in response to ADP, ristocetin, and collagen was studied with an aggregometer with a light-transmission recording technique. Adenosine diphosphate was used in a dilution series with a final concentration of up to 1 μg/ml of platelet-rich plasma (PRP); ristocetin was in a final concentration of 1.2 mg/ ml, and collagen was in a final
Huijgens PC, Verhulst JC, Thijs LG. Platelet Aggregation and Portal Cirrhosis. Arch Intern Med. 1977;137(2):257. doi:10.1001/archinte.1977.03630140097024