Abstract: Platelet microparticles (PMPs) are small membrane fragments released from activated platelets in response to various stimuli. PMPs serve as biomarkers for several diseases and conditions and are useful tools for prognostic, diagnostic, and therapeutic purposes. The objective of our study was to compare the direct effects of ethylenediaminetetraacetic acid (EDTA) and sodium citrate anticoagulants on platelet structure and PMP vesiculation using transmission electron microscopy to visualize the morphologic changes in platelets. Micrographs revealed that platelets in the EDTA-anticoagulated tube manifested with significant morphologic changes and induced PMP vesiculation. On the other hand, the sodium citrate-anticoagulated tube showed a normal platelet structure and minor modifications in some cases, with poor indication of PMP vesiculation. In conclusion, EDTA induced platelet activation and PMP vesiculation and represents a major source of artifacts during the pre-analysis steps of PMP vesiculation.
METHODS: Prospectively enrolled patients with RAP and CP were followed up, and the alcoholic and idiopathic subgroups were assessed for progression of structural and functional changes in the organ.
RESULTS: One hundred and forty patients (RAP = 44; 31.4 %, CP = 96; 68.5 %) were followed up over a median 12.2 (interquartile range 12.0-16.8) months. The cause was alcohol in 31 (22.1 %) and not evident in 109 (77.8 %). The disease progressed from RAP to CP in 7 (15.9 %), 6 (16.2 %) out of 37 in the idiopathic and 1 (14.2 %; p = 1.00) out of 7 in the alcoholic subgroups. Three (42.8 %) and 1 (14.2 %) developed steatorrhea and diabetes mellitus (DM), respectively, and 2 (4.5 %) developed calcification. Established CP progressed in 19 (19.7 %), 1 (1.0 %), 5 (5.2 %), 2 (2.0 %) and 11 (11.4 %) newly developed DM, steatorrhea, calcification and duct dilation during follow up. Among the idiopathic and alcoholic CP, disease progression was seen in 15 (20.8 %) out of 72 and 4 (16.6 %) out of 24 respectively.
CONCLUSIONS: Idiopathic RAP and CP progressed during the short-term follow up. This is similar to other etiological forms of pancreatitis, as described from elsewhere in the world.