Medical expert of the article
New publications
Acquired platelet dysfunction: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Acquired platelet dysfunction may result from aspirin, other nonsteroidal anti-inflammatory drugs, or systemic diseases. Acquired platelet dysfunction is fairly common. Aspirin is the most commonly used drug. Other drugs can also induce platelet dysfunction. Numerous diseases (eg, myeloproliferative disorders, myelodysplastic syndrome, uremia, macroglobulinemia and multiple myeloma, cirrhosis, systemic lupus erythematosus) can impair platelet function. Acquired platelet dysfunction is suspected in the presence of isolated prolongation of bleeding time when other possible diagnoses have been excluded. Platelet aggregation studies are not necessary.
Aspirin and nonsteroidal anti-inflammatory drugs prevent cyclooxygenase-mediated thromboxane A production. The effect may last 5-7 days. Aspirin moderately prolongs bleeding time in healthy individuals but may markedly prolong it in patients with platelet dysfunction or severe secondary hemostasis impairment (eg, heparin-treated patients or those with severe hemophilia). Platelets may become dysfunctional, leading to increased bleeding time when blood is circulated through a pump oxygenator during cardiopulmonary bypass. The mechanism of impairment involves activation of platelet membrane fibrinolysis with loss of glycoprotein Ib-IX, the binding site for von Willebrand factor. Despite the platelet count, patients with increased bleeding and prolonged bleeding time require platelet transfusions after cardiopulmonary bypass. Administration of aprotinin (a protease inhibitor that neutralizes plasmin activity) during bypass surgery may prevent platelet dysfunction, prevent prolongation of bleeding time, and reduce the need for transfusions.
The mechanism of prolongation of bleeding time in uremia is unknown. If bleeding is present, its correction can be carried out using hemodialysis, cryoprecipitate administration, or desmopressin infusion. In the presence of anemia, red blood cell transfusion or erythropoietin can be administered, which also shortens bleeding time.
[