Abnormalities of vascular and platelet responses in measles: state-of-the-art

V.V. Maleev¹, E.N. Lazareva¹, O.S. Astrina¹, N.I. Aleshina¹, Tsvetkova², E.T. Vdovina², L.N. Navruzova²

¹Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow

²Infectious Clinical Hospital No. 2, Moscow

We report our findings on vascular and platelet responses as the stages of hemostasis in measles to address current aspects of measles pathogenesis.

Aim: to determine the importance of vascular and platelet response abnormalities in measles.

Patients and Methods: clinical laboratory tests were performed in 40 patients aged 36.9 ± 9.2 years with measles (the diagnosis was verified by ELISA) and 20 healthy volunteers. ADP-induced platelet aggregation and the degree of aggregation were assessed using AP-2110 aggregometer (Solar, Russian Federation). The activity of von Willebrand factor was evaluated using LA 230 aggregometer (BIOLA, Russian Federation) and von Willebrand test system (RENAM, Russian Federation). D-dimers were analyzed using Sysmex CS5100 coagulation analyzer and D-Dimer INNOVANCE test system (Siemens, Germany).

Results: confluent maculopapular rash was detected in 100% and petechial rash in 3.3%. Complete blood count has revealed elevated band neutrophil  count (13.4±2.4%) and normal white blood cells (6.5±0.2×10⁹/L) in 97.1%. Thrombocytopenia (97×10⁹/L) but normal MPV and PDW were identified in 66.7%. Mean degrees of platelet aggregation demonstrate their increased functional activity. However, the degree of platelet aggregation was reduced to, on average, 30.4% in a quarter of patients. Second wave aggregation was revealed in 73.6%. Significant increase in the activity of von Willebrand factor (up to 157.8±7.58%) was detected in 100% and increase in D-dimer levels in 75%.

Conclusions: currently, measles is characterized by significant vascular damage which enhances regenerative processes mediated by platelets and results in platelet hyperaggregation. However, hypoaggregation revealed in some patients indicate potential hemorrhagic syndrome affecting the severity and the outcomes of measles.

Keywords: measles, hemostasis, aggregation, endothelium.

For citation: Maleev V.V., Lazareva E.N., Astrina O.S. et al. Abnormalities of vascular and platelet responses in measles: state-of-the-art. RMJ. 2019;10:4–7.