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Revista de investigación clínica

versión On-line ISSN 2564-8896versión impresa ISSN 0034-8376

Rev. invest. clín. vol.76 no.1 Ciudad de México ene./feb. 2024  Epub 16-Abr-2024

https://doi.org/10.24875/ric.23000276 

LETTERS TO EDITOR

Primary Thrombophilia in Mexico XVIII: Increased Rate of Thrombosis in Persons with the Sticky Platelet Syndrome in the COVID-19 Era

Miranda Melgar-de-la-Paz1  2 

Moises M. Gallardo-Pérez1 

Juan C. Olivares-Gazca1 

Guillermo J. Ruiz-Argüelles1  3  * 

1Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico;

2School of Health Sciences, Universidad Anáhuac, Puebla, Mexico;

3Faculty of Medicine, Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico


Sticky platelet syndrome (SPS) is an inherited thrombophilic condition that causes an abnormal increase in platelet aggregation and favors both arterial and venous thrombotic events1-4. Between January 2020 and August 2023, 11 persons with SPS were diagnosed and treated at the Center for Hematology and Internal Medicine of Puebla (Centro de Hematología y Medicina Interna de Puebla), Mexico. All patients were instructed to take aspirin, 100 mg/day, after the diagnosis of SPS. Five persons were infected with SARS-CoV-2. Two patients had a thrombotic episode in the period of observation; one patient did not have COVID-19 but she developed right iliofemoral thrombophlebitis a year after starting treatment with aspirin (Table 1). We have previously shown that the treatment with aspirin of persons with SPS significantly reduces the rate of re-thrombosis to 4%5. In this group of 11 persons with SPS, we have observed the following: (1) the re-thrombosis rate was very high: 2 out of 11,36%; and (2) in one case, thrombosis was triggered by the SARS-CoV-2 infection in the setting of withdrawal of the antiplatelet treatment.

Table 1. Salient features of the two patients with the sticky platelet syndrome who developed a vaso-occlusive episode 

Characteristics No SARS-CoV-2 With SARS-CoV-2
Female 1 1
Age 51 37
Treatment start date May 27, 2020 January 14, 2022
COVID-19 diagnosis date NA July 04, 2023
Thrombotic event date January 15, 2021 July 01, 2023
Thrombotic event Right iliofemoral thrombophlebitis Ischemic colitis
Interruption of treatment No Yes

The rate of thrombosis in patients with COVID-19 is around 13%6. In this small cohort of persons with COVID-19 and SPS (5 patients), the thrombosis rate was 20%, a figure higher than that observed in the general population infected with SARS-CoV-26.

We can assume that the rate of thrombosis in patients with previous prethrombotic states may increase with SARS-CoV-2 infection. More studies are needed to further explore the rate of thrombosis in persons with COVID-19 and SPS.

REFERENCES

1. Moncada B, Ruíz-Arguelles GJ, Castillo-Martínez C. The sticky platelet syndrome. Hematology. 2013;18:230-2. [ Links ]

2. Ruiz-Delgado GJ, Cantero-Fortiz Y, Mendez-Huerta MA, Leon-Gonzalez M, Nuñez-Cortes AK, Leon-Peña AA, et al. Primary thrombophilia in Mexico XII: miscarriages are more frequent in people with sticky platelet syndrome. Turk J Haematol. 2017; 34:239-43. [ Links ]

3. García-Villaseñor E, Bojalil-Álvarez L, Murrieta-Álvarez I, Cantero-Fortiz Y, Ruiz-Delgado GJ, Ruiz-Argüelles GJ. Primary thrombophilia XVI: a look at the genotype of the sticky platelet syndrome phenotype. Clin Appl Thromb Hemost. 2021;27: 10760296211044212. [ Links ]

4. Garcés-Eisele J, González-Carrillo ML, Reyes-Núñez V, Ruiz-Argüelles GJ. Primary thrombophilia in México VII: the V617F mutation of JAK2 is not a frequent cause of thrombosis. Hematology. 2008;13:244-6. [ Links ]

5. García-Navarrete YI, Vallejo-Villalobos MF, Olivares-Gazca JM, Cantero-Fortiz Y, León-Peña AA, Olivares-Gazca JC, et al. Primary thrombophilia XV: antithrombotic treatment of sticky platelet syndrome worldwide. Ann Blood. 2019;4:15. [ Links ]

6. Katsoularis I, Fonseca-Rodríguez O, Farrington P, Jerndal H, Lundevaller EH, Sund M, et al. Risks of deep vein thrombosis, pulmonary embolism, and bleeding after covid-19: nationwide self-controlled cases series and matched cohort study. BMJ. 2022;377:e069590. [ Links ]

Received: December 14, 2023; Accepted: January 11, 2024

* Corresponding author: Guillermo J. Ruiz-Argüelles. E-mail: gruiz1@clinicaruiz.com

Creative Commons License Revista de Investigación Clínica. Published by Permanyer. This is an open ccess article under the CC BY-NC-ND license