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 ]
Copyright: © 2024 Revista de Investigación
Clínica.