Platelet hyperactivity in sickle-cell disease: a consequence of hyposplenism

Platelet function was measured on 29 occasions in 16 adult patients in the asymptomatic steady state of sickle-cell anaemia. There was a significant increase in platelet number and micro-aggregate formation, and a lower aggregation threshold with adenosine diphosphate, compared with 23 healthy controls. Similar changes were found, however, in 12 splenectomised patients without sickle-cell diseases. The platelet hyperactivity of the sickle-cell steady state therefore reflects an increased circulating population of young, metabolically active platelets resulting from previous autosplenectomy.