ORIGINAL ARTICLESPlatelet ligands and ADAMTS13 during Puumala hantavirus infection and associated thrombocytopeniaLaine, Outia; Mäkelä, Satua; Mustonen, Jukkaa,b; Helminen, Mikac; Vaheri, Anttid; Lassila, Riittae; Joutsi-Korhonen, Lottae Author Information aDepartment of Internal Medicine, Tampere University Hospital bMedical School, University of Tampere cScience Center, Pirkanmaa Hospital District and School of Health Sciences, University of Tampere, Tampere dDepartment of Virology, Haartman Institute, University of Helsinki eCoagulation Disorders Unit, Department of Internal Medicine and Clinical Chemistry (HUSLAB Laboratory Services), Helsinki University Central Hospital, Helsinki, Finland Correspondence to Outi Laine, TAYS, PL 2000, 33521 Tampere, Finland Tel: +358 3 311 69333; fax: +358 3 311 64388; e-mail: [email protected] Received 17 October, 2010 Revised 1 March, 2011 Accepted 10 March, 2011 Blood Coagulation & Fibrinolysis: September 2011 - Volume 22 - Issue 6 - p 468-472 doi: 10.1097/MBC.0b013e328346a420 Buy Metrics Abstract We aimed here to elucidate the role of adhesive platelet ligands and endothelial involvement during the acute phase of Puumala hantavirus (PUUV) infection. Nineteen hospital-treated patients with serologically confirmed diagnosis of acute PUUV infection were included. Patient charts were reviewed for clinical and basic laboratory data. Plasma levels of von Willebrand factor antigen (VWF : Ag), ristocetin cofactor (VWF : RCo), factor VIII (FVIII : C) and a disintegrin and metalloproteinase with a thrombospondin type 1 domain 13 (ADAMTS13) activities as well as fibrinogen and fibronectin were measured three times acutely and once during the recovery phase. VWF : Ag and VWF : RCo were nearly three-fold higher acutely compared with recovery (median 252 vs. 88%, and mean 267 vs. 98%, respectively; P < 0.001 for both), whereas FVIII : C was only slightly elevated (median 118 vs. 88%, P = 0.002) and remarkably failed to show association with VWF in the acute phase. ADAMTS13 activity and fibronectin concentration were lower in the acute compared with the recovery phase (median 56 vs. 63%, P = 0.003, and median 221 vs. 330 μmol/l, P = 0.001, respectively). Fibrinogen raised acutely (mean 5.0 vs. 3.3 g/l, P < 0.001), negatively correlating with the platelet count (r = −0.468, P = 0.043). Markedly upregulated fibrinogen and VWF together with decreased levels of ADAMTS13 activity and fibronectin were observed during acute PUUV infection. VWF and FVIII : C did not associate during the acute phase, whereas thrombocytopenia correlated negatively with fibrinogen. These findings imply several rearranged interactions between platelets and their ligands. © 2011 Lippincott Williams & Wilkins, Inc.