PT  - JOURNAL ARTICLE
AU  - Lois Salter
AU  - Amaka C Offiah
AU  - Nicholas Bishop
TI  - Elevated platelet counts in a cohort of children with moderate-severe osteogenesis imperfecta suggest that inflammation is present
AID  - 10.1136/archdischild-2017-313859
DP  - 2018 Aug 01
TA  - Archives of Disease in Childhood
PG  - 767--771
VI  - 103
IP  - 8
4099  - http://adc.bmj.com/content/103/8/767.short
4100  - http://adc.bmj.com/content/103/8/767.full
SO  - Arch Dis Child2018 Aug 01; 103
AB  - Background Elevated platelet counts are observed in cancer, autoimmunity and inflammation with concurrent illness. Proinflammatory cytokines are elevated in murine osteogenesis imperfecta (OI) models. We hypothesised that platelet counts might be elevated in children with moderate-severe OI.Methods We reviewed the hospital records of 71 children with moderate-severe OI, treated in the Sheffield Children’s Hospital’s Severe, Complex and Atypical Osteogenesis Imperfecta Highly Specialised Service. Data relating platelet count (below/above average, above upper limit) to prior and concurrent events were summarised as event proportions per child. Additionally, we created platelet SD scores to assess age and time-related trends, and relationship with OI type.Results 1206 platelet counts were recorded. Platelet SD scores were right-shifted by 0.89 SD overall. 49 of 71 (69%) patients had at least one platelet count above the normal range and 246 (20.4%) of all counts were above the upper limit of normal. Of these, 101 (41%) were high despite no confounding factors being present. For the 47 children with data at age less than 2 years, 89 (30.0%) platelet counts were above the upper limit of normal and 39 (44%) had no associated confounding factor. Elevated platelet counts were recorded most often for children with new or existing vertebral fractures.Conclusions Raised platelet counts were observed in association with new and healing vertebral fractures, but also (41%–44%) in the absence of identified proinflammatory factors or events. We speculate that these findings are evidence for a proinflammatory component to OI that could be a target for therapeutic intervention.