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Glanzmann thrombasthenia 2(GT2; BDPLT23)

MedGen UID:
1782592
Concept ID:
C5543273
Disease or Syndrome
Synonym: BLEEDING DISORDER, PLATELET-TYPE, 23
 
Gene (location): ITGB3 (17q21.32)
 
Monarch Initiative: MONDO:0031009
OMIM®: 619267

Definition

Glanzmann thrombasthenia-2 (GT2) is an autosomal recessive bleeding disorder characterized by failure of platelet aggregation and by absent or diminished clot retraction. The abnormalities are related to quantitative or qualitative abnormalities of the GPIIb (607759)/IIIa platelet surface fibrinogen receptor complex resulting from mutations in the GPIIIa gene (Rosenberg et al., 1997). For a general phenotypic description and a discussion of genetic heterogeneity of Glanzmann thrombasthenia, see 273800. [from OMIM]

Clinical features

From HPO
Epistaxis
MedGen UID:
4996
Concept ID:
C0014591
Pathologic Function
Epistaxis, or nosebleed, refers to a hemorrhage localized in the nose.
Menorrhagia
MedGen UID:
44358
Concept ID:
C0025323
Pathologic Function
Prolonged and excessive menses at regular intervals in excess of 80 mL or lasting longer than 7 days.
Prolonged bleeding time
MedGen UID:
56231
Concept ID:
C0151529
Finding
Prolongation of the time taken for a standardized skin cut of fixed depth and length to stop bleeding.
Abnormal bleeding
MedGen UID:
264316
Concept ID:
C1458140
Pathologic Function
An abnormal susceptibility to bleeding, often referred to as a bleeding diathesis. A bleeding diathesis may be related to vascular, platelet and coagulation defects.
Prolonged bleeding after dental extraction
MedGen UID:
369536
Concept ID:
C1969572
Pathologic Function
Prolonged bleeding post dental extraction sufficient to require medical intervention.
Prolonged bleeding after surgery
MedGen UID:
867284
Concept ID:
C4021646
Pathologic Function
Bleeding that persists longer than the normal time following a surgical procedure.
Decreased platelet glycoprotein IIb-IIIa
MedGen UID:
892761
Concept ID:
C4021767
Finding
Decreased cell membrane concentration of glycoprotein IIb-IIIa.
Impaired ristocetin-induced platelet aggregation
MedGen UID:
868749
Concept ID:
C4023154
Pathologic Function
Abnormal response to ristocetin as manifested by reduced or lacking aggregation of platelets upon addition of ristocetin.
Impaired collagen-induced platelet aggregation
MedGen UID:
870264
Concept ID:
C4024703
Finding
Abnormal response to collagen or collagen-mimetics as manifested by reduced or lacking aggregation of platelets upon addition collagen or collagen-mimetics.
Impaired epinephrine-induced platelet aggregation
MedGen UID:
870285
Concept ID:
C4024727
Finding
Abnormal response to epinephrine as manifested by reduced or lacking aggregation of platelets upon addition of epinephrine.
Impaired ADP-induced platelet aggregation
MedGen UID:
870824
Concept ID:
C4025282
Finding
Abnormal platelet response to ADP as manifested by reduced or lacking aggregation of platelets upon addition of ADP.
Impaired clot retraction
MedGen UID:
1376447
Concept ID:
C4476985
Finding
Platelets contain contractile proteins (actin and myosin) that induce clot retraction. As the platelets contract, they pull on the surrounding fibrin strands, squeezing serum form the mass, compacting the clot and drawing the ruptured edges of the blood vessel more closely together. Clot retraction is directly proportional to the platelet count and inversely proportional to the fibrinogen concentration.
Bruising susceptibility
MedGen UID:
140849
Concept ID:
C0423798
Finding
An ecchymosis (bruise) refers to the skin discoloration caused by the escape of blood into the tissues from ruptured blood vessels. This term refers to an abnormally increased susceptibility to bruising. The corresponding phenotypic abnormality is generally elicited on medical history as a report of frequent ecchymoses or bruising without adequate trauma.

Professional guidelines

PubMed

Shapiro A
Thromb Res 2020 Dec;196:590-602. Epub 2019 Jul 19 doi: 10.1016/j.thromres.2019.07.014. PMID: 31420204
Fiore M, d'Oiron R, Pillois X, Alessi MC
Br J Haematol 2018 Apr;181(2):173-182. Epub 2018 Apr 2 doi: 10.1111/bjh.15087. PMID: 29611179
Poon MC, Di Minno G, d'Oiron R, Zotz R
Transfus Med Rev 2016 Apr;30(2):92-9. Epub 2016 Jan 30 doi: 10.1016/j.tmrv.2016.01.001. PMID: 26968829

Recent clinical studies

Etiology

Shapiro A
Thromb Res 2020 Dec;196:590-602. Epub 2019 Jul 19 doi: 10.1016/j.thromres.2019.07.014. PMID: 31420204
Fiore M, d'Oiron R, Pillois X, Alessi MC
Br J Haematol 2018 Apr;181(2):173-182. Epub 2018 Apr 2 doi: 10.1111/bjh.15087. PMID: 29611179
Poon MC, Di Minno G, d'Oiron R, Zotz R
Transfus Med Rev 2016 Apr;30(2):92-9. Epub 2016 Jan 30 doi: 10.1016/j.tmrv.2016.01.001. PMID: 26968829
Goodnough LT, Levy JH
Semin Thromb Hemost 2016 Mar;42(2):125-32. Epub 2016 Feb 2 doi: 10.1055/s-0035-1569068. PMID: 26838698
Blanchette VS, Sparling C, Turner C
Baillieres Clin Haematol 1991 Apr;4(2):291-332. doi: 10.1016/s0950-3536(05)80162-3. PMID: 1912663

Diagnosis

Nurden P, Stritt S, Favier R, Nurden AT
Haematologica 2021 Feb 1;106(2):337-350. doi: 10.3324/haematol.2020.248153. [Epub ahead of print] PMID: 33147934Free PMC Article
Zafarghandi Motlagh F, Fallah MS, Bagherian H, Shirzadeh T, Ghasri S, Dabbagh S, Jamali M, Salehi Z, Abiri M, Zeinali S
Orphanet J Rare Dis 2019 Apr 27;14(1):87. doi: 10.1186/s13023-019-1042-4. PMID: 31029159Free PMC Article
Harris ES, Weyrich AS, Zimmerman GA
Curr Opin Hematol 2013 Jan;20(1):16-25. doi: 10.1097/MOH.0b013e32835a0091. PMID: 23207660Free PMC Article
Blanchette VS, Sparling C, Turner C
Baillieres Clin Haematol 1991 Apr;4(2):291-332. doi: 10.1016/s0950-3536(05)80162-3. PMID: 1912663
Caen JP
Baillieres Clin Haematol 1989 Jul;2(3):609-25. doi: 10.1016/s0950-3536(89)80036-8. PMID: 2673430

Therapy

Fiore M, d'Oiron R, Pillois X, Alessi MC
Br J Haematol 2018 Apr;181(2):173-182. Epub 2018 Apr 2 doi: 10.1111/bjh.15087. PMID: 29611179
Poon MC, Di Minno G, d'Oiron R, Zotz R
Transfus Med Rev 2016 Apr;30(2):92-9. Epub 2016 Jan 30 doi: 10.1016/j.tmrv.2016.01.001. PMID: 26968829
Goodnough LT, Levy JH
Semin Thromb Hemost 2016 Mar;42(2):125-32. Epub 2016 Feb 2 doi: 10.1055/s-0035-1569068. PMID: 26838698
Di Minno G
Blood Rev 2015 Jun;29 Suppl 1:S26-33. doi: 10.1016/S0268-960X(15)30005-9. PMID: 26073366
Blanchette VS, Sparling C, Turner C
Baillieres Clin Haematol 1991 Apr;4(2):291-332. doi: 10.1016/s0950-3536(05)80162-3. PMID: 1912663

Prognosis

Nakajima Y, Yada K, Ogiwara K, Furukawa S, Shimonishi N, Shima M, Nogami K
Pediatr Int 2021 Feb;63(2):160-167. Epub 2020 Dec 5 doi: 10.1111/ped.14378. PMID: 32640065
Friend BD, Roach GD, Kempert PH, Moore TB
J Pediatr Hematol Oncol 2020 Aug;42(6):e521-e526. doi: 10.1097/MPH.0000000000001646. PMID: 31693514
van Geffen JP, Brouns SLN, Batista J, McKinney H, Kempster C, Nagy M, Sivapalaratnam S, Baaten CCFMJ, Bourry N, Frontini M, Jurk K, Krause M, Pillitteri D, Swieringa F, Verdoold R, Cavill R, Kuijpers MJE, Ouwehand WH, Downes K, Heemskerk JWM
Haematologica 2019 Jun;104(6):1256-1267. Epub 2018 Dec 13 doi: 10.3324/haematol.2018.198853. PMID: 30545925Free PMC Article
Zhou L, Jiang M, Shen H, You T, Ding Z, Cui Q, Ma Z, Yang F, Xie Z, Shi H, Su J, Cao L, Lin J, Yin J, Dai L, Wang H, Wang Z, Yu Z, Ruan C, Xia L
Clin Genet 2018 Aug;94(2):213-220. Epub 2018 May 22 doi: 10.1111/cge.13366. PMID: 29675921Free PMC Article
Wiegering V, Sauer K, Winkler B, Eyrich M, Schlegel PG
Hamostaseologie 2013;33(4):305-12. Epub 2013 Jul 18 doi: 10.5482/HAMO-12-08-0014. PMID: 23868573

Clinical prediction guides

Schönichen C, Montague SJ, Brouns SLN, Burston JJ, Cosemans JMEM, Jurk K, Kehrel BE, Koenen RR, Ní Áinle F, O'Donnell VB, Soehnlein O, Watson SP, Kuijpers MJE, Heemskerk JWM, Nagy M
Arterioscler Thromb Vasc Biol 2023 Sep;43(9):1700-1712. Epub 2023 Jul 6 doi: 10.1161/ATVBAHA.122.318767. PMID: 37409530Free PMC Article
Mehic D, Neubauer G, Janig F, Kaider A, Ay C, Pabinger I, Gebhart J
J Thromb Haemost 2023 Jul;21(7):1757-1768. Epub 2023 Mar 15 doi: 10.1016/j.jtha.2023.03.006. PMID: 36924834
Shapiro A
Thromb Res 2020 Dec;196:590-602. Epub 2019 Jul 19 doi: 10.1016/j.thromres.2019.07.014. PMID: 31420204
Di Minno G
Blood Rev 2015 Jun;29 Suppl 1:S26-33. doi: 10.1016/S0268-960X(15)30005-9. PMID: 26073366
Seligsohn U, Peretz H
Haemostasis 1994 Mar-Apr;24(2):81-5. doi: 10.1159/000217088. PMID: 7959366

Recent systematic reviews

Punt MC, Schuitema PCE, Bloemenkamp KWM, Kremer Hovinga ICL, van Galen KPM
Haemophilia 2020 Mar;26(2):216-227. Epub 2020 Jan 31 doi: 10.1111/hae.13927. PMID: 32004416Free PMC Article

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