To elucidate the pathogenetic mechanism of bleeding tendency in Korean hemorrhagic
fever, peripheral platelet counts, platelet aggregation and platelet adhesiveness were
measured from the early stages of this disease with the following results.
1) During the early acute stage by day 7 decrease of the platelet counts below 15, 000/
㎣ was observed in 20 of 23 patients (87.0%). Thereafter the platelet counts increased
slowly even to exceed normal range in some cases.
2) The maximal level of platelet aggregation by ADP was markedly decreased below
70% in 18 of 19 patients (94.7%) during the early acute stage. Epinephrine- and
collagen-induced platelet aggregation was also decreased below 70% in all of 19 patients
(100%) and 14 of 17 patients (82.4%) respectively during the same period. Platelet
aggregation was, however, recovered progressively during the course of the illness and,
in convalescence, almost all patients revealed normal levels.
3) Platelet adhesiveness was depressed below normal levels in 5 of 15 patients (33.3%)
during the early acute stage.
With the above results it was suggested that impaired platelet aggregation plays a
role together with disseminated intravascular coagulation in the pathogenesis of
thrombocytopenia in the early stages of Korean hemorrhagic fever, and that
disseminated intravascular coagulaction, thrombocytopenia and defects of platelet
functions including platetet aggregation and adhesiveness are all involved in the
pathogenetic mechanism of the bleeding tendency which is one of the characteristic
manifestations of this disease.
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