Reduced dense granules in platelet by electron microscopy in a patient with abnormal bleeding after self-applied leech therapy

INTRODUCTION: Delta storage pool disease (δ-SPD) is a platelet function disorder due to the decreased number and contents of dense granules causing bleeding symptoms. Diagnosis of δ-SPD is a complex procedure due to the variability of test results in platelet aggregometry and also it requires specialised tests. Electron microscopy (EM) is a promising tool to help in the diagnosis of this disorder. We report here a rare case of δ-SPD confirmed by EM. CASE REPORT: A 42-year-old lady presented with prolonged bleeding history from a leech bite for 3 days. She also has a history of bleeding of variable severity for more than 20 years. On presentation, blood was oozing from the bite mark on her right wrist and there were multiple small bruises over her lower limbs. Full blood count, peripheral blood smear, coagulation profile, factor VIII assay, factor IX assay, von Willebrand Factor antigen and activity, bleeding time, and clot retraction test were normal. Platelet aggregation tests showed poor aggregation with ADP with a lag phase >60 seconds with arachidonic acid. There was poor ATP release reaction with ADP and arachidonic acid suggesting a storage defect. Subsequently, the EM of the platelets was performed and showed reduced dense granules indicating delta storage pool deficiency (δ-SPD). She was counselled about her diet and medication which seems to control her symptoms. CONCLUSIONS: This case report highlights rare δ-SPD confirmed by EM. Diagnosis of this disorder is crucial in managing the patient. Highly specialised tests including platelet aggregometry, EM and molecular analysis are helpful in diagnosing this rare SPD.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Electron-microscopy diagnosis of reduced dense platelet granules in a patient with abnormal bleeding after self-applied leech therapy.

Erfahren Sie, wie diese Forschung mit der klinischen Praxis verknüpft ist

More peer-reviewed studies in Sicherheit & Infektionskontrolle.

• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• Efficacy and Safety of Hirudotherapy for Improving Sperm Quality Parameters in Male Infertility: A Randomized Controlled Trial — Abtahi-Forooshani M et al. (2026)
• Improvement of patient care through hirudotherapy and the management of leeches from their reception to their disposal in France — Vaesken C et al. (2023)
• Hirudotherapy in Medicine and Dentistry — Jha K et al. (2015)
• Management of Chronic Non-healing Wounds by Hirudotherapy — Iqbal A et al. (2017)
• Hirudotherapy attenuates arthritic pain in patients with various chronic pain syndromes: A retrospective analysis — Loeser J et al. (2020)
• Hirudotherapy (medicinal leeches) for treatment of upper airway obstruction in a dog — Trenholme H, Masseau I, Reinero C (2021)
• Analysis of antibiotic resistant infections associated with hirudotherapy — Brauer P et al. (2024)
• Leech Me Alone! Atraumatic Hemarthrosis after Hirudotherapy — Curcio J, Lloyd C (2020)

Browse all ASH-analysed research →