Excessive bleeding after gastrointestinal endoscopy in two children with Acquired Immunodeficiency Syndrome (AIDS) and normal coagulation studies prompted us to evaluate platelet function in children with AIDS. While thrombocytopenia is common in patients with AIDS, little is known about platelet function in these patients. We prospectively evaluated platelet function in 13 children with AIDS and no prior hisotry of bleeding (ages 1-13 years, median 4 1/2 years) over a 13-month period. None had received medication affecting platelet function prior to tesing. All had normal renal function, and 2 had moderate elevation of liver enzymes; serum globulin levels were elevated in 5 patients. Measurements included platelet count; bleeding time (BT) and platelet aggregation and ATP release with collagen (Col), arachidonic acid (Ara), ristocetin (Rist) and ADP. While all patients had normal platelet counts, 7 (55%) had prolongation of BT (9 to > 18 min). Marked impairment of ATP release following Ara and Col was observed in 6 and 5 patients respectively, and platelet aggregation to Ara and Col was abnormal in 4 and 5 patients respectively. As yet there is no significant correlation between the various abnormalities seen. The data suggest that platelet dysfunction may be common in children with AIDS. Clinical significance and the potential need for intervention remain to be determined.
