Adenovirus-induced thrombocytopenia: the role of von Willebrand factor | Blood | Othman et al American Society of Hematology 2007 |

1. Adenoviruses, when given intravenously as in gene therapy, may directly activate endothelial cells or

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2. Adenoviruses may also activate platelets, which aggregate with WBC's on to endothelium. This in turn activates the endothelial cells, release macrophages into tissue and release vWF (von Willebrand factor which is a procoagulant), leading to uncontrolled coagulopathy.

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3. The drop in platelets within 24 hours indicates innate immune response.

4. The virus directly binds on to platelets, enters platelets, they get sequestered by Kupffer cells in the liver sinusoids.

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