patients referred for bleeding symptoms of unknown cause: does evaluation of thrombin generation contribute to diagnosis?

patients referred for bleeding symptoms of unknown cause: does evaluation of thrombin generation contribute to diagnosis?

;Elena Holm;Eva Zetterberg;Susanna Lövdahl;Erik Berntorp
aktualʹnì pitannâ farmacevtičnoï ì medičnoï nauki ta praktiki 2016 Vol. 8 pp. e2016014-e2016014
150
holm2016mediterraneanpatients

Abstract

Introduction Patients with mild to moderate bleeding symptoms referred for coagulation investigation sometimes never receive a definitive diagnosis. Bleed assessment tools have been developed and validated to assess the severity of symptoms. Global coagulation assays, e.g., the thrombin generation test (thrombogram) have a potential to identify hemostatic defects that are not detected in specific assays. Material and Methods One hundred and eighty-five patients referred to our centre because of bleeding symptoms were evaluated using  the bleeding assessment tool (BAT) described by Tosetto and colleagues in 2006.  Blood samples were investigated for thrombin generation (TG) capacity (Technoclone) , in platelet poor (PPP)  plasma , and specific clotting factors, i.e, von Willebrand factor, factor VIII and IX, as well as INR, APTT, platelet count, and platelet adhesion. Results Of the 185 patients, five women were diagnosed with mild von Willebrand disease and one male with mild hemophilia A. The remaining 179 subjects (76% females and 24% males with average ages of 33 and 28 years, respectively) were evaluated further. In the total cohort and among women, peak TG, and lag time   correlated with bleeding score (p=0.01 and p=0.04, respectively with correlation coefficients).  No such correlations were found among males.   Discussion and conclusion   Although our study showed some correlation between TG and bleeding score, results are generally consistent with a previous report which failed to demonstrate the value of TG measurement in a similar setting. In conclusion, the complexity of the mechanisms underlying clinical bleeding complicates the ability to use TG tests as reliable predictors of bleeding. Mild congenital bleeding disorders, especially VWD, should be specifically screened for in patients with mild/moderate symtoms.

Citation

ID: 155406
Ref Key: holm2016mediterraneanpatients
Use this key to autocite in SciMatic or Thesis Manager

References

Blockchain Verification

Account:
NFT Contract Address:
0x95644003c57E6F55A65596E3D9Eac6813e3566dA
Article ID:
155406
Unique Identifier:
10.4084/mjhid.2016.014
Network:
Scimatic Chain (ID: 481)
Loading...
Blockchain Readiness Checklist
Authors
Abstract
Journal Name
Year
Title
5/5
Creates 1,000,000 NFT tokens for this article
Token Features:
  • ERC-1155 Standard NFT
  • 1 Million Supply per Article
  • Transferable via MetaMask
  • Permanent Blockchain Record
Blockchain QR Code
Scan with Saymatik Web3.0 Wallet

Saymatik Web3.0 Wallet