No abstract

Disseminated intravascular coagulation (DIC) is induced by excess activation coagulation, and activated platelets are also involved in pathogenesis. Therefore, plasma levels of soluble C-type lectin-like receptor 2 (sCLEC-2), a new marker for platelet activation, can be expected as a marker of DIC in critically ill patients. Plasma levels of sCLEC-2 and D-dimer were measured using the STACIA system. Plasma sCLEC-2 and D-dimer levels were significantly higher in patients with underlying diseases of DIC than in those with unidentified clinical syndrome (UCS). Plasma sCLEC-2 levels were significantly higher in the patients with DIC and Pre-DIC than in those without DIC or Pre-DIC. Similarly, plasma D-dimer levels were also significantly higher in patients with DIC and Pre-DIC than in those without DIC or Pre-DIC. The plasma sCLEC-2 levels in all patients and those with a DIC score ≤ 4 were significantly higher in non-survivors than survivors. The plasma D-dimer levels in all patients, those with a DIC score ≥ 5 and those with a DIC score ≤ 4, were significantly higher in non-survivors than in survivors. The plasma sCLEC-2 is expected as a marker for DIC/Pre-DIC as well as the prognostic marker in critically ill patients.

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The usefulness of lupus anticoagulant (LA) and several antibodies for predicting thrombosis was assessed in patients with idiopathic thrombocytopenic purpura (ITP), systemic lupus erythematosus (SLE), lupus like disease (LLD), recurrent abortion and primary antiphospholipid syndrome (APS). LA was measured using the diluted Russell Viper Venom test (DRVVT) and the diluted prothrombin time (dPT).In healthy volunteers, the median (range) of the DRVVT and dPT ratio were 0.97 (0.88 -1.08) and 1.05 (0.85 -1.29), respectively. The positive percent of dPT ratio was high in patients with ITP, SLE, recurrent abortion and primary APS. The sensitivity for thrombosis was highest for the dPT ratio and the specificity for thrombosis was highest for the DRVVT ratio. The sensitivity and the Odd's ratio for both the dPT and DRVVT ratio were high. A positive predictive value in DRVVT and a negative predictive value in dPT were high. The receiver operating characteristic (ROC) curve analysis indicates that the dPT ratio might be more useful for predicting thrombosis than the DRVVT ratio. The DRVVT and dPT ratios are useful for both the diagnosis of APS as well as predicting thrombosis.

Abstract:The usefulness of lupus anticoagulant (LA) and several antibodies for predicting thrombosis was assessed in patients with idiopathic thrombocytopenic purpura (ITP), systemic lupus erythematosus (SLE), lupus like disease (LLD), recurrent abortion and primary antiphospholipid syndrome (APS). LA was measured using the diluted Russell Viper Venom test (DRVVT) and the diluted prothrombin time (dPT).In healthy volunteers, the median (range) of the DRVVT and dPT ratio were 0.97 (0.88 -1.08) and 1.05 (0.85 -1.29), respectively. The positive percent of dPT ratio was high in patients with ITP, SLE, recurrent abortion and primary APS. The sensitivity for thrombosis was highest for the dPT ratio and the specificity for thrombosis was highest for the DRVVT ratio. The sensitivity and the Odd's ratio for both the dPT and DRVVT ratio were high. A positive predictive value in DRVVT and a negative predictive value in dPT were high. The receiver operating characteristic (ROC) curve analysis indicates that the dPT ratio might be more useful for predicting thrombosis than the DRVVT ratio. The DRVVT and dPT ratios are useful for both the diagnosis of APS as well as predicting thrombosis.