Coagulation, Platelets, and Acute Pancreatitis

Abstract

Acute pancreatitis generates a complex cascade of immunological events that affect the pathogenesis and the progression of this disease. Several inflammatory mediators seem to play a critical role in the pathogenesis of pancreatitis and the subsequent inflammatory response. In turn, these mediators can influence hemostasis. Coagulation abnormalities occur in acute pancreatitis and are related to its severity. The contribution of blood platelets in the disturbed hemostasis in acute pancreatitis, although extensively studied, remains obscure. This article reviews the local and systemic implications of hemostatic abnormalities during acute pancreatitis. Furthermore, we discuss the prognostic value and the potential therapeutic implications of platelet activation and other hemostatic variables.

Acute edematous and necrotic pancreatitis in a porcine model

“…In a review it was presented that patients with pancreatitis with differing levels of disease severity and experimental severe acute pancreatitis (SAP) were associated with a significant decrease in platelet count [33]. In mild human pancreatitis, platelets were activated but, owing to a rapid bone marrow response, the amount did not decrease [34].…”

“…During acute pancreatitis, platelets are activated and accumulate intra-and extravascularly, forming microthrombi [33,34]. In a review it was presented that patients with pancreatitis with differing levels of disease severity and experimental severe acute pancreatitis (SAP) were associated with a significant decrease in platelet count [33].…”

Higher Thrombin-Antithrombin III Complex Levels May Indicate Severe Acute Pancreatitis

“…Coagulation disorder is known to increase in line with the severity of disease in patients with AP [7, 8, 18-20, 23]. Microvascular thrombosis formation and impairment of the microcirculation inside the pancreas during the course of the disease increases the risk of local and systemic complications [24-28].…”

Acute Pancreatitis Induced by Activated Polyamine Catabolism Is Associated with Coagulopathy: Effects of α-Methylated Polyamine Analogs on Hemostasis

“…Coagulation abnormalities are often present in human patients with acute pancreatitis, and are connected to disease severity [30,31,32]. Activation of coagulation and fibrinolysis has also been observed in experimental models of acute pancreatitis induced by cerulein or taurodeoxycholate [33,34].…”