Plasma activity of thrombin activatable fibrinolysis inhibitor in Crimean-Congo hemorrhagic fever

Sönmez, Mehmet; Aydın, Kemalettin; Durmuş, Ahmet; N, Sucu; Yılmaz, Mustafa; Akdoğan, Elif; Köksal, İftihar; Ovalı, Ercüment; Omay, Serdar Bedii

doi:10.1016/j.jinf.2007.02.010

Cited by 18 publications

(25 citation statements)

References 19 publications

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“…Our thalassemic patients who suffered from bleeding displayed lower TAFI levels compared to those without bleeding (P < .001). These results are supported by previous studies on disseminated intravascular coagulopathy [29], Dengue hemorrhagic fever [30], and Crimean-Congo hemorrhagic fever [31] in which significantly reduced TAFI levels was associated with bleeding.…”

Section: Discussionsupporting

confidence: 89%

THROMBIN ACTIVATABLE FIBRINOLYSIS INHIBITOR (TAFI): Relationship to Hemostatic Alteration in Patients with β-Thalassemia

Mokhtar

Matter

Shawki

et al. 2010

Pediatric Hematology and Oncology

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Profound hemostatic changes have been observed among thalassemic patients. Thrombin activatable fibrinolysis inhibitor (TAFI) is a newly discovered protein that potentially attenuates fibrinolysis. The authors aimed to investigate plasma level of TAFI in beta-thalassemia patients in relation to clinical severity and hemostatic alteration. Fifty-one thalassemic patients (mean age 10.79 +/- 5.59 years) (21 splenectomized thalassemia major patients, 18 nonsplenectomized thalassemia major patients, 12 nonsplenectomized thalassemia intermedia) were recruited from Pediatric Hematology Clinic, Ain Shams University; in addition, 32 healthy age- and sex-matched controls (10.31 +/- 5.58 years) were also included. In addition to clinical assessment, laboratory investigations included complete blood count (CBC), hemoglobin electrophoresis, prothrombin time (PT), activated partial thromboplastin time (PTT), liver function tests, viral hepatitis markers, serum ferritin, and plasma TAFI levels. Nine out of 51 patients (17.5%) suffered from bleeding manifestations mainly in the form of epistaxis; none of the studied patients had thromboembolism. Significant reduction in TAFI levels was shown in thalassemic patients compared to controls (P < .0001), in splenectomized compared to nonsplenectomized thalassemia group (P < .0001), and in thalassemia major compared to thalassemia intermedia group (P < .0001). Negative correlation was present between TAFI levels and both liver enzymes and serum ferritin levels (P < .05). Thalassemic patients suffering from bleeding showed lower mean TAFI levels compared to those not suffering from bleeding (P < .001). Marked reduction in TAFI levels was observed in thalassemic patients with splenectomy, altered liver functions, and poor chelation who therefore might be at a higher risk for altered hemostasis.

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Section: Discussionsupporting

confidence: 89%

THROMBIN ACTIVATABLE FIBRINOLYSIS INHIBITOR (TAFI): Relationship to Hemostatic Alteration in Patients with β-Thalassemia

Mokhtar

Matter

Shawki

et al. 2010

Pediatric Hematology and Oncology

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“…Changes in the levels of coagulation factors and anticoagulant proteins and alterations to the fibrinolytic system in patients with CCHF have been investigated in a limited number of studies [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…The researchers concluded that low levels of TAFI activity may be an important factor leading to an imbalance in fibrinolysis, resulting in bleeding complications in patients with CCHF [9].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Antithrombin Activity in Patients with Crimean-Congo Hemorrhagic Fever

Özkurt

Özden

Kıkı

et al. 2011

EAJM

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Objective: Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral hemorrhagic fever. Disseminated intravascular coagulation (DIC) is an important complication of this disease, especially in severe and fatal cases. Antithrombin (AT) acts as an anticoagulant by inactivating thrombin, Factor IX, Factor X and Factor XI. We conducted this study to investigate the AT levels and their prognostic value in CCHF. Materials and Methods:Twenty-eight confirmed CCHF patients were included in this study. Diagnosis of the disease was made by CCHF IgM and/or PCR positivity. Patients were grouped based on the severity criteria described previously. The patients with platelet counts <20 000x10 6 cell/L, white blood counts >10x10 9 cell/L, prothrombin times >60 seconds, aspartate aminotransferase levels >700 IU/L or alanine aminotransferase levels >900 IU/L were accepted as severe cases. Patients whose illnesses were self-limited and who did not require blood component replacement were accepted as mild cases, and patients who improved but required blood component replacement were accepted as moderate cases. Blood samples were obtained on the day that the patient had the lowest platelet count and before any thrombocyte replacement. The antithrombin activity was measured using a chromogenic substrate test (Diagnostica Stago STA Compact) at a research laboratory.Results: Twenty-two (78.6%) of the cases were mild, 3 (10.7%) were moderate, and 3 were (10.7%) severe. The mean AT value was 101% for mild cases, 116.6 % for moderate cases, and 88% for severe cases (p>0.05). Although there were no statistically significant differences between the AT values, the mean AT activity was lower in severe CCHF cases. Conclusion:The AT activity may have been decreased in severe CCHF cases. Further studies with greater numbers of patients are required to determine the level of AT activity and its correlation with disease severity and the prognosis of CCHF.Key Words: Antithrombin, Coagulopathy, Crimean-Congo Hemorrhagic Fever ÖzetAmaç: Kırım-Kongo Kanamalı Ateşi (KKKA) kene kaynaklı bir viral kanamalı ateştir. Yaygın damariçi pıhtılaşma (YDP) KKKA'da özellikle ciddi ve ölümcül olgularda görülen önemli bir komplikasyondur. Antithrombin (AT) antikoagülan bir proteindir ve temelde trombin, Faktör IX, Faktör X ve Faktör XI'i inaktive eder. Bu çalışma KKKA'da AT aktivitesini ve prognostik değerini araştırmak amacıyla yürütüldü. Gereç ve Yöntem:Çalışmaya kesin KKKA tanılı 38 hasta dahil edildi. KKKA tanısı KKKA IgM ve/veya PCR pozitifliği ile konuldu. Hastalar daha önce tanımlanmış ciddiyet kriterlerine göre sınıflan-dırıldı. Trombosit sayısı <20 000x10 6 cell/L veya beyaz küre sayısı >10000x10 6 cell/L veya protrombin zamanı >60 saniye veya aspartat aminotransferaz düzeyi >700 IU/L ya da alanin aminotransferaz >900 IU/L olan hastalar ciddi olgu olarak kabul edildi. Ek olarak kendiliğinden düzelen, herhangi bir kan ürünü ihtiyacı gerektirmeyen hastalar hafif, iyileşen ancak replasman gerektiren hastalar orta ciddiyette kabul edildi. Hastalardan...

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“…However, hemorrhage may occasionally occur in unexpected areas except them. [1][2][3][4][5] We describe a case of perirenal hemorrhage associated with CCHF, which has not been reported previously.…”

mentioning

confidence: 97%

An Unusual Cause of Perirenal Hemorrhage

Çeri

2013

Renal Failure

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Plasma activity of thrombin activatable fibrinolysis inhibitor in Crimean-Congo hemorrhagic fever

Cited by 18 publications

References 19 publications

THROMBIN ACTIVATABLE FIBRINOLYSIS INHIBITOR (TAFI): Relationship to Hemostatic Alteration in Patients with β-Thalassemia

THROMBIN ACTIVATABLE FIBRINOLYSIS INHIBITOR (TAFI): Relationship to Hemostatic Alteration in Patients with β-Thalassemia

Prognostic Significance of Antithrombin Activity in Patients with Crimean-Congo Hemorrhagic Fever

An Unusual Cause of Perirenal Hemorrhage

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