Vitamin K dependent coagulation proteins in endemic hepatosplenomegaly in Egypt.

Omran, S. A.; Amin, Huma; El-Bassiouni, Nora E.; Essawy, Faiza M.; Toiema, S M

doi:10.1136/jcp.47.6.502

Cited by 11 publications

(13 citation statements)

References 9 publications

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“…Osuna et al (1977) suggested that hepatocellular damage can be the cause of increased PT, because most of the clotting factors are synthesised in the liver. Omran et al (1990Omran et al ( , 1994 suggested that hepatic fibrosis caused by S. mansoni in humans reduces the functional activities of the clotting factors, with the resultant prolongation of APTT and TT. Obviously, F. hepatica produces substances that lead to the activation of the intrinsic pathway of coagulation through the activation of F XII, XI, IX and VIII and have little effect on F V and no effect on F VII for the extrinsic pathway of coagulation.…”

Section: Discussionmentioning

confidence: 99%

Fasciola hepatica alters coagulation parameters in sheep plasma in vivo and in vitro

Joachim

Daugschies

2002

Parasitology Research

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The blood-sucking activities of the liver fluke, Fasciola hepatica, are likely to cause alterations in coagulation during the course of infection; and the effect of F. hepatica on various coagulation parameters was studied during the course of acute and chronic fasciolosis of sheep over a period of 17 weeks. Whole blood and plasma samples from infected sheep (with 800 metacercariae each) and uninfected controls were collected weekly until 17 weeks post-infection (w.p.i.) and the activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT) were determined. Additionally, adult F. hepatica were recovered from bile ducts, incubated for the production of excretory/secretory products (ESP) or homogenised and the effect of fluke products on APTT, PT and TT was determined. Anaemia was evident in infected sheep from 8 w.p.i. until 17 w.p.i. Plasma APTT was accelerated during 8, 9, 12, 14, 16 and 17 w.p.i., while PT was prolonged at 8-11 w.p.i. and TT at 10, 14 and 17 w.p.i. Addition of worm ESP or homogenate to plasma resulted in an enhancement of the intrinsic pathway (APTT) together with a prolongation of the extrinsic and common pathways (PT, TT) of coagulation. It was concluded that F. hepatica contains and releases substances that may contribute to coagulation changes in vivo. Further characterisation of the active substance(s) in vitro revealed heat inactivation, a size >30 kDa and inhibition by the proteinase inhibitors Complete and EDTA for the APTT-accelerating substance(s). The TT-deceleration, in contrast, was increased after heating.

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Section: Discussionmentioning

confidence: 99%

Fasciola hepatica alters coagulation parameters in sheep plasma in vivo and in vitro

Joachim

Daugschies

2002

Parasitology Research

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“…Several disorders of coagulation can occur in this disease due to reduced production, increased consumption and impaired hepatic clearance of both coagulant and anticoagulant proteins, with the possible occurrence of chronic consumption coagulopathy and hyperfibrinolyis among other alterations 4,5,16,25,57 .…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B and C virus markers among patients with hepatosplenic mansonic schistosomiasis

Aquino¹,

Chieffi

Catunda³

et al. 2000

Rev. Inst. Med. trop. S. Paulo

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SUMMARYPurpose: To evaluate the frequency and the consequences of the co-infection of hepatitis B and C viruses in patients with hepatosplenic schistosomiasis (HSS).Methods: B and C serologic markers, exposure to risk factors, biochemical assays, upper gastrointestinal endoscopies, and abdominal ultrasonograms were evaluated in 101 patients with HSS from 1994 to 1997. Whenever possible, PCR was tested and histopathological studies were reviewed.Results: At least one HBV virus marker was found in 15.8%, and anti-HCV was detected in 12.9% of the subjects. The seropositive subjects tended to be older than the seronegative ones. A history of blood transfusion was significantly related to the presence of anti-HCV. Three (18.75%) out of 16 subjects exposed to B virus were HBsAg positive. Eleven (84.6%) out of thirteen patients who were anti-HCV positive demonstrated viral activity. Patients with ongoing viral infection presented a higher average level of liver aminotransferases, a higher frequency of cell decompensation and a higher rate of chronic hepatitis. Portal hypertension parameters were not influenced by viral exposure. Conclusions:The rate of hepatitis B and C viruses serologic markers observed in the patients with HSS was higher than the control group. The co-infection was responsible for a higher frequency of cell decompensation.

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“…On the other hand, some studies have found reduced levels of blood coagulation proteins, which are synthesized by liver cells [9]–[11]. Classically, it is believed that liver cell function is preserved in hepatosplenic schistosomiasis and that the compromised hemostasis is due to a consumptive coagulopathy related to the enlarged liver and spleen.…”

Section: Introductionmentioning

confidence: 99%

Hemostatic Dysfunction Is Increased in Patients with Hepatosplenic Schistosomiasis Mansoni and Advanced Periportal Fibrosis

et al. 2013

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BackgroundSchistosomiasis mansoni is an endemic parasitic disease and a public health problem in Northeast Brazil. In some patients, hepatic abnormalities lead to periportal fibrosis and result in the most severe clinical form, hepatosplenic schistosomiasis. This study aimed to evaluate whether abnormal blood coagulation and liver function tests in patients with hepatosplenic schistosomiasis (n = 55) correlate with the severity of their periportal fibrosis.Methodology/Principal FindingsBlood samples were used for liver function tests, hemogram and prothrombin time (International Normalized Ratio, INR). The blood coagulation factors (II, VII, VIII, IX and X), protein C and antithrombin IIa (ATIIa), plasminogen activator inhibitor 1 (PAI-1) and D-dimer were measured by photometry or enzyme linked immunosorbent assay. Hyperfibrinolysis was defined on the basis of PAI-1 levels and a D-dimer concentration greater than a standard cut-off of 483 ng/mL. Standard liver function tests were all abnormal in the patient group compared to healthy controls (n = 29), including raised serum transaminases (p<0.001) and lower levels of albumin (p = 0.0156). Platelet counts were 50% lower in patients, while for coagulation factors there was a 40% increase in the INR (p<0.001) and reduced levels of Factor VII and protein C in patients compared to the controls (both p<0.001). Additionally, patients with more advanced fibrosis (n = 38) had lower levels of protein C compared to those with only central fibrosis (p = 0.0124). The concentration of plasma PAI-1 in patients was one-third that of the control group (p<0.001), and D-dimer levels 2.2 times higher (p<0.001) with 13 of the 55 patients having levels above the cut-off.Conclusion/SignificanceThis study confirms that hemostatic abnormalities are associated with reduced liver function and increased liver fibrosis. Of note was the finding that a quarter of patients with hepatosplenic schistosomiasis and advanced periportal fibrosis have hyperfibrinolysis, as judged by excessive levels of D-dimer, which may predispose them to gastrointestinal bleeding.

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Vitamin K dependent coagulation proteins in endemic hepatosplenomegaly in Egypt.

Cited by 11 publications

References 9 publications

Fasciola hepatica alters coagulation parameters in sheep plasma in vivo and in vitro

Fasciola hepatica alters coagulation parameters in sheep plasma in vivo and in vitro

Hepatitis B and C virus markers among patients with hepatosplenic mansonic schistosomiasis

Hemostatic Dysfunction Is Increased in Patients with Hepatosplenic Schistosomiasis Mansoni and Advanced Periportal Fibrosis

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