Hypercoagulable state as demonstrated by thromboelastometry in hemoglobin E/beta-thalassemia patients: Association with clinical severity and splenectomy status

© 2016 Elsevier Ltd. All rights reserved. Introduction Patients with hemoglobin E/beta-thalassemia disease (E/β) are at risk of thromboembolism. Rotational thromboelastometry (ROTEM®) can be used to determine a hypercoagulable state. The objective was to describe the hemostatic and thromboelastometr...

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Main Authors: Rungrote Natesirinilkul, Pimlak Charoenkwan, Weerasak Nawarawong, Settapong Boonsri, Pakinee Tantivate, Suwakon Wongjaikum, Suphara Manowong, Torpong Sanguansermsri
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Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/56164
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spelling th-cmuir.6653943832-561642018-09-05T03:09:57Z Hypercoagulable state as demonstrated by thromboelastometry in hemoglobin E/beta-thalassemia patients: Association with clinical severity and splenectomy status Rungrote Natesirinilkul Pimlak Charoenkwan Weerasak Nawarawong Settapong Boonsri Pakinee Tantivate Suwakon Wongjaikum Suphara Manowong Torpong Sanguansermsri Medicine © 2016 Elsevier Ltd. All rights reserved. Introduction Patients with hemoglobin E/beta-thalassemia disease (E/β) are at risk of thromboembolism. Rotational thromboelastometry (ROTEM®) can be used to determine a hypercoagulable state. The objective was to describe the hemostatic and thromboelastometric changes in pediatric patients with E/β with different clinical severity, in comparison with healthy children as controls. Materials and methods Fifty-three pediatric patients with E/β and 21 healthy children were enrolled. The clinical severity of E/β was categorized by using the clinical severity scores. All subjects were tested for complete blood count, protein C activity (PC), total protein S (PS), antithrombin (AT), D-dimer and fibrinogen (Fib) levels and thromboelastometry, measured by ROTEM®. Results The levels of PC (65.7 vs 118.5%), PS (46.8 vs 78.4%), AT (95.7 vs 105.7%) and Fib (217 vs 294 mg/dL) were significantly lower, and the platelet count (PLT) was significantly higher in the patient group than the controls. The maximum clot firmness (MCF) of patients with moderate disease who were previously splenectomized (seven patients) and patients with severe disease (nine patients) were higher than patients who had intact spleen with moderate disease, patients with mild disease and controls (P < 0.05). Only PLT had significant correlation with MCF (P < 0.05). Conclusions Hypercoagulable state was demonstrated by ROTEM® in patients with E/β with severe disease and who were previously splenectomized. The hypercoagulable state was associated with the higher numbers of PLT rather than the decrease of PC, PS, and AT. 2018-09-05T03:09:57Z 2018-09-05T03:09:57Z 2016-04-01 Journal 18792472 00493848 2-s2.0-84960334058 10.1016/j.thromres.2016.02.014 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84960334058&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/56164
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Rungrote Natesirinilkul
Pimlak Charoenkwan
Weerasak Nawarawong
Settapong Boonsri
Pakinee Tantivate
Suwakon Wongjaikum
Suphara Manowong
Torpong Sanguansermsri
Hypercoagulable state as demonstrated by thromboelastometry in hemoglobin E/beta-thalassemia patients: Association with clinical severity and splenectomy status
description © 2016 Elsevier Ltd. All rights reserved. Introduction Patients with hemoglobin E/beta-thalassemia disease (E/β) are at risk of thromboembolism. Rotational thromboelastometry (ROTEM®) can be used to determine a hypercoagulable state. The objective was to describe the hemostatic and thromboelastometric changes in pediatric patients with E/β with different clinical severity, in comparison with healthy children as controls. Materials and methods Fifty-three pediatric patients with E/β and 21 healthy children were enrolled. The clinical severity of E/β was categorized by using the clinical severity scores. All subjects were tested for complete blood count, protein C activity (PC), total protein S (PS), antithrombin (AT), D-dimer and fibrinogen (Fib) levels and thromboelastometry, measured by ROTEM®. Results The levels of PC (65.7 vs 118.5%), PS (46.8 vs 78.4%), AT (95.7 vs 105.7%) and Fib (217 vs 294 mg/dL) were significantly lower, and the platelet count (PLT) was significantly higher in the patient group than the controls. The maximum clot firmness (MCF) of patients with moderate disease who were previously splenectomized (seven patients) and patients with severe disease (nine patients) were higher than patients who had intact spleen with moderate disease, patients with mild disease and controls (P < 0.05). Only PLT had significant correlation with MCF (P < 0.05). Conclusions Hypercoagulable state was demonstrated by ROTEM® in patients with E/β with severe disease and who were previously splenectomized. The hypercoagulable state was associated with the higher numbers of PLT rather than the decrease of PC, PS, and AT.
format Journal
author Rungrote Natesirinilkul
Pimlak Charoenkwan
Weerasak Nawarawong
Settapong Boonsri
Pakinee Tantivate
Suwakon Wongjaikum
Suphara Manowong
Torpong Sanguansermsri
author_facet Rungrote Natesirinilkul
Pimlak Charoenkwan
Weerasak Nawarawong
Settapong Boonsri
Pakinee Tantivate
Suwakon Wongjaikum
Suphara Manowong
Torpong Sanguansermsri
author_sort Rungrote Natesirinilkul
title Hypercoagulable state as demonstrated by thromboelastometry in hemoglobin E/beta-thalassemia patients: Association with clinical severity and splenectomy status
title_short Hypercoagulable state as demonstrated by thromboelastometry in hemoglobin E/beta-thalassemia patients: Association with clinical severity and splenectomy status
title_full Hypercoagulable state as demonstrated by thromboelastometry in hemoglobin E/beta-thalassemia patients: Association with clinical severity and splenectomy status
title_fullStr Hypercoagulable state as demonstrated by thromboelastometry in hemoglobin E/beta-thalassemia patients: Association with clinical severity and splenectomy status
title_full_unstemmed Hypercoagulable state as demonstrated by thromboelastometry in hemoglobin E/beta-thalassemia patients: Association with clinical severity and splenectomy status
title_sort hypercoagulable state as demonstrated by thromboelastometry in hemoglobin e/beta-thalassemia patients: association with clinical severity and splenectomy status
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84960334058&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/56164
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