Assessment of coagulation state in untreated hyperthyroid and hypothyroid patients

Several studies have reported varoius hemotatic abnormalities in patients with thyroid diseases the traditional associations between hypercoagulable state and hyperthyroidism and between hypocoagulative state and hypothyroidism are critically revised on the basis of more recent litrature data the purpose of this study was to asessment of coagulation state in terms of bleeding and thrombosis in untreated hyperthyroid and hypothroid patients the study was carried out in 60 patients [30 hyperthyroidism 30 hypothyroidism and 30 healthy subjects as ontrol group] blood samples were collected in Al Mowasah Hospital and Nuclear meicine center during 2004 the partial thromboplastin time PTT prothrombin time PT and fibrinogen were determined with a coagulometer uing commercial kits of human factors VIII and IX activity were measured with coagulometer using commercial diamed. TSH and FT4 were measured by an autimated chemiluminescence system [Tosoho Corporation JAPAN] all meaurements performed immediately in Nuclear Medicine Center Statistics were caculated by using T-test and Pearsons correlation coeffieent for results processing Factors VIII and IX activity were singnificantly increased in untreated hyperthyroid patients [144.03% p<0.05 122.93%, p<0.05 respectively] and factors VIII and IX activity were singnificantly decreased in untreated hypothyroid patients [90.68%, p<0.05, p<0.05, respectively] compared with the control group [120.68%, 96.36%, respectively]. Levels of fibrinogen were elevated significantly in untreated hyperthyroid and hypothyroid patients [292 mg/dl, p<0.05, 272,93mg/dl p<0.05 respectively] compared with the control group [252.76 mg/dl]. The classic coagulation status PTT and PT were not greatly altered in untreated hyperthyroid and hypothyroid patiets we did not find significant correlation between both FT4 and TSH levels and haemostatic parameters that we measured Hypercoagulable state were found in untreated hyperthyroid patients and increase risk for thromboembolism Hypocoagulable and hypercoagulable state were found in untreated hypothyroid patients and increased risk for thromboembolism and bleeding tendency these alterations were subclinical and could not have been detected with the routin coagulation test such as the PTT and PT that came in concordance with what Erem C. et al. 2003 about blood coagulation and fibrinolytic activity in hypothyroidism and Erem C et al. 2002 about blood coagulation and fibrinollysis in patients with hyperthyroidism therefore we must control the coagulability state in untreated hyperthyroid and hypothyroid patients

Aclinico- haematological study of factor IX deficiency. Haemophilia B

A total of 100 cases of hereditary coagulation disorders were investigated in the city of Lahore - Punjab. Out of them 38 were found to have factor IX deficiency, Haemophilia B. All were males. 25 patients were children below the age of 12 years where as 13 were adults. Common presenting symptoms in these patients were easy bruising, prolonged bleeding from cuts, post circumcision bleeding, haemarthrosis, and haemotoma formation. Clotting time and Activated partial thromboplastin time were prolonged in all the cases. Mixing experiments were performed on 38 cases and all [100%] showed partial or complete correction of APTT with serum. A mild to moderate reduction of factor IX level was found in most of the cases. Only 3 patients had factor IX level of less than 2 U/dl i.e. severe deficiency of factor IX. Message to be conveyed is that, although factor IX deficiency is clinically indistinguishable from Haemophilia A, correct diagnosis of deficient factor is very important as further therapy and management of the patient in factor IX and factor VIII deficiency is different