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1.
SAGE Open Med Case Rep ; 9: 2050313X211016991, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104443

RESUMO

Patients with COVID-19 are at high risk of thromboembolic events; for this reason, the use of heparin is largely recommended but, in addition to thrombotic complications, bleeding is a significant cause of morbidity in patients with COVID-19. Idiopathic iliopsoas hematoma is a very rarely described hemorrhagic complication in patients with COVID-19. We report here two cases of iliopsoas hematoma in male patients with COVID-19 and being treated with heparin.

3.
Hematol Rep ; 11(1): 7912, 2019 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-30915205

RESUMO

Despite many articles regarding the antihemorrhagic treatment and prophylaxis, there is a lack of experience about how to best conduct major surgical procedures in patients with congenital factor XIII (FXIII) deficiency. Here we report a case of surgery (right inguinal hernia, complicated by heaviness and pain) performed in a patient with FXIII deficiency, receiving recombinant FXIII prophylaxis (Catridecacog 35 UI/kg every 28±2 days). Our experience shows that Catridecacog can be used safely and effectively not only for continued prophylaxis but also in surgery and adds to the very limited body of evidence currently available on surgery in this bleeding disorder.

4.
J Clin Med ; 6(9)2017 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-28926986

RESUMO

Von Willebrand disease (VWD) is the most frequent inherited bleeding disorder and is caused by either a quantitative and/or qualitative defect of the multimeric glycoprotein vonWillebrand factor (VWF).[...].

5.
J Clin Oncol ; 32(32): 3607-12, 2014 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-25267738

RESUMO

PURPOSE: We evaluated the role of residual vein thrombosis (RVT) to assess the optimal duration of anticoagulants in patients with cancer who have deep vein thrombosis (DVT) of the lower limbs. PATIENTS AND METHODS: Patients with active cancer and a first episode of DVT treated with low molecular weight heparin (LMWH) for 6 months were eligible. Patients were managed according to RVT findings: those with RVT were randomly assigned to continue LMWH for an additional 6 months (group A1) or to discontinue it (group A2), and patients without RVT stopped LMWH (group B). The primary end point was recurrent venous thromboembolism (VTE) during the 1 year after disconinuation of LMWH, and the secondary end point was major bleeding. Analyses are from the time of random assignment. RESULTS: Between October 2005 and April 2010, 347 patients were enrolled. RVT was detected in 242 patients (69.7%); recurrence occurred in 22 of the 119 patients in group A1compared with 27 of 123 patients in group A2. The adjusted hazard ratio (HR) for group A2 versus A1 was 1.37 (95% CI, 0.7 to 2.5; P = .311). Three of the 105 patients in group B developed recurrent VTE; adjusted HR for group A1 versus B was 6.0 (95% CI, 1.7 to 21.2; P = .005). Three major bleeding events occurred in group A1, and two events each occurred in groups A2 and B. The HR for major bleeding in group A1 versus group A2 was 3.78 (95% CI, 0.77 to 18.58; P = .102). Overall, 42 patients (12.1%) died during follow-up as a result of cancer progression. CONCLUSION: In patients with cancer with a first DVT, treated for 6 months with LMWH, absence of RVT identifies a population at low risk for recurrent thrombotic events. Continuation of LMWH in patients with RVT up to 1 year did not reduce recurrent VTE.


Assuntos
Heparina de Baixo Peso Molecular/uso terapêutico , Neoplasias/complicações , Tromboembolia Venosa/tratamento farmacológico , Trombose Venosa/tratamento farmacológico , Idoso , Anticoagulantes/uso terapêutico , Progressão da Doença , Feminino , Seguimentos , Humanos , Extremidade Inferior/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Fatores de Risco , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Tromboembolia Venosa/complicações , Tromboembolia Venosa/mortalidade , Trombose Venosa/complicações
6.
Clin Appl Thromb Hemost ; 16(5): 549-53, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19825913

RESUMO

INTRODUCTION: Elevated homocysteine (Hcy) is associated with the risk of deep vein thrombosis, pulmonary embolism, ischemic heart disease, and stroke. Several studies have suggested that hyperhomocysteinemia (HHcy) may predispose to retinal vein thrombosis (RVT) development. The aim of this study is to investigate the relationship between Hcy, C677T methylenetetrahydrofolate reductase (MTHFR) genotype, and RVT in patients compared with controls. MATERIALS AND METHODS: We evaluated the Hcy plasma level of 3114 consecutive participants in 2 Italian centers during a 2-year period. Hyperhomocysteinemia was found in 99 patients and 136 healthy participants. Of the 99 patients, 20 had RVT with a high prevalence of HHcy in the RVT subgroup (20.2%). This result suggested a possible relationship between HHcy and RVT development. We investigated 105 consecutive patients with recent diagnosis of RVT, and we compared them with 226 healthy controls to evaluate whether HHcy may be a risk factor for RVT. RESULTS: the prevalence of HHcy was higher in patients compared with controls (34.3% vs 14.2%; P < .001). The MTHFR C677T genotype was found in 69 of 105 (65.7%) patients with RVT (heterozygosity: 40 of 105 and homozygosity: 29 of 105). The control group showed the presence of MTHFR C677T genotype in 169 of 226 participants (74.8%; heterozygosity: 100 of 226 and homozygosity: 69 of 226) without difference between the 2 groups (P = .08). CONCLUSION: our study suggests that HHcy is a possible risk factor for RVT development, while no association was found between RVT and the C677T MTHFR genotype.


Assuntos
Hiper-Homocisteinemia/sangue , Hiper-Homocisteinemia/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Oclusão da Veia Retiniana/sangue , Oclusão da Veia Retiniana/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
7.
Clin Appl Thromb Hemost ; 15(3): 356-9, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19211580

RESUMO

Factor V Leiden (FVL) and G20210 prothrombin (FII G20210A) mutations are risk factors for thromboembolism. In Europe, FVL is more prevalent in the north (7%) than in the south (3%), whereas FII G20210A is more common in the south (3% to 7%) than in the north (2% to 5%). In Italy, the prevalence is 2% to 3% for both. The aim of this study was to assess if these polymorphisms could be more frequent in the south than in the rest of Italy. In 105 blood donors in southern Italy, the prevalence of FVL and FIIG20210A was 9.5% and 5.7%, respectively. These prevalence data are higher when compared with published data. The results of this study are as high as those observed in Greece and the Middle East. The diffusion of FVL and FII G20210A in the Mediterranean, consequent to Phoenician and Greek colonization, could be a reason for the high prevalence observed.


Assuntos
Fator V/genética , Polimorfismo Genético , Protrombina/genética , Adulto , Feminino , Frequência do Gene , Heterozigoto , Homozigoto , Humanos , Itália , Masculino , Valores de Referência , População Branca/genética
8.
Tumori ; 93(2): 155-9, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17557562

RESUMO

The aim of the study was to verify the utility of the clinical practice of administering thrombophilic screening and antithrombotic prophylaxis with low-molecular-weight heparin to healthy donors receiving granulocyte colony-stimulating factor to mobilize peripheral blood stem cells. Thrombophilia screening comprised of testing for factor V Leiden G1691A, prothrombin G20210A, the thermolabile variant (C677T) of the methylene tetrahydrofolate reductase gene, protein C, protein S, factor VIII and homocysteine plasmatic levels, antithrombin III activity, and acquired activated protein C resistance. We investigated prospectively 72 white Italian healthy donors, 39 men and 33 women, with a median age of 42 years (range, 18-65). Five donors (6.9%) were heterozygous carriers of Factor V Leiden G1691A; two healthy donors had the heterozygous prothrombin G20210A gene mutation; C677T mutation in the methylene tetrahydrofolate reductase gene was present in 34 (47.2%) donors in heterozygous and in 7 donors (9.7%) in homozygous. Acquired activated protein C resistance was revealed in 8 donors of the study (11.1%). The protein C plasmatic level was decreased in 3 donors (4.2%); the protein S level was decreased in 7 donors (9.7%). An elevated factor VIII dosage was shown in 10 donors (13.9%) and hyperhomocysteinemia in 9 donors (12.5%). Concentration of antithrombin III was in the normal range for all study group donors. The factor V Leiden mutation was combined with the heterozygous prothrombin G20210A in 2 cases and with protein S deficiency in one case; 2 healthy donors presented an associated deficiency of protein C and protein S. Although none of these healthy subjects had a previous history of thrombosis, low-molecular-weight heparin was administered to all donors during granulocyte colony-stimulating factor administration to prevent thrombotic events. No donor experienced short or long-term thrombotic diseases after a median follow-up of 29.2 months. Our data do not support this clinical practice because there is no evidence that the combination of granulocyte colony-stimulating factor to previous hypercoagulable conditions results in thrombotic events.


Assuntos
Fator Estimulador de Colônias de Granulócitos/efeitos adversos , Mobilização de Células-Tronco Hematopoéticas/efeitos adversos , Heparina de Baixo Peso Molecular/uso terapêutico , Trombofilia/diagnóstico , Trombose/prevenção & controle , Doadores de Tecidos , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Feminino , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Células-Tronco Hematopoéticas , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Pré-Medicação , Trombose/induzido quimicamente
9.
Clin Appl Thromb Hemost ; 13(1): 104-7, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17164500

RESUMO

Elevated plasma homocysteine (Hcy) level is considered a risk factor for vascular diseases. In recent years, many scientific reports have suggested that hyperhomocystinemia may be associated with an increased risk of retinal vascular occlusive disease (RVOD). The prevalence of elevation of homocysteine in patients with a recent retinal vascular occlusion was compared to a health control group in this study. Forty-nine consecutive patients (22 M; 27 F) (age 26-85 years, mean 69) with diagnosis of retinal vascular occlusion were compared with 71 healthy controls. These patients underwent laboratory evaluation for plasma fasting total homocysteine, activated protein C resistance, protein C, protein S, antithrombin III, and antiphospholipid and anticardiolipin antibodies. The G20210 prothrombin gene mutation (FII G20210A) and Factor V Leiden mutation (FVL) were evaluated. None of these enrolled subjects had other prothrombic risk factors. The health control group consisted of healthy subjects from the general population, with no history or clinical evidence of retinal vascular disease, recruited during the same 2-year period. High fasting homocystinemia (higher than 15 mumol/L) was detected in 24/49 subjects (48.9%) (P < .0005). There was a high prevalence of hyperhomocystinemia: these data suggest an association between RVOD and high fasting homocystinemia. Elevated homocysteine may be an independent risk factor, and its assessment may be important in the investigation, management, and follow-up of patients with RVOD. Further controlled studies are necessary to clarify the exact role of hyperhomocystinemia in RVOD and to evaluate the appropriate therapeutic approach.


Assuntos
Hiper-Homocisteinemia/complicações , Oclusão da Artéria Retiniana/etiologia , Oclusão da Veia Retiniana/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos de Casos e Controles , Jejum , Feminino , Homocisteína/sangue , Humanos , Hiper-Homocisteinemia/sangue , Masculino , Pessoa de Meia-Idade , Prevalência , Oclusão da Artéria Retiniana/sangue , Oclusão da Veia Retiniana/sangue , Fatores de Risco , Trombofilia/sangue
10.
Thromb Res ; 117(6): 681-4, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16014310

RESUMO

INTRODUCTION: Inherited thrombophilia has been associated with unexplained recurrent pregnancy loss (RPL) and stillbirth. This thrombotic tendency can manifest as thrombotic lesions in the placenta, and may lead to abortion and stillbirth. The aim of our case-control study was to investigate the prevalence of FVL and FII G20210A in women with adverse pregnancy outcome, compared to the prevalence of the same mutations in our health control group. MATERIALS AND METHODS: 102 consecutive women with unexplained pregnancy loss (55 with history of RPL, and 47 with history of stillbirth) were studied for hereditary thrombophilia. The health control group consisted of 217 healthy women from the general population. RESULTS AND CONCLUSIONS: Of the 55 women with recurrent abortions, we found the same prevalence for the FVL and the FII G20210A(9.1%, 5 pts). (p=NS compared to control group). Of the 47 women with stillbirth, 11 (23.4%) had the FVL and 9 (19.1%) had the FII G20210A(p<0.0005 for both mutations). In our experience the prevalence of FVL and the FII G20210Amutations was significantly higher in women with unexplained stillbirth, instead the prevalence of genetic thrombophilia was high but not statistically significant in women with recurrent pregnancy loss.


Assuntos
Aborto Habitual/genética , Complicações na Gravidez/genética , Protrombina/genética , Trombofilia/complicações , Trombofilia/genética , Aborto Habitual/epidemiologia , Adulto , Estudos de Casos e Controles , Fator V/genética , Feminino , Humanos , Mutação , Gravidez , Complicações na Gravidez/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Natimorto
11.
Clin Appl Thromb Hemost ; 8(3): 213-5, 2002 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12361197

RESUMO

The aim of this report was to determine the frequency of thrombocytopenia in a cohort of 1,126 patients receiving oral anticoagulant therapy (OAT), and to compare the grade of thrombocytopenia and the severity of bleeding complications. Severe thrombocytopenia was observed in five patients, and moderate and light thrombocytopenia were observed in 208 patients. Thrombocytopenic patients receiving OAT presented five major and six minor hemorrhages. The presence of hepatitis markers and autoantibodies was assessed. All parameters at the time of the bleeding complication were in the therapeutic range.


Assuntos
Anticoagulantes/efeitos adversos , Trombocitopenia/induzido quimicamente , Administração Oral , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Autoanticorpos/sangue , Estudos de Coortes , Feminino , Hemorragia/induzido quimicamente , Hepatite B/etiologia , Hepatite C/etiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias
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