RESUMO
Hypercoagulable states are characterized by an increased risk for developing venous and arterial thrombosis. This situation is the consequence of inbalance of the hemostatic activity (fibroinformation > fibrinolysis). Primary and secondary hypercoagulable states are reviewed and clinical situations mandatory for a laboratory evaluation are discussed.
Assuntos
Trombose/sangue , Trombose/etiologia , Deficiência de Antitrombina III , Deficiência de Proteína C , Deficiência de Proteína S/complicações , Fatores de Risco , Trombose/fisiopatologiaAssuntos
Síndrome da Imunodeficiência Adquirida/complicações , Linfoma de Burkitt/complicações , Soropositividade para HIV/complicações , Síndrome da Imunodeficiência Adquirida/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma de Burkitt/tratamento farmacológico , Linfoma de Burkitt/imunologia , Soropositividade para HIV/imunologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
In this prospective study, antithrombin III, plasminogen and alpha 2 antiplasmin which are synthetised by the liver were measured and compared with the Normotest, Thrombotest and fibrinogen concentrations in 92 consecutive jaundiced patients. Antithrombin III appeared to be the most discriminant coagulation test in differentiating hepatocellular from cholestatic jaundice. A high correlation was observed between antithrombin III, plasminogen and alpha 2 antiplasmin values suggesting that the liver synthesis of these parameters was closely linked. The prognostic significance of the blood coagulation tests in patients with jaundice has been studied. In parenchymatous liver disease, antithrombin III, plasminogen and alpha 2 antiplasmin were superior to the Normotest, Thrombotest and fibrinogen concentrations in predicting the prognosis of the patients at the time of admission. In cholestatic jaundice, however, none of the blood coagulation tests studied had a prognostic significance.
Assuntos
Antitrombina III/análise , Icterícia/sangue , Plasminogênio/análise , alfa 2-Antiplasmina/análise , Adulto , Idoso , Testes de Coagulação Sanguínea , Colestase/sangue , Feminino , Fibrinogênio/análise , Humanos , Icterícia/etiologia , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos ProspectivosRESUMO
Biochemical tests (serum glutamic pyruvic transaminase, serum glutamic oxaloacetic transaminase, alkaline phosphatase, gammaglutamyltranspeptidase, bilirubin, and serum amylase) were performed upon admission in 84 patients with suspected (36) or proven (48) acute pancreatitis at the time of the first episode of acute abdominal pain suspected clinically as acute pancreatitis. These parameters all increased significantly more in patients with gallstone pancreatitis. Among them, the SGPT was the most discriminant test between biliary and nonbiliary pancreatitis. The positive predictive value of SGPT was 92%, when the cutoff point was chosen at twice the upper limit of normal. In patients with increased SGPT, a SGOT-SGPT ratio less than 1 is the rule (88%) for those with gallstone pancreatitis. This enzymatic determination allowed us to select more accurately the patients suitable for morphological procedures to confirm the biliary origin of the pancreatitis.
Assuntos
Colelitíase/complicações , Pancreatite/diagnóstico , Doença Aguda , Alanina Transaminase/sangue , Alcoolismo/complicações , Fosfatase Alcalina/sangue , Amilases/sangue , Aspartato Aminotransferases/sangue , Bilirrubina/sangue , Diagnóstico Diferencial , Humanos , Pancreatite/sangue , Pancreatite/etiologia , Estudos Prospectivos , Fatores de Tempo , gama-Glutamiltransferase/sangueRESUMO
The transfer test (TT) measures by means of thromboelastography the capacity of a plasma to shorten the coagulation time of a control plasma. The value of the TT was compared to that of fibrin(ogen), degradation products (FDP), and ethanol gelatin test (EGT) in various diseases (group I), in confirmed deep venous thrombosis (group II), and in confirmed pulmonary embolism (group III). In 211 consecutive patients admitted for various diseases the results of the TT, FDP, and EGT were abnormal in 12.3, 11.3, and 66.6%, respectively, of the cases. In 59 consecutive patients with deep venous thrombosis confirmed by radiological phlebography the results of TT, FDP, and EGT were abnormal at admission time in 96.6, 89.8, and 44%, respectively, of the cases. In 45 consecutive patients with pulmonary embolism confirmed by lung scintigraphy the results of TT, FDP, and EGT were abnormal at admission time in 97.7, 97.6, and 88%, respectively, of the cases. Among the three parameters which were evaluated, the TT seems to be the most sensitive screening procedure for thrombotic diseases. A normal result of TT is a strong argument against a recent thrombotic venous phenomenon.
Assuntos
Embolia Pulmonar/diagnóstico , Tromboelastografia/métodos , Tromboflebite/diagnóstico , Doença Aguda , Adolescente , Adulto , Idoso , Testes de Coagulação Sanguínea , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Insuficiência Cardíaca/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Pancreatite/sangue , Embolia Pulmonar/sangue , Tromboflebite/sangueRESUMO
Blood and urine samples of 37 patients hospitalized with a proved diagnosis of acute pancreatitis are reviewed. Value of serum glutamic transaminase activity is the best discriminator between biliary and non biliary pancreatitis (p less than 0.0025). Hypercoagulability is very often observed but there is no correlation between the importance of this abnormality and the severity of the disease. No single specific marker of the prognostic is identified.
