Does the evaluation of coagulation factors contribute to etiological diagnosis of pleural effusions?
Clinics
; Clinics;64(9): 891-895, 2009. graf
Article
in En
| LILACS
| ID: lil-526329
Responsible library:
BR1.1
ABSTRACT
OBJECTIVE:
The aim of this study was to identify the participation of the coagulation system in the differential diagnosis of pleural effusions.INTRODUCTION:
Imbalance between immunologic and metabolic factors triggers a sequence of events resulting in pleural reactions and accumulation of fluid. The coagulation system, which is fundamental for the maintenance of homeostasis, contributes to the inflammatory process responsible for pleural effusions, and participates in cellular proliferation and migration as well as in the synthesis of inflammatory mediators.METHODS:
We evaluated the laboratory profile of coagulation and fibrinolysis in 54 pleural fluids (15 transudates and 39 exudates).RESULTS:
The coagulation system acts according to the pathophysiologic mechanisms involved in the development of pleural effusions. In inflammatory effusions (exudates), there is activation of coagulation with increased levels of fragment 1+2 and thrombin-antithrombin complex in addition to reduction of fibrinogen levels due to fibrinolysis and fibrin tissue incorporation. As a consequence, there is activation of the fibrinolytic system with increased levels of fibrin degradation products, including the D-dimer. These changes are not sufficient for differentiation of different subgroups of exudates. In transudates, these events were observed to a lesser degree.CONCLUSION:
The coagulation system plays an important role in the development of pleural diseases. Coagulation tests show differences between transudates and exudates but not among exudate subgroups. Understanding the physiopathological mechanisms of pleural disorders may help to define new diagnostic and therapeutic approaches.Key words
Full text:
1
Collection:
01-internacional
Database:
LILACS
Main subject:
Pleural Effusion
/
Blood Coagulation
/
Fibrinolysin
/
Exudates and Transudates
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Clinics
Journal subject:
MEDICINA
Year:
2009
Document type:
Article
Affiliation country:
Brazil
Country of publication:
Brazil