Research and Practice in Thrombosis and Haemostasis最新文献

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Impact of the VTE-PREDICT calculator on clinicians’ decision making in fictional patients with venous thromboembolism: a randomized controlled trial VTE-PREDICT 计算器对临床医生为静脉血栓栓塞症虚构患者做出决策的影响:随机对照试验
IF 3.4 3区 医学
Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-10-01 DOI: 10.1016/j.rpth.2024.102569
Daniël Duijzer , Maria A. de Winter , Marc Carrier , Alexander T. Cohen , John-Bjarne Hansen , Karin A.H. Kaasjager , Ajay K. Kakkar , Saskia Middeldorp , Henrik T. Sørensen , Frank L.J. Visseren , Philip S. Wells , Jannick A.N. Dorresteijn , Mathilde Nijkeuter
{"title":"Impact of the VTE-PREDICT calculator on clinicians’ decision making in fictional patients with venous thromboembolism: a randomized controlled trial","authors":"Daniël Duijzer ,&nbsp;Maria A. de Winter ,&nbsp;Marc Carrier ,&nbsp;Alexander T. Cohen ,&nbsp;John-Bjarne Hansen ,&nbsp;Karin A.H. Kaasjager ,&nbsp;Ajay K. Kakkar ,&nbsp;Saskia Middeldorp ,&nbsp;Henrik T. Sørensen ,&nbsp;Frank L.J. Visseren ,&nbsp;Philip S. Wells ,&nbsp;Jannick A.N. Dorresteijn ,&nbsp;Mathilde Nijkeuter","doi":"10.1016/j.rpth.2024.102569","DOIUrl":"10.1016/j.rpth.2024.102569","url":null,"abstract":"<div><h3>Background</h3><div>After 3 months of anticoagulation for venous thromboembolism (VTE), the decision needs to be made whether to stop anticoagulation or extend treatment indefinitely. The VTE-PREDICT calculator can be used to estimate individual risks of VTE recurrence and bleeding to guide this decision.</div></div><div><h3>Objectives</h3><div>To evaluate the impact of predicted individual risks of recurrence and bleeding on clinicians’ decisions on anticoagulation duration and to assess usefulness of the VTE-PREDICT calculator.</div></div><div><h3>Methods</h3><div>A randomized controlled trial and within-subject study was conducted among clinicians treating VTE patients. The clinicians were asked to complete an online survey containing 6 fictional case vignettes. Group A proposed anticoagulant duration for each case without additional information first and subsequently after seeing calculator-predicted risks (within-subject analysis). Group B was directly provided with calculator risks and proposed treatment duration for each case vignette (for comparison with group A results in a randomized controlled trial analysis). Then, group B received questions on usefulness and credibility of the calculator.</div></div><div><h3>Results</h3><div>Forty-five clinicians were assigned to group A and 48 to B. Overall, group A did not propose different anticoagulation durations than group B. However, individual clinicians in group A changed proposed duration in 35% of the cases after seeing the calculator risks. The calculator was considered useful and credible by most clinicians.</div></div><div><h3>Conclusion</h3><div>Overall, use of the VTE-PREDICT calculator did not affect proposed anticoagulation duration. However, individual clinicians frequently changed their proposed duration after using the calculator, especially for patients with high bleeding risk.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"8 7","pages":"Article 102569"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How to treat patients with bleeding disorder of unknown cause? 如何治疗原因不明的出血性疾病患者?
IF 3.4 3区 医学
Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-10-01 DOI: 10.1016/j.rpth.2024.102585
Caroline Mussert , Amaury Monard , Floor Heubel-Moenen
{"title":"How to treat patients with bleeding disorder of unknown cause?","authors":"Caroline Mussert ,&nbsp;Amaury Monard ,&nbsp;Floor Heubel-Moenen","doi":"10.1016/j.rpth.2024.102585","DOIUrl":"10.1016/j.rpth.2024.102585","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"8 7","pages":"Article 102585"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Balancing safety and efficacy of low-molecular-weight heparins in neonates: a systematic review 平衡新生儿使用低分子量肝素的安全性和有效性:系统综述
IF 3.4 3区 医学
Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-10-01 DOI: 10.1016/j.rpth.2024.102601
Marieke Verweij , Mirjam M. van Weissenbruch , Irene L.M. Klaassen
{"title":"Balancing safety and efficacy of low-molecular-weight heparins in neonates: a systematic review","authors":"Marieke Verweij ,&nbsp;Mirjam M. van Weissenbruch ,&nbsp;Irene L.M. Klaassen","doi":"10.1016/j.rpth.2024.102601","DOIUrl":"10.1016/j.rpth.2024.102601","url":null,"abstract":"<div><div>The rising incidence of venous thromboembolism (VTE) in neonates has led to increased use of low-molecular-weight heparins (LMWHs), but optimal dosages remain uncertain. A serious adverse effect of LMWHs is major bleeding. Given the vulnerability of neonates to major bleeding, we aimed to review therapeutic and prophylactic LMWH dosages to achieve target anti-factor Xa ranges of 0.5 and 1.0 U/mL and 0.1 and 0.4 U/mL, respectively. Our secondary aim was to assess the safety and efficacy of LMWHs in neonates. A systematic review of all published studies between 1996 and 2023 that pertained to the dosing, safety, or efficacy of LMWH in preterm and term neonates. Studies were identified through the Medline database. Data on LMWH dosages, bleeding events, resolution and recurrence, and anti-factor Xa levels were analyzed. A total of 38 studies involving 1145 neonates were included. To achieve a therapeutic or prophylactic target range, weight-adjusted initial dosages of LMWH had to be increased by 21% particularly in premature neonates. During therapeutic therapy, major bleeding occurred in 4.1% and minor bleeding in 7.1%. During prophylactic therapy, 11.4% experienced major bleeding and 17.1% minor bleeding. With therapeutic dosages, 55.8% achieved complete VTE resolution. Additionally, 68.5% of neonates initially failed to achieve therapeutic anti-factor Xa levels, persisting in 29.4% despite dose adjustments. A higher initial therapeutic dosage of LMWHs may be needed in neonates. In addition, the patient’s gestational age must be considered in the dosing strategy to optimize outcomes. Although this must be weighed against bleeding risk at an individual level.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"8 7","pages":"Article 102601"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142653585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corrigendum to ‘Hand grip strength and risk of incident venous thromboembolism: The Tromsø study’ 手部握力与静脉血栓栓塞症发病风险:特罗姆瑟研究
IF 3.4 3区 医学
Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-10-01 DOI: 10.1016/j.rpth.2024.102621
Oda G.R. Leknessund BSc , Vania M. Morelli MD PhD , Bjørn Heine Strand , John-Bjarne Hansen MD PhD , Sigrid K. Brækkan PhD
{"title":"Corrigendum to ‘Hand grip strength and risk of incident venous thromboembolism: The Tromsø study’","authors":"Oda G.R. Leknessund BSc ,&nbsp;Vania M. Morelli MD PhD ,&nbsp;Bjørn Heine Strand ,&nbsp;John-Bjarne Hansen MD PhD ,&nbsp;Sigrid K. Brækkan PhD","doi":"10.1016/j.rpth.2024.102621","DOIUrl":"10.1016/j.rpth.2024.102621","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"8 7","pages":"Article 102621"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multiple myeloma: retrospective assessment of routine thromboprophylaxis and utility of thrombotic risk scores 多发性骨髓瘤:常规血栓预防措施和血栓风险评分效用的回顾性评估
IF 3.4 3区 医学
Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-10-01 DOI: 10.1016/j.rpth.2024.102571
Omar Eduardo Fernandez-Vargas, Isabel Amezcua, Beatriz Cabello, Andrea Quintana Martinez, Ramiro Espinoza, Gabriela Cesarman-Maus
{"title":"Multiple myeloma: retrospective assessment of routine thromboprophylaxis and utility of thrombotic risk scores","authors":"Omar Eduardo Fernandez-Vargas,&nbsp;Isabel Amezcua,&nbsp;Beatriz Cabello,&nbsp;Andrea Quintana Martinez,&nbsp;Ramiro Espinoza,&nbsp;Gabriela Cesarman-Maus","doi":"10.1016/j.rpth.2024.102571","DOIUrl":"10.1016/j.rpth.2024.102571","url":null,"abstract":"<div><h3>Background</h3><div>The high risk of venous thromboembolism (VTE) in multiple myeloma (MM) warrants primary thromboprophylaxis for most patients. Myeloma-specific thrombotic risk scores (TRSs), such as IMPEDE-VTE, SAVED, and PRISM, were developed to improve risk assessment and guide antithrombotic strategies. Their performance is variable and has not yet been tested in Latin America.</div></div><div><h3>Objectives</h3><div>We aimed to assess the use of primary thromboprophylaxis, the incidence of VTE and bleeding events, and the effectiveness of TRSs in patients with newly diagnosed MM.</div></div><div><h3>Methods</h3><div>This was a retrospective, single-center study. Cumulative VTE rates and TRS performance were analyzed using survival and receiver operating characteristic curves.</div></div><div><h3>Results</h3><div>The study included 250 newly diagnosed MM patients; the vast majority (98.6%) received aspirin as thromboprophylaxis. VTE occurred in 8% within the initial 6 months, increasing to 14.8% over a median follow-up of 19 months. High rates of major bleeding (4.8%) and clinically relevant nonmajor bleeding (4.4%) events were documented. A minimal proportion (0.8%, 0.5%, and 1.2%) of patients were classified as low risk by IMPEDE-VTE, PRISM, and SAVED scores, respectively. Only IMPEDE-VTE exhibited a trend for distinguishing between intermediate-risk (7.14%) and high-risk (13.2%) groups (<em>P</em> = .09). PRISM and SAVED scores showed limited utility. VTE did not impact survival.</div></div><div><h3>Conclusion</h3><div>Aspirin as primary thromboprophylaxis carries an unacceptable risk of VTE and bleeding in patients at intermediate or high thrombotic risk. The IMPEDE-VTE score performed best, although without reaching statistical significance. We confirm that VTE does not portend poor overall survival in MM.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"8 7","pages":"Article 102571"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hyperfibrinolysis: a crucial phenotypic abnormality of posttraumatic fibrinolytic dysfunction 纤溶亢进:创伤后纤溶功能障碍的关键表型异常
IF 3.4 3区 医学
Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-10-01 DOI: 10.1016/j.rpth.2024.102568
Kyosuke Takahashi , Kazuma Yamakawa , Anaar E. Siletz , Morihiro Katsura , John B. Holcomb , Charles E. Wade , Jessica C. Cardenas , Erin E. Fox , Morgan Schellenberg , Matthew Martin , Kenji Inaba , Kazuhide Matsushima
{"title":"Hyperfibrinolysis: a crucial phenotypic abnormality of posttraumatic fibrinolytic dysfunction","authors":"Kyosuke Takahashi ,&nbsp;Kazuma Yamakawa ,&nbsp;Anaar E. Siletz ,&nbsp;Morihiro Katsura ,&nbsp;John B. Holcomb ,&nbsp;Charles E. Wade ,&nbsp;Jessica C. Cardenas ,&nbsp;Erin E. Fox ,&nbsp;Morgan Schellenberg ,&nbsp;Matthew Martin ,&nbsp;Kenji Inaba ,&nbsp;Kazuhide Matsushima","doi":"10.1016/j.rpth.2024.102568","DOIUrl":"10.1016/j.rpth.2024.102568","url":null,"abstract":"<div><h3>Background</h3><div>Traumatic fibrinolytic dysfunction is often categorized into 3 phenotypes based on the result of thromboelastography (TEG) lysis at 30 minutes (LY30): fibrinolysis shutdown, physiologic fibrinolysis, and hyperfibrinolysis. However, the molecular pathophysiology of fibrinolytic dysfunction and the association with clinical outcomes have not been fully evaluated.</div></div><div><h3>Objectives</h3><div>To assess whether posttraumatic fibrinolysis phenotypes identified by TEG correlate with levels of key fibrinolysis-related serum markers and with risk of mortality and hospital complications.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of the Pragmatic, Randomized Optimal Platelet and Plasma Ratios trial. Patients were stratified according to the degree of fibrinolysis upon arrival using TEG LY30 values: low LY30, &lt;0.8%; normal LY30, 0.81% to 0.9%; and high LY30, ≥3%. Serial values of molecular markers (0-72 hours after admission) and clinical outcomes were compared between fibrinolysis groups.</div></div><div><h3>Results</h3><div>A total of 547 patients were included (low LY30, 320; normal LY30, 108; high LY30, 119). The high LY30 group had higher tissue plasminogen activator and plasmin-antiplasmin values upon hospital arrival than the low LY30 or normal LY30 groups (<em>P</em> &lt; .001, respectively). There was no significant difference in levels of tissue plasminogen activator, plasmin-antiplasmin, and plasminogen activator inhibitor 1 between the low LY30 and normal LY30 groups. The high LY30 group was associated with an increased risk of 24-hour and 30-day mortality, while there was no significant difference in mortality between the low LY30 and normal LY30 groups.</div></div><div><h3>Conclusion</h3><div>Our results suggest that hyperfibrinolysis is the most common form of traumatic fibrinolytic dysfunction and is associated with worse outcome.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"8 7","pages":"Article 102568"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparable hemostatic capacity of blood taken from the portal vein compared with systemic blood in patients with cirrhosis 肝硬化患者门静脉血液与全身血液的止血能力相当
IF 3.4 3区 医学
Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-10-01 DOI: 10.1016/j.rpth.2024.102583
Annabel Blasi , Andrea Calvo , Ricard Mellado , Miguel Angel Torrente , Fanny Turon , Juan Carlos Garcia-Pagan , Virginia Hernandez-Gea , Dolors Tassies , Joan Carles Reverter , Ton Lisman
{"title":"Comparable hemostatic capacity of blood taken from the portal vein compared with systemic blood in patients with cirrhosis","authors":"Annabel Blasi ,&nbsp;Andrea Calvo ,&nbsp;Ricard Mellado ,&nbsp;Miguel Angel Torrente ,&nbsp;Fanny Turon ,&nbsp;Juan Carlos Garcia-Pagan ,&nbsp;Virginia Hernandez-Gea ,&nbsp;Dolors Tassies ,&nbsp;Joan Carles Reverter ,&nbsp;Ton Lisman","doi":"10.1016/j.rpth.2024.102583","DOIUrl":"10.1016/j.rpth.2024.102583","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"8 7","pages":"Article 102583"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safety and efficacy of direct oral anticoagulants in chronic kidney disease: a meta-analysis 直接口服抗凝剂对慢性肾病的安全性和疗效:荟萃分析
IF 3.4 3区 医学
Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-10-01 DOI: 10.1016/j.rpth.2024.102584
Daniel Tham , Lucy Zhao , Wenhui Yu , Jayhan Kherani , Roger Kou , Allen Li , Pei Ye Li , Ali Eshaghpour , Mark Andrew Crowther
{"title":"Safety and efficacy of direct oral anticoagulants in chronic kidney disease: a meta-analysis","authors":"Daniel Tham ,&nbsp;Lucy Zhao ,&nbsp;Wenhui Yu ,&nbsp;Jayhan Kherani ,&nbsp;Roger Kou ,&nbsp;Allen Li ,&nbsp;Pei Ye Li ,&nbsp;Ali Eshaghpour ,&nbsp;Mark Andrew Crowther","doi":"10.1016/j.rpth.2024.102584","DOIUrl":"10.1016/j.rpth.2024.102584","url":null,"abstract":"<div><h3>Background</h3><div>Direct oral anticoagulants (DOACs) have emerged as the first-line therapy for venous thromboembolism and stroke prophylaxis in atrial fibrillation. As DOACs are partially excreted renally, their safety in patients with chronic kidney disease (CKD) is unclear.</div></div><div><h3>Objectives</h3><div>To synthesize primary evidence on the safety profile of DOACs in patients with CKD.</div></div><div><h3>Methods</h3><div>We searched MEDLINE and Embase from inception to June 2023 for randomized and nonrandomized cohort studies comparing DOACs with vitamin K antagonists (VKAs) in CKD patients. Screening and data collection were conducted in duplicate. The primary safety outcome was major bleeding, defined by International Society on Thrombosis and Haemostasis criteria, stratified by CKD severity. Meta-analysis was done using the Mantel–Haenszel random-effects model, presented as odds ratios (ORs) with corresponding 95% CIs.</div></div><div><h3>Results</h3><div>Of the 2355 articles captured in the literature search, 25 nonrandomized studies (<em>n</em> = 6832) and 6 randomized studies (<em>n</em> = 66,898) were included. DOACs reduced major bleeding compared with VKAs in all subgroups (stage 4: OR, 0.73; 95% CI, 0.58, 0.93; stage 5/renal replacement therapy: OR, 0.70; 95% CI, 0.50, 0.98; stage unspecified: OR, 0.72; 95% CI, 0.63, 0.83). Apixaban and rivaroxaban both reduced major bleeding in stage 5/renal replacement therapy patients (apixaban: OR, 0.66; 95% CI, 0.52, 0.85; rivaroxaban: OR, 0.58; 95% CI, 0.35, 0.94).</div></div><div><h3>Conclusion</h3><div>In this meta-analysis, DOACs reduced major bleeding compared with VKAs in stage 4, stage 5/renal replacement therapy, and CKD stage unspecified patients. Future analysis should evaluate the impact of specific DOACs and dosage on safety and efficacy in this population.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"8 7","pages":"Article 102584"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A cluster of pediatric vaccine-induced immune thrombotic thrombocytopenia–like cases with thrombosis and thrombocytopenia following respiratory infections—case series 呼吸道感染后血栓形成和血小板减少的小儿疫苗诱发免疫性血栓性血小板减少症样病例群--病例系列
IF 3.4 3区 医学
Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-10-01 DOI: 10.1016/j.rpth.2024.102589
Dimitra Dimopoulou , Lida Mentesidou , Athina Dettoraki , Christina Karastathi , Maria Berikopoulou , Panagiota Katsouli , Ioanna Anastasopoulou , Iason G. Stamatakis , Theodora Bachou , Flora Tzifi , Aikaterini Michalopoulou , Anna Messaritaki , Vana Spoulou , Helen Pergantou
{"title":"A cluster of pediatric vaccine-induced immune thrombotic thrombocytopenia–like cases with thrombosis and thrombocytopenia following respiratory infections—case series","authors":"Dimitra Dimopoulou ,&nbsp;Lida Mentesidou ,&nbsp;Athina Dettoraki ,&nbsp;Christina Karastathi ,&nbsp;Maria Berikopoulou ,&nbsp;Panagiota Katsouli ,&nbsp;Ioanna Anastasopoulou ,&nbsp;Iason G. Stamatakis ,&nbsp;Theodora Bachou ,&nbsp;Flora Tzifi ,&nbsp;Aikaterini Michalopoulou ,&nbsp;Anna Messaritaki ,&nbsp;Vana Spoulou ,&nbsp;Helen Pergantou","doi":"10.1016/j.rpth.2024.102589","DOIUrl":"10.1016/j.rpth.2024.102589","url":null,"abstract":"<div><h3>Background</h3><div>Adenoviral vector COVID-19 vaccine-induced immune thrombotic thrombocytopenia (VITT) is a heparin-independent platelet-activating disorder. An increasing number of VITT-like disorders without previous vaccination are being identified.</div></div><div><h3>Key Clinical Question</h3><div>To explore the association of the pediatric cluster of postinfectious thrombosis and thrombocytopenia with VITT-like disorders.</div></div><div><h3>Clinical Approach</h3><div>Three children with severe thrombocytopenia, coagulopathy, elevated D-dimer, and thrombotic events (cerebral venous sinus thrombosis) were reported. Two had positive nasopharyngeal samples for adenovirus, and 1 had group A streptococcus infection. They all had a COVID-19 history and low-risk antiphospholipid syndrome. Heterozygosity for factor V Leiden was found in 2 children. In 2 patients for whom anti–platelet factor 4 (PF4) serology was performed, positive results were found by PF4/polyanion lateral-flow immunoassay but negative results by PF4/polyanion chemiluminescence immunoassay. All patients were treated with enoxaparin or fondaparinux and intravenous immunoglobulin, while 3 received platelets transfusion and steroids.</div></div><div><h3>Conclusion</h3><div>This cluster of pediatric cases with thrombosis and thrombocytopenia may indicate a postinfectious (most notably, postadenovirus) VITT-like disorder.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"8 7","pages":"Article 102589"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical characteristics, treatment, and outcomes of provoked acute cerebral sinovenous thrombosis in patients <21 years old: findings from the Kids-DOTT Multinational Trial 21 岁以下患者急性脑静脉血栓形成的临床特征、治疗和预后:Kids-DOTT 多国试验的发现
IF 3.4 3区 医学
Research and Practice in Thrombosis and Haemostasis Pub Date : 2024-10-01 DOI: 10.1016/j.rpth.2024.102605
Gary M. Woods , Alexandra Miller , Maua Mosha , Christoph Male , Anupam Verma , Nicole Kucine , Christine Sabapathy , Kisha Beg , Sanjay Ahuja , Deepti Raybagkar , Kerry Hege , Clara Lo , Rukhmi Bhat , Thomas Abshire , Neil A. Goldenberg
{"title":"Clinical characteristics, treatment, and outcomes of provoked acute cerebral sinovenous thrombosis in patients <21 years old: findings from the Kids-DOTT Multinational Trial","authors":"Gary M. Woods ,&nbsp;Alexandra Miller ,&nbsp;Maua Mosha ,&nbsp;Christoph Male ,&nbsp;Anupam Verma ,&nbsp;Nicole Kucine ,&nbsp;Christine Sabapathy ,&nbsp;Kisha Beg ,&nbsp;Sanjay Ahuja ,&nbsp;Deepti Raybagkar ,&nbsp;Kerry Hege ,&nbsp;Clara Lo ,&nbsp;Rukhmi Bhat ,&nbsp;Thomas Abshire ,&nbsp;Neil A. Goldenberg","doi":"10.1016/j.rpth.2024.102605","DOIUrl":"10.1016/j.rpth.2024.102605","url":null,"abstract":"<div><h3>Background</h3><div>Prospective multicenter data on the treatment and outcomes of children with cerebral sinovenous thrombosis (CSVT) are limited. We aimed to describe the clinical characteristics, treatment strategies, and outcomes of patients with a first-episode of provoked acute CSVT enrolled in the Kids-DOTT trial and compare these features with those of participants with non-CSVT venous thromboembolism (VTE).</div></div><div><h3>Methods</h3><div>This was a subgroup analysis from the Kids-DOTT trial, a multinational randomized clinical trial on duration of anticoagulation for provoked acute VTE in patients younger than 21 years. Patient and thrombus characteristics, treatments, and outcomes of patients diagnosed with CSVT were compared with those of patients with non-CSVT VTE.</div></div><div><h3>Results</h3><div>CSVT was diagnosed in 75 of the 532 (14%), 25 of whom received 6 weeks of anticoagulant treatment and 50 received 3 or more months. When compared with non-CSVT VTE, CSVT was more likely to occur in neonates and young children, associated with infection in general and acute head/neck infection in particular, and less likely to be related to central venous catheter. No patient in either group developed symptomatic recurrent VTE or clinically relevant bleeding, and there was no significant difference in rates of complete thrombus resolution between the 2 treatment durations.</div></div><div><h3>Conclusion</h3><div>CSVT is most common in neonates and young children and those with acute head and neck infections. A 6-week anticoagulation treatment course appears to be safe (no clinically relevant bleeding) and effective (no difference in symptomatic recurrent VTE) for provoked acute pediatric CSVT. Nevertheless, given the nature of a subpopulation analysis, these findings should be interpreted with caution.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"8 7","pages":"Article 102605"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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