Blood Coagulation & Fibrinolysis最新文献

Concurrence of prothrombin nonneutralizing antibody and factor XI neutralizing inhibitor in lupus anticoagulant positive patient.

IF 1.2 4区医学

Blood Coagulation & Fibrinolysis Pub Date : 2025-04-04 DOI: 10.1097/MBC.0000000000001360

Ju Hyeong Lee, Ja-Yoon Gu, Junshik Hong, Kwon-Wook Joo, Eun Young Lee, Hyun Kyung Kim

{"title":"Concurrence of prothrombin nonneutralizing antibody and factor XI neutralizing inhibitor in lupus anticoagulant positive patient.","authors":"Ju Hyeong Lee, Ja-Yoon Gu, Junshik Hong, Kwon-Wook Joo, Eun Young Lee, Hyun Kyung Kim","doi":"10.1097/MBC.0000000000001360","DOIUrl":"https://doi.org/10.1097/MBC.0000000000001360","url":null,"abstract":"Isolated prothrombin antibody or isolated factor XI inhibitor have been reported separately in lupus-anticoagulant positive patients. We report the first case of a lupus-anticoagulant positive patient that both simultaneously occurred. A 30-year-old man with a history of systemic lupus erythematosus was positive for lupus-anticoagulant. He exhibited significantly high bleeding score compared to previous reports of lupus-anticoagulant positive patients with isolated prothrombin or factor XI deficiency. Examination via one-stage clotting assays revealed decreased levels of both prothrombin and factor XI. Factor parallelism was proven for prothrombin but not for factor XI. The factor XI inhibitor was quantified at 2.1 Bethesda units in the Bethesda assay, and antiprothrombin nonneutralizing antibody tested positive in ELISA. This study suggests that the concurrence of prothrombin nonneutralizing antibody and factor XI neutralizing inhibitor can aggravate bleeding tendency synergistically in lupus-anticoagulant positive patient. Bethesda assay or ELISA may be considered depending on the factor-parallelism in one-stage clotting assay.","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An atypical presentation of catastrophic antiphospholipid syndrome with refractoriness to treatment.

IF 1.2 4区医学

Blood Coagulation & Fibrinolysis Pub Date : 2025-04-01 Epub Date: 2025-01-29 DOI: 10.1097/MBC.0000000000001348

Shannon Zhang, Jesse Qiao

引用次数: 0

Effectiveness of different anticoagulation regimens in critically ill patients - experience from COVID 19 patients.

IF 1.2 4区医学

Blood Coagulation & Fibrinolysis Pub Date : 2025-04-01 Epub Date: 2025-03-06 DOI: 10.1097/MBC.0000000000001354

Igor Vasković, Marija Marković, Ivo Udovičić, Ljiljana Arsenović, Mihailo Stojić, Aleksandra Ignjatović, Dragana Jovanović, Vojislava Nešković

{"title":"Effectiveness of different anticoagulation regimens in critically ill patients - experience from COVID 19 patients.","authors":"Igor Vasković, Marija Marković, Ivo Udovičić, Ljiljana Arsenović, Mihailo Stojić, Aleksandra Ignjatović, Dragana Jovanović, Vojislava Nešković","doi":"10.1097/MBC.0000000000001354","DOIUrl":"10.1097/MBC.0000000000001354","url":null,"abstract":"This study compared the efficacy of therapeutic anticoagulation guided by anti-Xa levels vs. a D-dimer-based protocol in ICU patients with COVID-19. Given the heightened risk of thrombosis despite anticoagulation therapy in some cases, we hypothesised that anti-Xa measurement improves anticoagulation effectiveness and clinical outcomes in this population. We retrospectively analysed data from ICU patients at COVID Hospital Karaburma between April 2020 and December 2021. The primary outcome was the incidence of failed noninvasive ventilation necessitating intubation. Secondary endpoints included mortality rates, thromboembolic and bleeding complications, and anticoagulation effectiveness assessed by antifactor Xa activity. The analysis included 395 patients - 137 in the anti-Xa group and 258 in the D-dimer group. The D-dimer group showed a higher rate of failed noninvasive ventilation requiring intubation (65.7% vs. 50%, P = 0.009). The overall mortality was 48.3%, significantly higher in the D-dimer group (52.7%) compared to the anti-Xa group (40.1%, P = 0.02). Thromboembolic complications were lower in the anti-Xa group (2.9%) than in the D-dimer group (9.7%, P = 0.014), with no significant difference in bleeding. Following the first LMWH administration, 70.8% of patients had anti-Xa levels below the therapeutic and 11.7% below the prophylactic range. Anti-Xa-guided anticoagulation improves survival and reduces thromboembolic complications compared to D-dimer-based treatment without increasing bleeding risk. This study highlights the potential of the anti-Xa assay in managing anticoagulation in critically ill COVID-19 patients. Our findings provide a foundation for future research on using anti-Xa measurements as a guiding tool to optimise anticoagulation therapy in other critically ill populations.","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":"82-89"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An exceptional presentation of nephrotic syndrome: bilateral massive pulmonary embolism. 肾病综合征的特殊表现：双侧大面积肺栓塞。

IF 1.2 4区医学

Blood Coagulation & Fibrinolysis Pub Date : 2025-04-01 Epub Date: 2025-03-07 DOI: 10.1097/MBC.0000000000001353

Büşra Daştan İnce, Zeynelabidin Ozturk, Nilgün Eroğlu, Hasibe Gökçe Çinar, Bahriye Uzun Kenan, Ali Fettah

{"title":"An exceptional presentation of nephrotic syndrome: bilateral massive pulmonary embolism.","authors":"Büşra Daştan İnce, Zeynelabidin Ozturk, Nilgün Eroğlu, Hasibe Gökçe Çinar, Bahriye Uzun Kenan, Ali Fettah","doi":"10.1097/MBC.0000000000001353","DOIUrl":"10.1097/MBC.0000000000001353","url":null,"abstract":"Venous thromboembolism (TE) and arterial TE are rare in children, but can cause severe morbidity and mortality. The incidence of TE is 8.6-57 per 100 000 among hospitalized children and 0.14-0.9 per 100 000 in the general pediatric population. The risk of TE is increased in pediatric nephrotic syndrome (NS) patients. The incidence of thromboembolic complications in pediatric NS patients is approximately 3%. Herein we report a pediatric patient that presented with massive bilateral pulmonary embolism (PE) in whom the underlying condition was NS. At the onset of the clinical course the clinical findings were attributed to heart failure and, therefore, the diagnosis and treatment of NS was delayed. Based on the presented case, we think that clinicians should consider NS in pediatric patients with PE when hypoalbuminemia, diffuse edema, and massive proteinuria are present, and that timely initiation of NS treatment and concomitant administration of TE treatment can yield positive results. We further think that pediatric patients diagnosed with PE that have concomitant hypoalbuminemia, generalized edema, and massive proteinuria should be considered to have NS and that treatment for NS should be started without delay and concomitantly with TE treatment in order to achieve a positive result.","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":"113-116"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Concurrent hemophagocytic lymphohistiocytosis and thrombotic microangiopathy in a patient with Epstein-Barr virus infection and gastric adenocarcinoma: the puzzle started with microangiopathic hemolytic anemia.

IF 1.2 4区医学

Blood Coagulation & Fibrinolysis Pub Date : 2025-04-01 Epub Date: 2025-01-30 DOI: 10.1097/MBC.0000000000001349

Kehua Zhou, Aniqa Faraz, Yazhini Vallatharasu

{"title":"Concurrent hemophagocytic lymphohistiocytosis and thrombotic microangiopathy in a patient with Epstein-Barr virus infection and gastric adenocarcinoma: the puzzle started with microangiopathic hemolytic anemia.","authors":"Kehua Zhou, Aniqa Faraz, Yazhini Vallatharasu","doi":"10.1097/MBC.0000000000001349","DOIUrl":"10.1097/MBC.0000000000001349","url":null,"abstract":"Malignancy-associated-hemophagocytic lymphohistiocytosis (HLH) is rare and often seen in high-grade lymphomas and acute leukemias; solid-tumor-associated HLH is extremely uncommon. The diagnosis of malignancy-associated-HLH remains challenging in clinical practices as it masquerades as and coexists with many other conditions. Here we presented a case with concurrent solid-tumor-associated HLH and thrombotic microangiopathy. The patient was an 80-year-old male with microangiopathic hemolytic anemia (MAHA), progressive bi-lineage cytopenia, and active Epstein-Barr virus (EBV) infection. Extensive lab works excluded all other alternative etiologies for MAHA but B12 deficiency, malignancy, and EBV infection. Concurrently, poorly differentiated gastric adenocarcinoma-associated HLH and thrombotic microangiopathy (TMA) were confirmed with extensive lab work. This patient passed away despite high-dose dexamethasone treatment. In the paper, we also discussed the possible pathophysiology of EBV infection in the development of MAHA and HLH and reviewed the treatment options for HLH and TMA.","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":"108-112"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Time-in-therapeutic range falls as the target international normalized ratio range increases in patients on warfarin.

IF 1.2 4区医学

Blood Coagulation & Fibrinolysis Pub Date : 2025-04-01 Epub Date: 2025-02-05 DOI: 10.1097/MBC.0000000000001347

Imran Malik, Paul Priest, Ian Jennings, Keith Gomez

{"title":"Time-in-therapeutic range falls as the target international normalized ratio range increases in patients on warfarin.","authors":"Imran Malik, Paul Priest, Ian Jennings, Keith Gomez","doi":"10.1097/MBC.0000000000001347","DOIUrl":"10.1097/MBC.0000000000001347","url":null,"abstract":"The main objective was to assess whether the time-in-therapeutic range (TTR) in patients on warfarin is affected by the international normalized ratio (INR) range. We also evaluated whether the performance of the INR is negatively impacted as its absolute value increases. First, we extracted key performance indicators of the INR from 22 surveys of the UK National External Quality Assurance Scheme (NEQAS). We then analysed TTR in 6584 warfarin monitoring episodes that were categorized by range and indication. NEQAS surveys in which the sample INR was above 3.0 had more participants outwith consensus with higher coefficient of variation and standard error mean. The outwith consensus percentage was correlated with the mean reported INR value. In warfarinised patients, we found that the TTR was lower at INR ranges above the standard 2.0 to 3.0. We concluded that the performance of the INR assay decreases at higher values. Furthermore, increasing the INR range above the standard 2.0 to 3.0 in warfarinised patients has an adverse effect on TTR. This is important because the INR range may be increased to try and improve efficacy, whereas these data suggest that it may have the opposite effect.","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":"78-81"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

CRISPR/Cas9 mediated generation of zebrafish f9a mutant as a model for hemophilia B.

IF 1.2 4区医学

Blood Coagulation & Fibrinolysis Pub Date : 2025-04-01 Epub Date: 2025-03-19 DOI: 10.1097/MBC.0000000000001355

Sanchi Dhinoja, Ayah Al Qaryoute, Afnan Deebani, Anthony De Maria, Pudur Jagadeeswaran

{"title":"CRISPR/Cas9 mediated generation of zebrafish f9a mutant as a model for hemophilia B.","authors":"Sanchi Dhinoja, Ayah Al Qaryoute, Afnan Deebani, Anthony De Maria, Pudur Jagadeeswaran","doi":"10.1097/MBC.0000000000001355","DOIUrl":"10.1097/MBC.0000000000001355","url":null,"abstract":"Aim: This study aimed to develop a zebrafish model for hemophilia B by creating a f9a knockout, as f9a has previously demonstrated functional similarity to human Factor IX.Methods: Using CRISPR/Cas9 technology, two gRNAs targeting exon 8 of the f9a gene, were injected along with Cas9 protein into single-cell zebrafish wild-type embryos. DNA was harvested from the tail tips of the resulting adult zebrafish and screened for mutations using PCR. The founder mutant was crossed with wild-type fish to confirm heritability and subsequently reared to homozygosity. Homozygous mutants were analyzed through quantitative RT-PCR and Western blot to assess f9a RNA and F9a protein levels, respectively. Functional assays like kinetic partial thromboplastin time (kPTT), bleeding assay in adult mutants, and venous laser injury on mutant larvae were performed to assess the hemostatic role.Results: Around 61 adults from the CRISPR/Cas9 knockouts were screened, which resulted in a mutant line with a 72 bp deletion in the exon 8 encoding catalytic domain. Quantitative RT-PCR and Western Blot analysis showed reduced levels of f9a RNA and F9a protein in the homozygous mutants compared to wild-type siblings. At five dpf, f9a homozygous mutant larvae demonstrated prolonged venous occlusion times in a laser injury assay. Additionally, plasma from the mutants displayed delayed fibrin formation in kPTT assays and exhibited increased bleeding after mechanical injury.Conclusion: This study created a zebrafish f9a knockout model that mimics the bleeding phenotype observed in hemophilia B patients, which will be valuable for evaluating novel therapeutic approaches for hemophilia B.","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":"90-98"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Venous thromboembolism secondary prophylaxis in elderly people (over 75 years old) with low-dose direct oral anticoagulants.

IF 1.2 4区医学

Blood Coagulation & Fibrinolysis Pub Date : 2025-04-01 Epub Date: 2025-04-04 DOI: 10.1097/MBC.0000000000001350

Hinpetch Daungsupawong, Viroj Wiwanitkit

引用次数: 0

Impact of cytochrome P-450 3A4 enzyme/P-glycoprotein inducing antiseizure medications on direct oral anticoagulant therapy.

IF 1.2 4区医学

Blood Coagulation & Fibrinolysis Pub Date : 2025-04-01 Epub Date: 2025-01-22 DOI: 10.1097/MBC.0000000000001342

Sean M McNary, Madalyn Kuhlenberg, Lucia F Basilio, Nathan P Clark, Rita L Hui, Fang Niu, Thomas Delate

{"title":"Impact of cytochrome P-450 3A4 enzyme/P-glycoprotein inducing antiseizure medications on direct oral anticoagulant therapy.","authors":"Sean M McNary, Madalyn Kuhlenberg, Lucia F Basilio, Nathan P Clark, Rita L Hui, Fang Niu, Thomas Delate","doi":"10.1097/MBC.0000000000001342","DOIUrl":"10.1097/MBC.0000000000001342","url":null,"abstract":"Objectives: Concomitant use of cytochrome P-450 and P-glycoprotein (CYP 3A4/P-gp) inducing antiseizure medications and direct oral anticoagulants (DOAC) may result in reduced DOAC effectiveness, but study results are inconsistent and of variable quality. The purpose of this study was to assess the safety of concomitant CYP 3A4/P-gp inducing antiseizure medications and DOAC use.Methods: This was a retrospective cohort study of adult patients who were newly, concomitantly receiving a DOAC (apixaban, dabigatran, or rivaroxaban) and either a CYP 3A4/P-gp inducer (carbamazepine, phenytoin, phenobarbital, or primidone) or noninducer (gabapentin). The primary outcome was the occurrence of a thromboembolic complication, defined as the composite of ischemic stroke and systemic embolism (S/SE) and venous thromboembolism (VTE). Secondary outcomes included the components of the primary composite as well as all-cause mortality and clinically relevant bleeding. Adjusted multivariate proportional hazards modeling was used to compare outcomes for each DOAC individually in the inducer and noninducer groups.Results: There were 1843 and 14 647 patients who received a DOAC plus a CYP3A4/P-gp inducer and noninducer, respectively. Overall, patients were primarily older, white, had atrial fibrillation, and were dispensed dabigatran. After adjustment, there were no statistically significant differences in the primary outcome between the groups ( P > 0.05); however, concomitant inducer and DOAC use was associated with an increased risk of all-cause mortality ( P < 0.05).Conclusions: No excess risk of thrombosis during concomitant use of DOACs with CYP3A4/P-gp inducing antiseizure medications compared to use with gabapentin was identified. Further research is needed to confirm an association with excess all-cause mortality.","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":"71-77"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coincidental occurrence of severe factor XII deficiency in a case of mild hemophilia A: a unique coagulation laboratory diagnostic conundrum.

IF 1.2 4区医学

Blood Coagulation & Fibrinolysis Pub Date : 2025-04-01 Epub Date: 2025-01-24 DOI: 10.1097/MBC.0000000000001346

Bipin P Kulkarni, Chandrakala Shanmukhaiah, Kirti Ghargi, Puloma Pandey, Shruti Kharat, Prachi Pawar, Sayali Shinde, Nikesh Kawankar, Sharda Shanbhag

引用次数: 0