BibTex RIS Kaynak Göster

Protein C pathway and antithrombin in thrombosis-related gastrointestinal disorders

Yıl 2010, Cilt: 9 Sayı: 2, 48 - 54, 01.08.2010

Öz

Background and Aims: We aimed to determine the frequency of activated protein C resistance and deficiencies of protein C, protein S and antithrombin in different gastrointestinal diseases (portal vein thrombosis, Budd-Chiari syndrome, liver cirrhosis, inflammatory bowel disease and gastrointestinal malignancies), which related with thrombosis etiologically and/or pathogenetically. Materials and Methods: Protein C, protein S and antithrombin activities were measured by functional methods. Activated protein C resistance was detected by the modified method using factor V-deficient plasma. Results: Protein C deficiency in the cirrhosis, malignancy and secondary portal vein thrombosis groups was significantly higher than in the other groups (p

Kaynakça

  • Harker LA. Disorders of hemostasis and thrombosis: Pathogenesis of thrombosis. In: Williams WJ, Beutler E, Erslev AJ, Lichtman MA, Eds. Hematology 4thed. New York, McGraw Hill 1991; 1559-69.
  • Handin RI. Bleeding and thrombosis. In: Fauci AS, Braunwald Eeds. Harrison’s Principles of Internal Medicine 14thed. New York, McGraw Hill 1998; 339-45.
  • Florell SR, Rodgers GM. Inherited thrombotic disorders: an update. Am J Hematol 1997; 54: 53-60.
  • Martinelli I, Mannuci PM, De Stefano V, et al. Different risks of thrombosis in four coagulation defects associated with inherited thrombophilia: a study of 150 families. Blood 1998; 92: 2353-8.
  • Murin S, Marelich G, Arroliga A, Matthay R. Hereditary thrombop- hilia and venous thromboembolism. Am J Respir Crit Care Med 1998; 158: 1369-73.
  • Dahlbäck B, Carlsson M, Svensson PJ. Familial thrombophilia due to a previously unrecognized mechanism characterized by poor an- ticoagulant response to activated protein C: prediction of a cofac- tor to activated protein C. Proc Natl Acad Sci USA 1993; 90: 1004- 8.
  • Bertina RM, Koeleman BPC, Koster T, et al. Mutation in blood co- agulation factor V associated with resistance to activated protein C. Nature 1994 ;369: 64-7.
  • Gürgey A, Mesci L. The prevalence of factor V Leiden (1691G-A) mutation in Turkey. Turk J Pediatr 1997; 39: 313-5.
  • Akar N, Akar E, Dalgın G, et al. Frequency of factor V Leiden (1691G-A) mutation in Turkish population. Thromb Haemost 1997; 78: 1527-8.
  • Özbek U, Tangün Y. Frequency of factor V Leiden in Turkey. Br J Haematol 1997; 97: 504-5.
  • Aboud MR, Ma DDF. A comparison between two activated prote- in C resistance methods as routine diagnostic tests for factor V Lei- den mutation. Br J Haematol 1997; 97: 798-803.
  • Tripodi A, Negri B, Bertina RM, Mannuci PM. Screening for the FV:Q506 mutation-evaluation of thirteen plasma-based methods for their diagnostic efficacy in comparison with DNA analysis. Thromb Haemost 1997; 77: 436-9.
  • Svensson PJ, Zöller B, Dahlbäck B. Evaluation of original and modi- fied APC-resistance tests in unselected outpatients with clinically suspected thrombosis and in healthy controls. Thromb Haemost 1997; 77: 332-5.
  • Parikh S, Shah R, Kapoor P. Portal vein thrombosis. Am J Med 2010; 123: 111-9.
  • Kelly DA, Tuddenham EGD. Haemostatic problems in liver disease. Gut 1986; 27: 339-49.
  • Bick RL, Strauss JF, Frenkel EP. Thrombosis and hemorrhage in on- cology patients. Hematol Oncol Clin North Am 1996; 10: 875-907.
  • Hudson M, Chitolie A, Hutton RA, et al. Thrombotic vascular risk factors in inflammatory bowel disease. Gut 1996; 38: 733-7.
  • Dhillon AP, Anthony A, Sim R, et al. Mucosal capillary thrombi in rectal biopsies. Histopathology 1992; 21: 127-33.
  • Michiels JJ, Hamulyak K. Laboratory diagnosis of hereditary throm- bophilia. Semin Thromb Hemost 1998; 24: 309-20.
  • Rees DC, Cox M, Clegg JB. World distribution of factor V Leiden. Lancet 1995; 346: 1133-4.
  • Thompson NP, Wakefield AJ, Pounder RE. Inherited disorders of coagulation appear to protect against inflammatory bowel disea- se. Gastroenterology 1995; 108: 1011-5.
  • Folwaczny C, Wiebecke B, Loeschke K. Unfractioned heparin in the therapy of patients with highly active inflammatory bowel disease. Am J Gastroenterol 1999; 94: 1551-5.
  • Liebman HA, Kashani N, Sutherland D, et al. The factor V Leiden mutation increases the risk of venous thrombosis in patients with inflammatory bowel disease. Gastroenterology 1998; 115: 830-4.
  • Probert CSJ, Haslam N, Alsam S, Standen G. Is factor V Leiden as- sociated with inflammatory bowel disease? Gut 1997; 40 (Suppl1): A36.
  • Falanga A, Rickles FR. Pathophysiology of the thrombophilic state in the cancer patient. Semin Thromb Hemost 1999; 25: 173-82.
  • Monreal M, Prandoni P. Venous thromboembolism as first mani- festation of cancer. Semin Thromb Hemost 1999; 25: 131-6.
  • Violi F, Ferro D, Basili S, et al. Ongoing prothrombotic state in the portal circulation of cirrhotic patients. Thromb Haemost 1997; 77: 44-7.
  • Tilanus HW. Budd-Chiari syndrome. Br J Surg 1995; 82: 1023-30.
  • Mohanty D, Shetty S, Narayanan TS, Abraham P. Factor V Leiden mutation and Budd-Chiari syndrome. Blood 1998; 92: 1838-9.
  • Das R, Garewal G, Chawla Y, Dhiman RK. Prevalence of the factor V Leiden mutation in portal and hepatic vein thrombosis. Gut 1998; 43: 147.
  • Mahmoud AEA, Elias E, Beauchamp N, Wilde JT. Prevalence of the factor V Leiden mutation in hepatic and portal vein thrombosis. Gut 1997; 40: 798-800.
  • Chamouard P, Pencreach E, Maloisel F, et al. Frequent factor II G20210A mutation in idiopathic portal vein thrombosis. Gastroen- terology 1999; 116: 144-8.

Trombozla ilişkili gastrointestinal hastalıklarda protein C yolağı ve antitrombin

Yıl 2010, Cilt: 9 Sayı: 2, 48 - 54, 01.08.2010

Öz

Giriş ve Amaç: Etyolojisinde tromboz olan ve/veya doğal seyrinde
trombotik komplikasyonlarla sık karşılaşılan gastrointestinal hastalıklarda
(portal ven trombozu, Budd-Chiari sendromu, karaciğer sirozu, inflamatuar
barsak hastalığı ve gastrointestinal malignite) aktive protein
C direnci sıklığı ile protein C, protein S ve antitrombin eksikliklerini
araştırmak üzere bu prospektif çalışma planlandı. Gereç ve Yöntem:
Hastalardan fonksiyonel yöntemlerle protein C, protein S, antitrombin
aktiviteleri ve koagülasyon faktörü V’den yoksun test plazması kullanılarak modifiye yöntemle aktive protein C direnci araştırıldı. Bulgular:
Protein C eksikliği siroz, malign ve sekonder portal ven trombozu gruplarında
diğer gruplardan daha sıktı (p < 0.05). Primer portal ven trombozu
ve Budd-Chiari sendromundaki protein C eksikliği ise kontrolden
daha fazlaydı (p < 0.05). Protein S eksikliği Budd-Chiari sendromunda
diğer tüm gruplardan istatistiksel önemde fazlaydı. ‹nflamatuar barsak
hastalığı, malign ve her iki portal ven trombozu grubunda protein S eksikliği
oranı siroz ve kontrolden yüksekdi (p < 0.05). Antitrombin eksikliği
sirozda diğer tüm gruplardan daha fazlaydı. Aktive protein C direnci
varlığı oranı tüm hasta gruplarında kontrolden istatistiksel önemde
fazlalık gösteriyordu (p < 0.05). Budd-Chiari sendromunda aktive protein
C direnci bulunma oranı ise diğer tüm gruplardan fazlaydı (p < 0.05).
Ayrıca sirozlu ve maligniteli hastalarda tromboz varlığıyla aktive protein
C direnci bulunması korelasyon gösteriyordu (p < 0.05). Trombofilik
faktörlerden iki veya daha fazlasının birarada bulunması tromboz riskinde
belirgin artışa neden olmaktaydı. Sonuç: Protein C, protein S ve
antitrombin eksikliklerinin ve özellikle aktive protein C direnci varlığının; Budd-Chiari sendromu ve portal ven trombozu etyolojisinde rol oynayabileceği,
sirozlu, inflamatuar barsak hastalıklı ve maligniteli hastalarda
tromboz gelişme riskini arttırdığı saptandı.

Kaynakça

  • Harker LA. Disorders of hemostasis and thrombosis: Pathogenesis of thrombosis. In: Williams WJ, Beutler E, Erslev AJ, Lichtman MA, Eds. Hematology 4thed. New York, McGraw Hill 1991; 1559-69.
  • Handin RI. Bleeding and thrombosis. In: Fauci AS, Braunwald Eeds. Harrison’s Principles of Internal Medicine 14thed. New York, McGraw Hill 1998; 339-45.
  • Florell SR, Rodgers GM. Inherited thrombotic disorders: an update. Am J Hematol 1997; 54: 53-60.
  • Martinelli I, Mannuci PM, De Stefano V, et al. Different risks of thrombosis in four coagulation defects associated with inherited thrombophilia: a study of 150 families. Blood 1998; 92: 2353-8.
  • Murin S, Marelich G, Arroliga A, Matthay R. Hereditary thrombop- hilia and venous thromboembolism. Am J Respir Crit Care Med 1998; 158: 1369-73.
  • Dahlbäck B, Carlsson M, Svensson PJ. Familial thrombophilia due to a previously unrecognized mechanism characterized by poor an- ticoagulant response to activated protein C: prediction of a cofac- tor to activated protein C. Proc Natl Acad Sci USA 1993; 90: 1004- 8.
  • Bertina RM, Koeleman BPC, Koster T, et al. Mutation in blood co- agulation factor V associated with resistance to activated protein C. Nature 1994 ;369: 64-7.
  • Gürgey A, Mesci L. The prevalence of factor V Leiden (1691G-A) mutation in Turkey. Turk J Pediatr 1997; 39: 313-5.
  • Akar N, Akar E, Dalgın G, et al. Frequency of factor V Leiden (1691G-A) mutation in Turkish population. Thromb Haemost 1997; 78: 1527-8.
  • Özbek U, Tangün Y. Frequency of factor V Leiden in Turkey. Br J Haematol 1997; 97: 504-5.
  • Aboud MR, Ma DDF. A comparison between two activated prote- in C resistance methods as routine diagnostic tests for factor V Lei- den mutation. Br J Haematol 1997; 97: 798-803.
  • Tripodi A, Negri B, Bertina RM, Mannuci PM. Screening for the FV:Q506 mutation-evaluation of thirteen plasma-based methods for their diagnostic efficacy in comparison with DNA analysis. Thromb Haemost 1997; 77: 436-9.
  • Svensson PJ, Zöller B, Dahlbäck B. Evaluation of original and modi- fied APC-resistance tests in unselected outpatients with clinically suspected thrombosis and in healthy controls. Thromb Haemost 1997; 77: 332-5.
  • Parikh S, Shah R, Kapoor P. Portal vein thrombosis. Am J Med 2010; 123: 111-9.
  • Kelly DA, Tuddenham EGD. Haemostatic problems in liver disease. Gut 1986; 27: 339-49.
  • Bick RL, Strauss JF, Frenkel EP. Thrombosis and hemorrhage in on- cology patients. Hematol Oncol Clin North Am 1996; 10: 875-907.
  • Hudson M, Chitolie A, Hutton RA, et al. Thrombotic vascular risk factors in inflammatory bowel disease. Gut 1996; 38: 733-7.
  • Dhillon AP, Anthony A, Sim R, et al. Mucosal capillary thrombi in rectal biopsies. Histopathology 1992; 21: 127-33.
  • Michiels JJ, Hamulyak K. Laboratory diagnosis of hereditary throm- bophilia. Semin Thromb Hemost 1998; 24: 309-20.
  • Rees DC, Cox M, Clegg JB. World distribution of factor V Leiden. Lancet 1995; 346: 1133-4.
  • Thompson NP, Wakefield AJ, Pounder RE. Inherited disorders of coagulation appear to protect against inflammatory bowel disea- se. Gastroenterology 1995; 108: 1011-5.
  • Folwaczny C, Wiebecke B, Loeschke K. Unfractioned heparin in the therapy of patients with highly active inflammatory bowel disease. Am J Gastroenterol 1999; 94: 1551-5.
  • Liebman HA, Kashani N, Sutherland D, et al. The factor V Leiden mutation increases the risk of venous thrombosis in patients with inflammatory bowel disease. Gastroenterology 1998; 115: 830-4.
  • Probert CSJ, Haslam N, Alsam S, Standen G. Is factor V Leiden as- sociated with inflammatory bowel disease? Gut 1997; 40 (Suppl1): A36.
  • Falanga A, Rickles FR. Pathophysiology of the thrombophilic state in the cancer patient. Semin Thromb Hemost 1999; 25: 173-82.
  • Monreal M, Prandoni P. Venous thromboembolism as first mani- festation of cancer. Semin Thromb Hemost 1999; 25: 131-6.
  • Violi F, Ferro D, Basili S, et al. Ongoing prothrombotic state in the portal circulation of cirrhotic patients. Thromb Haemost 1997; 77: 44-7.
  • Tilanus HW. Budd-Chiari syndrome. Br J Surg 1995; 82: 1023-30.
  • Mohanty D, Shetty S, Narayanan TS, Abraham P. Factor V Leiden mutation and Budd-Chiari syndrome. Blood 1998; 92: 1838-9.
  • Das R, Garewal G, Chawla Y, Dhiman RK. Prevalence of the factor V Leiden mutation in portal and hepatic vein thrombosis. Gut 1998; 43: 147.
  • Mahmoud AEA, Elias E, Beauchamp N, Wilde JT. Prevalence of the factor V Leiden mutation in hepatic and portal vein thrombosis. Gut 1997; 40: 798-800.
  • Chamouard P, Pencreach E, Maloisel F, et al. Frequent factor II G20210A mutation in idiopathic portal vein thrombosis. Gastroen- terology 1999; 116: 144-8.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Hüseyin Alkım Bu kişi benim

Selime Ayaz Bu kişi benim

Canan Alkım Bu kişi benim

Nurgül Şaşmaz Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2010
Yayımlandığı Sayı Yıl 2010 Cilt: 9 Sayı: 2

Kaynak Göster

APA Alkım, H., Ayaz, S., Alkım, C., Şaşmaz, N. (2010). Trombozla ilişkili gastrointestinal hastalıklarda protein C yolağı ve antitrombin. Akademik Gastroenteroloji Dergisi, 9(2), 48-54.

test-5