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Type: Artigo de periódico
Title: Elevated Hypercoagulability Markers In Hemoglobin Sc Disease.
Author: Colella, Marina P
de Paula, Erich V
Machado-Neto, João A
Conran, Nicola
Annicchino-Bizzacchi, Joyce M
Costa, Fernando F
Olalla Saad, Sara T
Traina, Fabiola
Abstract: Hemoglobin SC disease is a very prevalent hemoglobinopathy, however very little is known specifically about this condition. There appears to be an increased risk of thromboembolic events in hemoglobin SC disease, but studies evaluating the hemostatic alterations are lacking. We describe a cross-sectional observational study evaluating coagulation activation markers in adult hemoglobin SC patients, in comparison with sickle cell anemia patients and healthy controls. A total of 56 hemoglobin SC and 39 sickle cell anemia patients were included in the study, all in steady state, and 27 healthy controls. None of the patients were in use of hydroxyurea. Hemoglobin SC patients presented a significantly up-regulated relative expression of tissue factor, as well as elevations in thrombin-antithrombin complex and D-dimer, in comparison to controls (p<0.01). Hemoglobin SC patients presented lower tissue factor expression, and thrombin-antithrombin complex and D-dimer levels when compared to sickle cell anemia patients (p<0.05). Endothelial activation (soluble thrombomodulin and soluble vascular cell adhesion molecule-1), and inflammation (tumor necrosis factor-alpha) markers were both significantly elevated in hemoglobin SC patients when compared to controls, being as high as the levels seen in sickle cell anemia. Overall, in hemoglobin SC patients, higher hemolytic activity and inflammation were associated with a more intense activation of coagulation, and hemostatic activation was associated with two very prevalent chronic complications seen in hemoglobin SC disease: retinopathy and osteonecrosis. In summary, our results demonstrate that hemoglobin SC patients present a hypercoagulable state, although this manifestation was not as intense as that seen in sickle cell anemia.
Subject: Disorders Of Coagulation And Fibrinolysis
Hemoglobin Sc Disease
Sickle Cell Anemia
Citation: Haematologica. , 2015-Jan.
Rights: aberto
Identifier DOI: 10.3324/haematol.2014.114587
Date Issue: 2015
Appears in Collections:Unicamp - Artigos e Outros Documentos

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