ROTEM could be useful for lupus anticoagulant hypoprothrombinemia syndrome

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Main Authors: Koyo Yamada, Yuto Nakajima, Kenichi Ogiwara, Toshiyuki Sakai, Kazuyoshi Fukuda, Keiji Nogami
Format: Artículo Open Access
Published: Wiley 2024
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author Koyo Yamada
Yuto Nakajima
Kenichi Ogiwara
Toshiyuki Sakai
Kazuyoshi Fukuda
Keiji Nogami
author_facet Koyo Yamada
Yuto Nakajima
Kenichi Ogiwara
Toshiyuki Sakai
Kazuyoshi Fukuda
Keiji Nogami
Koyo Yamada
Yuto Nakajima
Kenichi Ogiwara
Toshiyuki Sakai
Kazuyoshi Fukuda
Keiji Nogami
collection Wiley Open Access
contents ROTEM could be useful for lupus anticoagulant hypoprothrombinemia syndrome Koyo Yamada Yuto Nakajima Kenichi Ogiwara Toshiyuki Sakai Kazuyoshi Fukuda Keiji Nogami Pediatrics International Abstract Background Lupus anticoagulant‐hypoprothrombinemia syndrome (LAHPS) is a rare disease caused by acquired factor II (FII) deficiency and lupus anticoagulant. Patients with LAHPS typically present with thrombosis and bleeding. However, little information is available on the evaluation of coagulation potential in patients with LAHPS. We examined global coagulation potentials in patients with LAHPS during the clinical course in this study. Methods Coagulation potentials in two pediatric patients with LAHPS were assessed by measuring clotting time (CT) and clot formation time using Ca 2+ ‐triggered rotational thromboelastometry (ROTEM), CT and maximum coagulation velocity using clot waveform analysis (CWA), and lag time and peak thrombin using the thrombin generation assay (TGA). The day of admission was defined as day 0. Results In case 1, the bleeding symptoms disappeared by day 5. However, the TGA and CWA results were markedly lower than normal, although FII activity (FII:C) returned to within the normal range by day 14. In contrast, ROTEM revealed a recovery to near‐normal levels (day 14). All coagulation parameters (day 80) were within normal ranges. In case 2, coagulation potential was severely depressed until day 12, although FII:C returned to normal levels. Bleeding symptoms disappeared on day 19, and the ROTEM data revealed that the parameters were close to the normal range. The coagulation parameters in all assays were normalized on day 75. Conclusions Recovery of coagulation potential in patients with LAHPS was slower than the recovery of FII:C. Moreover, ROTEM appeared to be clinically useful for assessing coagulation potential in patients with LAHPS. 10.1111/ped.15773 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/ped.15773
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institution Wiley Open Access
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publishDate 2024
publisher Wiley
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spellingShingle ROTEM could be useful for lupus anticoagulant hypoprothrombinemia syndrome
Koyo Yamada
Yuto Nakajima
Kenichi Ogiwara
Toshiyuki Sakai
Kazuyoshi Fukuda
Keiji Nogami
Pediatrics International
ROTEM could be useful for lupus anticoagulant hypoprothrombinemia syndrome Koyo Yamada Yuto Nakajima Kenichi Ogiwara Toshiyuki Sakai Kazuyoshi Fukuda Keiji Nogami Pediatrics International Abstract Background Lupus anticoagulant‐hypoprothrombinemia syndrome (LAHPS) is a rare disease caused by acquired factor II (FII) deficiency and lupus anticoagulant. Patients with LAHPS typically present with thrombosis and bleeding. However, little information is available on the evaluation of coagulation potential in patients with LAHPS. We examined global coagulation potentials in patients with LAHPS during the clinical course in this study. Methods Coagulation potentials in two pediatric patients with LAHPS were assessed by measuring clotting time (CT) and clot formation time using Ca 2+ ‐triggered rotational thromboelastometry (ROTEM), CT and maximum coagulation velocity using clot waveform analysis (CWA), and lag time and peak thrombin using the thrombin generation assay (TGA). The day of admission was defined as day 0. Results In case 1, the bleeding symptoms disappeared by day 5. However, the TGA and CWA results were markedly lower than normal, although FII activity (FII:C) returned to within the normal range by day 14. In contrast, ROTEM revealed a recovery to near‐normal levels (day 14). All coagulation parameters (day 80) were within normal ranges. In case 2, coagulation potential was severely depressed until day 12, although FII:C returned to normal levels. Bleeding symptoms disappeared on day 19, and the ROTEM data revealed that the parameters were close to the normal range. The coagulation parameters in all assays were normalized on day 75. Conclusions Recovery of coagulation potential in patients with LAHPS was slower than the recovery of FII:C. Moreover, ROTEM appeared to be clinically useful for assessing coagulation potential in patients with LAHPS. 10.1111/ped.15773 http://onlinelibrary.wiley.com/termsAndConditions#vor
title ROTEM could be useful for lupus anticoagulant hypoprothrombinemia syndrome
topic Pediatrics International
url https://onlinelibrary.wiley.com/doi/10.1111/ped.15773