Retrospective evaluation of bleeding tendency and simultaneous thrombin and plasmin generation in patients with rare bleeding disorders

M. Van Geffen, M. Menegatti, A. Loof, P. Lap, M. Karimi, B. A P Laros-van Gorkom, P. Brons, W. L. Van Heerde

Research output: Contribution to journalArticlepeer-review

Abstract

Rare bleeding disorders (RBDs) are a heterogeneous group of diseases with varying bleeding tendency, only partially explained by their laboratory phenotype. We analysed the separate groups of RBD abnormalities, and we investigated retrospectively whether the novel haemostasis assay (NHA) was able to differentiate between bleeding tendency. We have performed simultaneous thrombin generation (TG) and plasmin generation (PG) measurements in 41 patients affected with deficiencies in prothrombin, factor (F) V, FVII, FX, FXIII and fibrinogen. Parameters of the NHA were classified based on (major or minor) bleeding tendency. Patients with deficiencies in coagulation propagation (FII, FV and FX) and major type of bleedings had diminished TG (expressed as AUC) below 20% of control. FVII deficient patients only had prolonged thrombin lag-time ratio of 1.6±0.2 (P<0.05) and normal AUC (92-125%). Afibrinogenemic patients demonstrated PG of 2-29% of normal and appeared to correlate with the type of mutation. Thrombin peak-height (57±16%) was reduced (not significant) in these patients and AUC was comparable to the reference (102±27%). FXIII-deficient plasmas resulted in a reduced thrombin peak-height of 59± 13% (P

Original languageEnglish
Pages (from-to)630-638
Number of pages9
JournalHaemophilia
Volume18
Issue number4
DOIs
Publication statusPublished - Jul 2012

Keywords

  • Bleeding tendency
  • Phenotype
  • Plasmin
  • Rare bleeding disorders
  • Thrombin

ASJC Scopus subject areas

  • Hematology
  • Genetics(clinical)

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