| Autor: |
STUART, MARIE J., SPITZER, ROGER E., NELSON, DOUGLAS A., SILLS, RICHARD H. |
| Zdroj: |
Pediatric Research (Ovid); September 1980, Vol. 14 Issue: 9 p1078-1081, 4p |
| Abstrakt: |
Nephrotic syndrome is associated with an increased incidence of arterial and venous thrombosis. Platelet function was evaluated in 6 children with active disease (group I) and in 5 children in remission (group II). Platelet malonyldialdchyde in the presence of N-ethyl maleimide (1 mM) or thromhin (0.5 unit/ml) was used as an indicator of platelet prostaglandin endoperoxide formation in all patients evaluated, and platelet survivals were performed in 3 of 11. Platelet hyperaggregability was present in group 1 and was associated with a significant increase (P < O.001) in platelet MDA formation in the presence of either N-ethyl maleimide [4.0 ± 0.29 (1 S.D.) nmoles/109platelets] or thrombin (1.77 ± 0.32) when compared to normal controls (3.20 ± 0.26: 1.26 ± 0.18). Other evidence for a “hypercoagulable” state included a marked reduction (P < 0.001) in plasma antithrombin III levels to 9.4 ± 3.8 mg/dl (controls, 24 ± 3) and a reduction in platelet life span in both children in whom this study was performed (half-life of 2.1 and 2.5 days), Group II patients in remission did not demonstrate platelet hyperaggregability. and platelet malonyldialdehyde was normal (3.21 ± 0.4; 1.13 ± 0.19). Antithrombin III levels were normal (26.5 ± 4.8), and platelet life-span was normal in both (iroup II children in whom this parameter was measured (half-life of 3.6 and 4.4 days). The normal half-life of 4.4 days was obtained in the same child in whom a half-life of 2.5 days was present during active disease. Platelet hyperaggregability in this syndrome appears to be due to increased prostaglandin endoperoxide synthesis. Inasmuch as a reduction in plasma antithrombin HI levels predisposes to thrombosis and a decrease in platelet survival has been documented to increase the risk of (hromboembolism in a number of pathologic states, these findings appear to be of importance in the etiology of hypercoagulability associated with nephrotic syndrome. |
| Databáze: |
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