Place du test de génération de thrombine dans les maladies auto-immunes

Autor: Paul Billoir, Vincent Richard, Sébastien Miranda, Ygal Benhamou, V. Le Cam Duchez
Rok vydání: 2021
Předmět:
Zdroj: La Revue de Médecine Interne. 42:862-868
ISSN: 0248-8663
DOI: 10.1016/j.revmed.2021.06.006
Popis: Thrombin generation assay (TGA) is a useful tool to evaluate the initiation, propagation and inhibition of coagulation. TGA is a global test that is used to assess hemorrhagic risk in hemophilia patients, but it can also be used to study hypercoagulable states. The interest of TGA is to screen for cardiovascular risk, which is regularly associated with autoimmune disease (AID) such as antiphospholipid syndrome. Indeed, TGA has been used to evaluate hypercoagulability in patients with antiphospholipid syndrome treated with rivaroxaban versus warfarin. In other AIDs without thrombotic events, TGA measurement is elevated, mainly in rheumatoid arthritis (RA), systemic lupus erythematosus and Behcet's disease. These findings in RA are correlated with the inflammatory activity of the disease. In systemic lupus erythematosus and Behcet's disease, TGA appears to reflect disease activity. In conclusion, TGA remains relatively under used in the clinical evaluation of AID, but it could play a greater role in the evaluation of certain potentially thrombogenic treatments in AID. Finally, TGA helps measuring AID activity, due to the clearlink between coagulation and inflammation, despite some limitations of interpretation mainly due to a lack of standardization.
Databáze: OpenAIRE
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