Coagulation Profile Dynamics in Pediatric Patients with Cushing Syndrome: A Prospective, Observational Comparative Study
| Autor: | Maya Lodish, Amit Tirosh, Mark Keil, Constantine A. Stratakis, Leah Birdwell, Elena Belyavskaya, Prashant Chittiboina, Richard A Feelders, C. Lyssikatos |
|---|---|
| Přispěvatelé: | Internal Medicine |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Antifibrinolytic Adolescent medicine.drug_class 030209 endocrinology & metabolism Adrenocorticotropic hormone 030204 cardiovascular system & hematology Article 03 medical and health sciences Cushing syndrome 0302 clinical medicine Von Willebrand factor Internal medicine medicine Humans Thrombophilia Prospective Studies Cushing Syndrome Retrospective Studies medicine.diagnostic_test biology business.industry medicine.disease Surgery Hypercortisolemia Pediatrics Perinatology and Child Health biology.protein Female Observational study business Body mass index Partial thromboplastin time |
| Zdroj: | Journal of Pediatrics, 177, 227-231. Mosby Inc. |
| ISSN: | 0022-3476 |
| DOI: | 10.1016/j.jpeds.2016.06.087 |
| Popis: | To evaluate the association between Cushing syndrome and hypercoagulability in children.A prospective, observational study was performed of 54 patients with Cushing syndrome, 15.1 ± 3.9 years, treated at the National Institutes of Health Clinical Center. Coagulation profiles were taken before and 6-12 months after surgery and compared with18 normocortisolemic children, 13.7 ± 3.6 years.At baseline, patients with Cushing syndrome had greater levels of the procoagulant factor VIII (FVIII) vs controls (145 IU/dL ± 84 vs 99 ± 47, P = .04); 6-12 months after surgery, FVIII levels decreased to 111 ± 47, P = .05. Patients with Cushing syndrome had greater levels of the antifibrinolytic α2-antiplasmin, 96 ± 17% vs 82 ± 26%, P = .015. After surgery, antifibrinolytic α2-antiplasmin levels decreased to 82 ± 24%, P .001. Anticoagulants were greater in patients with Cushing syndrome vs controls at baseline, including protein C (138 ± 41% vs 84 ± 25%, P .001), protein S (94 ± 19% vs 74 ± 19%, P = .001), and antithrombin III (96 ± 18% vs 77 ± 13%, P .0001). The 24-hour urinary free cortisol levels correlated positively with FVIII levels, r = 0.43, P = .004.Children with Cushing syndrome had elevated procoagulants, antifibrinolytics, and anticoagulants at baseline compared with controls; normalization of coagulation measures was seen after surgical cure. Despite the increase in anticoagulants, hypercortisolemia is associated with a hypercoagulable state in children, as is the case in adults. This finding has potential implications for prevention of venous thromboembolism in children with Cushing syndrome.ClinicalTrials.gov:NCT00001595. |
| Databáze: | OpenAIRE |
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