Enhanced thrombin formation and fibrinolysis during acute Puumala hantavirus infection

Thrombosis Research
Outi LaineLotta Joutsi-Korhonen

Abstract

Nephropathia epidemica (NE) is a viral hemorrhagic fever with renal syndrome associated with thrombocytopenia and mild bleeding. We assessed activation of coagulation and fibrinolysis during the acute phase of NE. 19 hospital-treated patients were involved. Plasma levels of D-dimer, prothrombin fragments 1+2 (F1+2), activated partial thromboplastin time (APTT), prothrombin time (PT%), thrombin time (TT), fibrinogen, antithrombin (AT), protein S free antigen (PS), protein C (PC) and complete blood count (CBC) were measured three times during the acute phase and once at 32-54 days after the onset of fever (recovery phase). Laboratory abnormalities were evaluated by the disseminated intravascular coagulation (DIC) scoring advocated by the International Society of Thrombosis and Haemostasis (ISTH). APTT was prolonged and D-dimer and F1+2 increased during the acute phase of NE. AT, PC and PS decreased, and TT was shortened, all implying increased thrombin generation. Acutely F1+2 was 3.4-fold and D-dimer even 24-fold higher compared with the recovery phase (median 726 vs 213 pmol/l, and median 4.8 vs 0.2mg/l, respectively, p<0.001 for both). Platelet count correlated with AT, PC, and PS (r=0.73, r=0.81, and r=0.71, respectively, p<0...Continue Reading

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Citations

Oct 29, 2013·BMC Infectious Diseases·Johan RasmusonClas Ahlm
Sep 9, 2011·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·T K OutinenJ Mustonen
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Apr 22, 2011·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Outi LaineLotta Joutsi-Korhonen
Sep 11, 2013·Nature Reviews. Microbiology·Antti VaheriJukka Mustonen
Dec 25, 2012·Emerging Infectious Diseases·Anne-Marie Connolly-AndersenJonas Klingström
Oct 3, 2017·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Sirpa M KoskelaOuti K Laine
Oct 12, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Anne-Marie Connolly-AndersenClas Ahlm
Oct 8, 2017·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·J ClementP Maes
Nov 14, 2019·The Journal of Infectious Diseases·Clare M SchmedesAnne-Marie Fors Connolly
Jan 6, 2017·Journal of Immunology Research·Ekaterina V MartynovaSvetlana F Khaiboullina
Apr 23, 2014·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Outi K LaineJukka T Mustonen

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