Abstract Number: PB0108
Meeting: ISTH 2021 Congress
Theme: Coagulation and Natural Anticoagulants » Hemostasis and Organ Dysfunction
Background: Coagulation factor assays usually are performed in patients with congenital bleeding disorders, Assays in the special coagulation laboratory are affected by numerous situations. However, when we review all the factor assays performed in our center in last 12 years, we found many assays had been performed in hospitalized patients or with pathologies affect hemostasis.
Aims: Analyze the secondary causes of low clotting factors leves in patients in our center.
Methods: We retrospectively reviewed all factor assays (II, V, VII, VIII, IX, X, XI) performed in our center from 02/09/2009 to 08/31/2020. 3911 assays performed, in 594 cases level was below the reference range and 100 of these test, were performed on patients with multiple pathologies.
Results:
| II | V | VII | VIII | IX | X | XI | Total | |
| Liver diseases | 3 | 11 | 6 | 0 | 1 | 1 | 2 | 24 |
| Vitamina K deficiency | 5 | 0 | 6 | 0 | 2 | 4 | 0 | 17 |
| Lupus anticoagulant | 2 | 3 | 2 | 2 | 2 | 4 | 4 | 19 |
| Infection | 0 | 0 | 9 | 0 | 1 | 0 | 0 | 10 |
| Hematological diseases – Myeloproliferative síndromes Polycythemia vera Myelofibrosis – Plasma cell dyscrasias Multiple myeloma MGUS – Hodgkin’s disease |
0 0 |
2 3 |
0 2 |
0 0 |
0 |
1 |
1 |
5 8 1 |
| Bleeding | 0 | 1 | 5 | 0 | 0 | 3 | 1 | 0 |
| Inflammatory bowel disease |
0 | 0 | 1 | 0 | 0 | 1 | 0 | 2 |
| Others | 0 | 0 | 1 | 0 | 2 | 0 | 1 | 4 |
| Total | 10 | 20 | 33 | 2 | 8 | 16 | 11 | 100 |
Secondary causes of low clotting factor levels
| FACTOR | II | V | VII | VIII | IX | X | XI |
| Total factor assays |
113 | 144 | 365 | 1330 | 723 | 173 | 1063 |
| Total patients | 107 | 104 | 104 | 895 | 558 | 156 | 558 |
| Low levels assays | 12 | 54 | 156 | 104 | 78 | 42 | 148 |
| Low levels patients | 11 | 36 | 89 | 63 | 32 | 34 | 83 |
| Congenital factor deficiency | 0 | 15 | 48 | 10 | 17 | 15 | 55 |
| Secondary deficiency | 10 | 20 | 33 | 5 | 8 | 16 | 11 |
Factor assays performed in our centre
Table 2 shows the data of our series. Secondary cause that that most frequently produced low factors levels was liver disease (viral hepatitis, autoimmune hepatitis and liver metastases), followed by the presence of a lupus anticoagulant and vitamin K deficiency. In FII series, 100% of low levels corresponded to secondary causes, 55% in FV, 47% in FX and 37% in FVII series (27% of patients had a severe infection). 14 low factor levels results corresponded to 7 patients with hematological diseases (plasma cell dyscrasias, chronic myeloproliferative syndromes and a lymphoma), all patients had a normal coagulation test prior to the diagnosis of hematological disease. In 10 cases the analysis was performed in hospitalized patients with active Bleeding and in another 10 cases in patients with severe active infection.
Conclusions: Multiple pathologies and clinical situations may affect coagulation tests and factors assays.
In our series, many factor assays were performed in patients with liver diseases, elderly patients with vitamin K deficiency, and patients with infections.
We recommend not performed clotting factor assays in hospitalized patients or with pathologies that affect hemostasis, to avoid unnecessary tests and falsely altered results.
To cite this abstract in AMA style:
Lorenzo Jambrina A, Mosquera Tapia M, Torres Tienza A, Zato Hernández E, Cardos Gómez V, Galán Álvarez P, Olivier Cornacchia C, Queizán Herández JA. Coagulation Abnormalities in Patients without Congenital Bleeding Disorders: Analysis of Secondary Causes of Low Clotting Factors Levels [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/coagulation-abnormalities-in-patients-without-congenital-bleeding-disorders-analysis-of-secondary-causes-of-low-clotting-factors-levels/. Accessed November 28, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/coagulation-abnormalities-in-patients-without-congenital-bleeding-disorders-analysis-of-secondary-causes-of-low-clotting-factors-levels/