Abstract Number: PB1244
Meeting: ISTH 2020 Congress
Background: Currently data is increasingly accumulated on the correlation of hepatic diseases and coagulation disorders and on the role of haemostatic proteins in the hepatic fibrosis pathogenesis.
Aims: To assess haemostatic disorders and their correlation with hepatic fibrosis markers in children suffering from hepatic cirrhosis.
Methods: The study group consisted of 31 children with hepatic cirrhosis aged between 3 and 17 years old. To assess haemostatic disorders, there were determined the platelet count, the activated partial thromboplastin time (APTT), thrombin time, the Quick’s prothrombin activity (PT), antithrombin activityIII, C-protein, vonWillebrand factor (VWF), plasminogen, alpha-2-ntiplasmin (α-2AP), XIIa-dependent fibrinolysis, fibrinogen content, SFC (soluble fibrin complexes), D-dimers, endothelin-1. The concentration of the following hepatic fibrosis markers was also determined: collagen IV, the platelet-derived growth factor (PDGF). The control group (n=15) consisted of children included in health groups I-II.
Statistic methods: Mann-Whitney U-test, Spearman’s rank correlation coefficient. Quantitative data are herein presented as Me (Q1;Q3).
The study was approved by the Local Ethics Committee (Protocol No.16, December 5, 2017). All the study participants signed their informed consent.
Results: The clinical evidence of haemorrhagic events (ecchymoses, petechiae, frequent nosebleeds) was recorded in each second patient. Changes in the haemostatic system were characterized by liability to thrombocytopenia, endothelium hyperthrombogenicity and moderate decrease in the coagulation, anticoagulant and fibrinolytic activity (Table 1). All patients had higher concentrations of hepatic fibrosis markers, which were directly correlated with indicators of coagulation hemostasis, anticoagulant system and endothelium dysfunction markers (Table2).
| Indicator | The study group n=31 | The control group n=15 | р |
| Thrombocytes, (109/l) | 150(117; 212) | 311.0(266.0;349.0) | р=0.000 |
| Endothelin-1, (fmol/ml) | 1.80(0.82; 5.05) | 0.55(0.22; 0.63) | р=0.000 |
| VWF, (%) | 167.5(149.0; 267.0) | 76.6 (58.85;105.4) | р=0.000 |
| APTT, (s) | 40.4(34.2; 42.4) | 30.53(28.9; 33.2) | р=0.000 |
| PT (%) | 81.0(70.0; 88.5) | 102.5(89.0; 124.0) | р=0.000 |
| С-protein, (%) | 69.4(59.0; 86.3) | 99.5(88.1; 113.1) | р=0.002 |
| α2-AP, (%) | 81.3(63.0; 95.8) | 115.8(102.1; 124.6) | р=0.000 |
| Collagen IV, ng/ml | 50.55(29.67; 74.20) | 18.48(14.12;21.31) | р=0.000 |
| PDGF, pg/ml | 4137.5(2812.5; 5677.9) | 2862.6(2462.4; 3437.6) | р=0.045 |
[Table 1Changes in hemostasiologic indicators and fibrosis markers (Me (Q1;Q3)) (Note: n is the number of observations, р is the significance level)]
| Fibrosis markers | Haemostatic indicators | Spearman’s rank correlation coefficient (r) | p |
| Collagen IV | VWF | r=0.519 | р=0.019 |
| Collagen IV | Endothelin – 1 | r=0.527 | р=0.012 |
| Collagen IV | Quick’s PT | r= – 0.453 | р=0.023 |
| Collagen IV | С-protein | r= – 0.482 | р=0.031 |
| PDGF | VWF | r=0.661 | р=0.002 |
| PDGF | Endothelin – 1 | r=0.600 | р=0.005 |
| PDGF | Quick’s PT | r= – 0.459 | р=0.027 |
[Table 2 Correlation relationships of haemostatic indicators and fibrosis markers (Spearman’s method) (Note: р is the reliability of correlation relat)]
Conclusions: Haemostatic disorders in case of cirrhosis are directly correlated with fibrosis markers. So, it proves their role in the fibrogenesis development and determines the need to monitor all links of the haemostatic system in order to comprehensively assess the disease severity and to prevent the further progression of grave complications. Financing: the research was completed under the Governmental task for 2017-2020.
To cite this abstract in AMA style:
Konovalova E, Lavrova A, Presnyakova M. Haemostatic Disorders and their Correlation with Hepatic Fibrosis Markers in Case of Hepatic Cirrhosis in Children [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/haemostatic-disorders-and-their-correlation-with-hepatic-fibrosis-markers-in-case-of-hepatic-cirrhosis-in-children/. Accessed November 26, 2020.« Back to ISTH 2020 Congress
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