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Haemostatic Profile of Nigerian Children with Nephrotic Syndrome (NS)

C. Odimegwu1, T. Nwagha2, J. Chinawa1, A. Ubesie1, H. Okafor1, A. Ikefuna1

1University of Nigeria Teaching Hospital, Paediatrics, Enugu, Nigeria, 2University of Nigeria Teaching Hospital, Bleeding and Thrombosis Unit, Department of Haematology and Immunology, Enugu, Nigeria

Abstract Number: PB0352

Meeting: ISTH 2020 Congress

Theme: Coagulation and Natural Anticoagulants » Hemostasis and Organ Dysfunction

Background: Hypercoagulability occurs in NS with episodes of thrombotic complications.

Aims: This study evaluated the haemostatic profile of Nigerian children with NS and the relationship between haemostatic variables and the disease states.

Methods: Forty-six children with NS (2 -18 years) attending the Paediatric Nephrology Clinic of the University of Nigeria Teaching Hospital Enugu and an equal number of age and gender-matched healthy controls were studied. APTT and PT were assayed manually. Fibrinogen was assayed with a semi- automated Coagulometer (KHB202 Kinghawk, China), Antithrombin (AT) by ELISA (Mindray MR-96A Plate-reader, China) and platelet count using a Haematology Analyzer (Mindray BC5300, China).

Results: There were 28 males and 18 females. Twenty (43.5%) of the 46 children with NS were in remission, 19 (41.3%) were in relapse and 7 (15.2%) had new disease.
The median fibrinogen levels in NS and controls group were 2.9g/L with IQR 1.1 to 7.2g/L and 1.4 to 4.5g/L respectively. The median fibrinogen levels were 4.9, 4.1, 2.3 and 3.0g/L in new disease, relapse, remission and controls respectively Sixteen (35%) children with NS had hyperfibrinogenaemia. The median fibrinogen levels of children in remission differed significantly with those of children in relapse (p = 0.001).
.The median AT levels were not significant, 142% and 131% in children with and without NS respectively, (p=0.134).
The median APTT was significantly different in NS and control group (p value = 0.02). The median PT levels also differed significantly (p = 0.004) and 90% of children with NS had INR within reference range. Thrombocytosis occurred in 15% of NS group. The median platelet count in those with new disease was significantly higher ((p = 0.01).

Conclusions: We observed haemostatic derangements in Nigerian children with NS especially involving Fibrinogen, APTT, PT, INR and Platelet count,warranting a high index of clinical suspicion and monitoring in children with NS. Antithrombin was unaffected.

To cite this abstract in AMA style:

Odimegwu C, Nwagha T, Chinawa J, Ubesie A, Okafor H, Ikefuna A. Haemostatic Profile of Nigerian Children with Nephrotic Syndrome (NS) [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/haemostatic-profile-of-nigerian-children-with-nephrotic-syndrome-ns/. Accessed October 1, 2023.

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