Coagulation and Fibrinolysis Index Profile in Patients with ANCA-associated Vasculitis

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2014 May 21

PMID 24842719

Citations 24

Authors

Tian-Tian Ma

Yi-Min Huang

Chen Wang

Ming-Hui Zhao

Min Chen

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies observed the high prevalence of venous thromboembolism in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The current study analyzed the coagulation and fibrinolysis index profile in AAV patients.

Methods: The current study recruited 321 AAV patients in active stage and 78 AAV patients in quiescent stage. Coagulation and fibrinolysis index profiles in these AAV patients were analysed, and their associations with various clinical and pathological parameters were further investigated.

Results: The circulating levels of D-dimer, fibrin degradation products and platelet count were significantly higher in AAV patients in active stage compared with those in remission [0.8 (0.4, 1.5) mg/L vs. 0.28 (0.2, 0.55) mg/L, P<0.05; 5.6 (5.0, 10.0) mg/L vs. 1.9 (1.2, 2.8) mg/L, P<0.05; 269±127×109/L vs. 227±80×109/L, P<0.05, respectively]. Among the 321 AAV patients in active stage, compared with patients with normal levels of D-dimer, patients with elevated D-dimer levels had significantly higher levels of initial serum creatinine, erythrocyte sedimentation rate, C reactive protein and the Birmingham Vasculitis Activity Scores (P = 0.014, P<0.001, P<0.001, P = 0.002, respectively). Moreover, correlation analysis showed that the levels of D-dimer correlated with erythrocyte sedimentation rate and C reactive protein levels (r = 0.384, P<0.001; r = 0.380, P<0.001, respectively).

Conclusion: Patients with active AAV are in hypercoagulable states, and circulating levels of D-dimer are associated with disease activity of AAV.

Citing Articles

Low platelet count at diagnosis of anti-neutrophil cytoplasmic antibody-associated vasculitis is correlated with the severity of disease and renal prognosis.

Jin Y, Wang F, Tang J, Luo L, Huang L, Zhou F Clin Exp Med. 2024; 24(1):70.

PMID: 38578316 PMC: 10997538. DOI: 10.1007/s10238-024-01333-z.

Pathogenesis of anti-neutrophil cytoplasmic antibody-associated vasculitis.

Sun X, Li Z, Chen M Rheumatol Immunol Res. 2023; 4(1):11-21.

PMID: 37138650 PMC: 10150877. DOI: 10.2478/rir-2023-0003.

New Insights into Pathogenesis and Treatment of ANCA-Associated Vasculitis: Autoantibodies and Beyond.

Paroli M, Gioia C, Accapezzato D Antibodies (Basel). 2023; 12(1).

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Implication of platelets and complement C3 as link between innate immunity and tubulointerstitial injury in renal vasculitis with MPO-ANCA seropositivity.

Baier E, Tampe D, Kluge I, Hakroush S, Tampe B Front Immunol. 2022; 13:1054457.

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Zhang K, Salih Makawi M, Saab O, Elshakh H, Trivedi P Cureus. 2022; 14(10):e30102.

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References

Luqmani R, Bacon P, Moots R, Janssen B, Pall A, Emery P . Birmingham Vasculitis Activity Score (BVAS) in systemic necrotizing vasculitis. QJM. 1994; 87(11):671-8. View

. Etanercept plus standard therapy for Wegener's granulomatosis. N Engl J Med. 2005; 352(4):351-61. DOI: 10.1056/NEJMoa041884. View

Diamantopoulos A . Extracellular neutrophil traps: a novel therapeutic target in ANCA-associated vasculitis?. Front Immunol. 2013; 4:24. PMC: 3562994. DOI: 10.3389/fimmu.2013.00024. View

Markiewski M, Nilsson B, Nilsson Ekdahl K, Mollnes T, Lambris J . Complement and coagulation: strangers or partners in crime?. Trends Immunol. 2007; 28(4):184-92. DOI: 10.1016/j.it.2007.02.006. View

Kroneman H, Nieuwenhuizen W, Knot E . Monoclonal antibody-based plasma assays for fibrin(ogen) and derivatives, and their clinical relevance. Blood Coagul Fibrinolysis. 1990; 1(1):91-111. DOI: 10.1097/00001721-199003000-00012. View

Springer J, Villa-Forte A . Thrombosis in vasculitis. Curr Opin Rheumatol. 2012; 25(1):19-25. DOI: 10.1097/BOR.0b013e32835ad3ca. View

Hilhorst M, Winckers K, Wilde B, Van Oerle R, Ten Cate H, Cohen Tervaert J . Patients with antineutrophil cytoplasmic antibodies associated vasculitis in remission are hypercoagulable. J Rheumatol. 2013; 40(12):2042-6. DOI: 10.3899/jrheum.130200. View

von Scheven E, Lu T, Emery H, Elder M, Wara D . Thrombosis and pediatric Wegener's granulomatosis: acquired and genetic risk factors for hypercoagulability. Arthritis Rheum. 2003; 49(6):862-5. DOI: 10.1002/art.11454. View

Bombeli T, Karsan A, Tait J, Harlan J . Apoptotic vascular endothelial cells become procoagulant. Blood. 1997; 89(7):2429-42. View

10.

Rowbotham B, Carroll P, Whitaker A, Bunce I, Cobcroft R, Elms M . Measurement of crosslinked fibrin derivatives--use in the diagnosis of venous thrombosis. Thromb Haemost. 1987; 57(1):59-61. View

11.

Merkel P, Lo G, Holbrook J, Tibbs A, Allen N, Davis Jr J . Brief communication: high incidence of venous thrombotic events among patients with Wegener granulomatosis: the Wegener's Clinical Occurrence of Thrombosis (WeCLOT) Study. Ann Intern Med. 2005; 142(8):620-6. DOI: 10.7326/0003-4819-142-8-200505030-00011. View

12.

Abril A, Calamia K, Cohen M . The Churg Strauss syndrome (allergic granulomatous angiitis): review and update. Semin Arthritis Rheum. 2003; 33(2):106-14. DOI: 10.1016/s0049-0172(03)00083-0. View

13.

Kambas K, Mitroulis I, Apostolidou E, Girod A, Chrysanthopoulou A, Pneumatikos I . Autophagy mediates the delivery of thrombogenic tissue factor to neutrophil extracellular traps in human sepsis. PLoS One. 2012; 7(9):e45427. PMC: 3446899. DOI: 10.1371/journal.pone.0045427. View

14.

Kessenbrock K, Krumbholz M, Schonermarck U, Back W, Gross W, Werb Z . Netting neutrophils in autoimmune small-vessel vasculitis. Nat Med. 2009; 15(6):623-5. PMC: 2760083. DOI: 10.1038/nm.1959. View

15.

Hellmich B, Flossmann O, Gross W, Bacon P, Cohen-Tervaert J, Guillevin L . EULAR recommendations for conducting clinical studies and/or clinical trials in systemic vasculitis: focus on anti-neutrophil cytoplasm antibody-associated vasculitis. Ann Rheum Dis. 2006; 66(5):605-17. PMC: 2703775. DOI: 10.1136/ard.2006.062711. View

16.

Hong Y, Eleftheriou D, Hussain A, Price-Kuehne F, Savage C, Jayne D . Anti-neutrophil cytoplasmic antibodies stimulate release of neutrophil microparticles. J Am Soc Nephrol. 2011; 23(1):49-62. PMC: 3269928. DOI: 10.1681/ASN.2011030298. View

17.

Monach P . ANCA-associated vasculitis: a prothrombotic state even in remission?. J Rheumatol. 2013; 40(12):1935-7. DOI: 10.3899/jrheum.131069. View

18.

Hergesell O, Andrassy K, Nawroth P . Elevated levels of markers of endothelial cell damage and markers of activated coagulation in patients with systemic necrotizing vasculitis. Thromb Haemost. 1996; 75(6):892-8. View

19.

Kambas K, Chrysanthopoulou A, Vassilopoulos D, Apostolidou E, Skendros P, Girod A . Tissue factor expression in neutrophil extracellular traps and neutrophil derived microparticles in antineutrophil cytoplasmic antibody associated vasculitis may promote thromboinflammation and the thrombophilic state associated with the disease. Ann Rheum Dis. 2013; 73(10):1854-63. DOI: 10.1136/annrheumdis-2013-203430. View

20.

Cockwell P, Savage C . Role of leukocytes in the immunopathogenesis of ANCA-associated glomerulonephritis. Nephron. 2000; 85(4):287-306. DOI: 10.1159/000045679. View