thromboplastin and Hematuria

Topics: Adult; Child; Ecchymosis; Epistaxis; Factor V; Factor V Deficiency; Female; Gastrointestinal Hemorrhage; Hemarthrosis; Hematuria; Hemorrhage; Humans; Hypoprothrombinemias; Male; Menstruation Disturbances; Prothrombin Time; Thromboplastin

Topics: Anticoagulants; Blood Coagulation; Blood Coagulation Disorders; Factor VIII; Fibrinolytic Agents; Hematuria; Hemostasis; Heparin; Humans; Kidney; Kidney Cortex Necrosis; Kidney Transplantation; Methods; Renal Dialysis; Thromboembolism; Thromboplastin; Uremia

Topics: Blood Coagulation Factors; Blood Coagulation Tests; Blood Transfusion; Cerebral Hemorrhage; Epistaxis; Factor VIII; Gastrointestinal Hemorrhage; Hemarthrosis; Hematuria; Hemophilia A; Hemorrhage; Humans; Oral Hemorrhage; Thromboplastin; Wounds and Injuries

The tissue factor (TF)-dependent extrinsic pathway has been suggested to be a central mechanism by which the coagulation cascade is locally activated in the lungs of patients with acute lung injury and acute respiratory distress syndrome (ALI/ARDS) and thus represents an attractive target for therapeutic intervention. This study was designed to determine the pharmacokinetic and safety profiles of ALT-836, an anti-TF antibody, in patients with ALI/ARDS.. This was a prospective, randomized, placebo-controlled, dose-escalation Phase I clinical trial in adult patients who had suspected or proven infection, were receiving mechanical ventilation and had ALI/ARDS (PaO(2)/FiO(2) ≤ 300 mm). Eighteen patients (6 per cohort) were randomized in a 5:1 ratio to receive ALT-836 or placebo, and were treated within 48 hours after meeting screening criteria. Cohorts of patients were administered a single intravenously dose of 0.06, 0.08 or 0.1 mg/kg ALT-836 or placebo. Blood samples were taken for pharmacokinetic and immunogenicity measurements. Safety was assessed by adverse events, vital signs, ECGs, laboratory, coagulation and pulmonary function parameters.. Pharmacokinetic analysis showed a dose dependent exposure to ALT-836 across the infusion range of 0.06 to 0.1 mg/kg. No anti-ALT-836 antibody response was observed in the study population during the trial. No major bleeding episodes were reported in the ALT-836 treated patients. The most frequent adverse events were anemia, observed in both placebo and ALT-836 treated patients, and ALT-836 dose dependent, self-resolved hematuria, which suggested 0.08 mg/kg as an acceptable dose level of ALT-836 in this patient population.. Overall, this study showed that ALT-836 could be safely administered to patients with sepsis-induced ALI/ARDS.. ClinicalTrials.gov: NCT01438853.

Topics: Acute Lung Injury; Adult; Aged; Anemia; Antibodies; Biological Products; Cohort Studies; Female; Hematuria; Humans; Immunoglobulin G; Male; Middle Aged; Prospective Studies; Recombinant Fusion Proteins; Recombinant Proteins; Respiration, Artificial; Respiratory Distress Syndrome; Thromboplastin

A woman with gross hematuria was shown to have a severe isolated factor V deficiency due to a factor V inhibitor of 200 U/ml titer. Hematuria persisted despite multiple infusions of plasma but, after one transfusion with 1 U platelets, urine red blood cells decreased by more than 98%. To evaluate the patient's platelet function we performed prothrombinase and tenase assays with platelets from the patient and from normal donors. By prothrombinase assay, ionophore-activated patient platelets showed 42% of the activity of normal platelets in their ability to support prothrombin activation by activated factor X; whereas in a 'tenase' assay, which measures the platelets' ability to support factor X activation by activated factor IX + activated factor VIII, their activity was 117% of normal. The addition of excess bovine activated factor V to the prothrombinase assay fully corrected the defect. The results demonstrate the benefit of platelet transfusion and indicate that in this case the platelets are the primary source of factor V for hemostasis.

Topics: Cysteine Endopeptidases; Factor V; Factor V Deficiency; Female; Hematuria; Hemostasis; Humans; Middle Aged; Neoplasm Proteins; Platelet Transfusion; Thromboplastin; Treatment Outcome

To investigate factors that influence urinary tissue factor (uTF) measurements: glomerular permeability and filtration, tubular function, haematuria, and urine bacterial growth.. uTF, protein creatinine index, glomerular filtration rate, retinol binding protein, N-acetyl-beta-D-glucosaminidase (NAG) and urinary haemoglobin (uHb) were measured in patients with hypertension, diabetes mellitus and nephrotic syndrome (n = 342), tubulo-interstitial disease (n = 50), and haematuria of uncertain cause (n = 50); measurements were also made in urine samples from healthy subjects for "simulated" haematuria (n = 6) and bacterial growth (n = 4) studies.. There was a weak correlation of uTF with glomerular permeability and filtration (protein creatinine index and glomerular filtration rate) and with markers of tubular function (retinol binding protein and NAG). uTF concentrations were not affected by the presence of blood or bacteria in the urine sample.. uTF concentrations are relatively stable. This is an important finding if the assay is to be used in clinical practice.

Topics: Acetylglucosaminidase; Bacteriuria; Biomarkers; Glomerular Filtration Rate; Hematuria; Humans; Kidney; Kidney Tubules; Proteinuria; Retinol-Binding Proteins; Thromboplastin

A case is reported of a 60 year-old patient with chronic disseminated intravascular coagulation (DIC) which was increased by the therapeutic embolization of a renal tumour. The patient had 2 primary carcinomas (renal and prostatic) with vertebral metastases, severe chronic anaemia (due to haematuria), and chronic DIC, with thrombocytopaenia, soluble complexes, and fibrinogen and fibrin degradation products. Therapeutic embolization of the renal artery was carried out with fragments of dura mater. Although the result was anatomically very satisfactory, the patient's condition worsened, with continuing haematuria, and development of an haematoma in the lumbar fossa. Coagulation factors and antithrombin III (AT III) concentrations decreased, whereas the activated partial thromboplastin, thrombin and reptilase times increased. The patient also suffered from acute renal failure (creatinine: 690 mumol.l-1). Treatment consisted in fluid replacement, red blood cell and platelet transfusions, 150 IU.kg-1.d-1 heparin and 20 IU.kg-1.d-1 AT III. Haematological tests returned to pre-embolization values on the ninth day. The sudden worsening in the patient's condition was probably due to the sudden massive release of tissue thromboplastins related to the renal necrosis induced by the therapeutic embolization. The use of heparin AT III in the management of this patient is discussed.

Topics: Antithrombin III; Blood Coagulation Factors; Blood Platelets; Blood Transfusion; Chronic Disease; Disseminated Intravascular Coagulation; Embolization, Therapeutic; Hematuria; Heparin; Humans; Kidney Neoplasms; Male; Middle Aged; Renal Artery; Thromboplastin

Four patients had clinical manifestations of the hemolytic-uremic syndrome. No evidence of active intravascular coagulation was found during the acute phase of the illness, using a sensitive assay to measure soluble circulating fibrin in the plasma of these patients, three of whom developed the clinical syndrome while hospitalized for gastro-enteritis. These findings, coupled with the findings of others, suggest that either the episode of intravascular coagulation precedes the development of the clinical manifestations, or that platelet thrombosis is occurring in the absence of activation of plasma clotting factors. In any case, heparin anticoagulant therapy does not seem indicated.

Topics: Anuria; Blood Cell Count; Blood Coagulation Tests; Blood Platelets; Blood Pressure; Blood Urea Nitrogen; Carbon Radioisotopes; Child; Child, Preschool; Creatinine; Disseminated Intravascular Coagulation; Factor V; Factor VIII; Female; Fibrin; Fibrinogen; Hematuria; Hemoglobins; Hemolytic-Uremic Syndrome; Heparin; Humans; Infant; Male; Proteinuria; Prothrombin Time; Thromboplastin; Thrombosis

Topics: Aged; Autopsy; Chronic Disease; Disseminated Intravascular Coagulation; Female; Fibrin; Fibrosarcoma; Hematoma; Hematuria; Humans; Leiomyosarcoma; Pulmonary Artery; Sarcoma; Thromboplastin

Topics: Alanine Transaminase; Aspartate Aminotransferases; Clot Retraction; Disability Evaluation; Epistaxis; Factor IX; Hemarthrosis; Hematuria; Hemophilia B; Hemorrhage; Hospitalization; Humans; Injections, Intravenous; Length of Stay; Prothrombin Time; Schools; Thrombelastography; Thromboplastin

Topics: Adult; Antibodies; Antigens; Appendectomy; Blood Coagulation Disorders; Blood Coagulation Factors; Blood Coagulation Tests; Blood Transfusion; Factor VII; Factor X; Female; Hematuria; Hemorrhage; Heterozygote; Humans; Hypoprothrombinemias; Immunodiffusion; Italy; Neutralization Tests; Pedigree; Phosphatidylethanolamines; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders; Thromboplastin; Tooth Extraction

Topics: Anticoagulants; Blood Coagulation Disorders; Blood Coagulation Factors; Child; Female; Hematuria; Humans; Hypoprothrombinemias; Lupus Erythematosus, Systemic; Prednisone; Prothrombin; Prothrombin Time; Thromboplastin; Vitamin K

Topics: ABO Blood-Group System; Adolescent; Adult; Aged; Anemia, Aplastic; Blood Coagulation; Blood Coagulation Tests; Blood Transfusion; Capillary Fragility; Centrifugation; Female; Fibrinolysin; Fibrinolysis; Gastrointestinal Hemorrhage; Hematuria; Hemostasis; Hepatitis; Humans; Leukemia, Myeloid; Male; Middle Aged; Prothrombin Time; Stomach Neoplasms; Stomach Ulcer; Thrombin; Thromboangiitis Obliterans; Thromboplastin

Topics: Blood Coagulation; Fibrin; Fibrinolysis; Fibrinolytic Agents; Hematuria; Humans; In Vitro Techniques; Male; Thromboplastin

Topics: Aminocaproates; Blood Coagulation Tests; Blood Platelets; Factor V; Factor VII; Fibrinogen; Fibrinolytic Agents; Hematuria; Humans; Male; Plasminogen; Postoperative Complications; Prostatectomy; Prostatic Hyperplasia; Thromboplastin

Topics: Anticoagulants; Blood Coagulation Tests; Coumarins; Erythrocytes; Hematuria; Heparin; Humans; Postoperative Care; Postoperative Complications; Thromboembolism; Thromboplastin