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Disorders of Hemostasis01:24

Disorders of Hemostasis

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Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
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Venous Thrombosis I: Introduction01:30

Venous Thrombosis I: Introduction

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Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Hyperosmolar Hyperglycemic State01:21

Hyperosmolar Hyperglycemic State

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Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...
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Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

58
Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

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A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
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Related Experiment Video

Updated: May 7, 2026

Experimental and Imaging Techniques for Examining Fibrin Clot Structures in Normal and Diseased States
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Experimental and Imaging Techniques for Examining Fibrin Clot Structures in Normal and Diseased States

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Thalassemia and the hypercoagulable state.

Nongnuch Sirachainan1

  • 1Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Thrombosis Research
|October 16, 2013
PubMed
Summary

Thalassemia patients face high thrombosis risk due to abnormal red blood cells and platelet activation. Aspirin is now recommended for splenectomized patients with thrombocytosis to prevent these dangerous blood clots.

Keywords:
Abnormal RBC surfaceEndothelial activationHypercoagulable statePlatelet activationThalassemiaThromboembolism

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Area of Science:

  • Hematology
  • Vascular Medicine
  • Genetics

Background:

  • Thalassemia is an inherited hemolytic anemia with a significant risk of thrombosis.
  • Key mechanisms include abnormal red blood cells (RBCs), platelet activation, and endothelial dysfunction.
  • Splenectomized thalassemia patients exhibit higher thromboembolism (TE) risk due to thrombocytosis and circulating abnormal RBCs.

Purpose of the Study:

  • To review the mechanisms of thromboembolism in thalassemia.
  • To evaluate the role of regular red blood cell transfusions in mitigating TE risk.
  • To discuss current recommendations for preventing TE in at-risk thalassemia patients.

Main Methods:

  • Literature review of studies on thalassemia, thrombosis, and treatment strategies.
  • Analysis of factors contributing to thromboembolism in splenectomized patients.
  • Evaluation of the impact of red blood cell transfusions and aspirin therapy.

Main Results:

  • Abnormal RBC surface, platelet, and endothelial activation are primary drivers of TE in thalassemia.
  • Splenectomy exacerbates TE risk through thrombocytosis and increased abnormal RBCs.
  • Regular RBC transfusions can decrease abnormal RBCs, suppress erythropoiesis, reduce coagulation markers, and lower pulmonary artery pressure.

Conclusions:

  • Thrombosis is a major complication of thalassemia, influenced by RBC abnormalities and platelet activation.
  • Splenectomy increases TE risk in thalassemia patients.
  • Aspirin is recommended for splenectomized, thrombocytosis-positive thalassemia patients to prevent thromboembolic events.