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[The hemostatic system and DIC syndrome in cholestatic forms of viral hepatitis]
Insights
Viral hepatitis impacts blood clotting differently based on disease severity and type. Severe cases, especially with prolonged cholestasis or viral hepatitis B, risk disseminated intravascular coagulation (DIC), manageable with specific treatments.
Area of Science:
- Hepatology
- Hematology
- Virology
Background:
- Viral hepatitis presents with diverse clinical forms, including cholestatic variants.
- Coagulation activity disorders are frequently observed in patients with viral hepatitis.
- The specific impact on coagulation varies based on disease presentation and patient factors.
Purpose of the Study:
- To investigate the heterogeneity of coagulation disorders in viral hepatitis.
- To identify factors influencing coagulation abnormalities in cholestatic and non-cholestatic viral hepatitis.
- To determine the role of cholestasis and specific viral hepatitis types in coagulation derangements.
Main Methods:
- Comparative analysis of coagulation activity in 159 patients with cholestatic viral hepatitis and 82 patients with non-cholestatic viral hepatitis.
- Assessment of clinical variants, disease period, severity, premorbid background, and infection routes.
- Monitoring for the development of disseminated intravascular coagulation (DIC).
Main Results:
- Coagulation disorders were nonhomogeneous, varying with clinical presentation, disease stage, and severity.
- Severe hepatitis forms, prolonged maximal bile stasis, and viral hepatitis B were associated with a higher risk of DIC.
- The development of DIC was observed in the most severe cases.
Conclusions:
- Coagulation abnormalities in viral hepatitis are multifactorial and clinically dependent.
- Disseminated intravascular coagulation (DIC) is a significant complication in severe viral hepatitis, particularly with cholestasis and in viral hepatitis B.
- Timely intervention with heparin, contrical, and antihemorrhagic drugs can prevent or manage DIC syndrome.
Abstract:
A study is presented of 159 patients with cholestatic forms of viral hepatitis and 82 patients with viral hepatitis showing no cholestasis. The disorders of the coagulation activity were found to be nonhomogeneous and depended on the clinical variant of viral hepatitis, the period and severity of the disease, premorbid background and ways of infection. It is emphasized that development of the syndrome of disseminated intravascular coagulation is characteristic of the most severe forms of hepatitis against the background of prolonged and maximal bile stasis as well as in viral hepatitis B. Use of heparine, contrical and antihemorrhagic drugs when indicated prevents or controls the DIC syndrome.