Thromboelastogram as a Tool to Predict Hypercoagulability in Children With Cystic Fibrosis
Hülya Anıl1, Gonca Kılıç Yıldırım2, Koray Harmancı1
11 Department of Pediatric Allergy and Immunology, Faculty of Medicine, Osmangazi University, Eskisehir, Turkey.
Insights
Children with cystic fibrosis (CF) exhibit a hypercoagulable state, as indicated by thromboelastography (TEG) analysis. This suggests an increased risk of thrombosis in pediatric CF patients, warranting further investigation into coagulation factors.
Area of Science:
- Pediatric Hematology
- Pulmonology
- Thrombosis Research
Background:
- Cystic Fibrosis (CF) is associated with an increased tendency for thrombosis.
- The specific factors contributing to thrombosis risk in pediatric CF patients are not well understood.
Purpose of the Study:
- To investigate the thromboelastography (TEG) profile in children diagnosed with cystic fibrosis.
- To compare the coagulation status of pediatric CF patients with healthy controls using ROTEM analysis.
Main Methods:
- Nineteen pediatric patients with CF and 20 healthy controls were enrolled.
- Standard coagulation tests (prothrombin time, activated prothrombin time, fibrinogen, d-dimer) and ROTEM assays (INTEM, EXTEM) were performed.
- Key parameters including clotting time, clot formation time (CFT), and maximum clot firmness (MCF) were analyzed.
Main Results:
- Patients with CF showed significantly increased maximum clot firmness (MCF) in both INTEM and EXTEM assays compared to controls.
- Clot formation time (CFT) was significantly decreased in the INTEM assay for CF patients.
- Strong positive correlations were observed between fibrinogen levels and MCF, and negative correlations with CFT.
Conclusions:
- Thromboelastography profiles indicate a hypercoagulable state in children with cystic fibrosis.
- These findings highlight potential prothrombotic tendencies in pediatric CF, necessitating further research into clinical implications.
Abstract:
Increased thrombophilic tendency in patients with cystic fibrosis (CF) has recently been reported. The determinants of thrombosis in children with CF remain largely unknown. Our aim in this study was to evaluate the thromboelastography (TEG) profile of children with CF through ROTEM (whole blood rotation thromboelastometry). Nineteen patients with CF and 20 controls were included in the study. Whole blood count, prothrombin time, activated prothrombin time, fibrinogen, d-dimer levels, and ROTEM assays (INTEM, EXTEM) were performed. Clotting time, clot formation time (CFT), and maximum clot firmness (MCF) were determined by INTEM and EXTEM analysis. In INTEM assay, MCF ( P = .001) value was significantly increased and CFT ( P = .031) value was decreased in patients with CF compared with those of the control group. In the EXTEM assay, there was a similar significant increase in MCF ( P = .023) value in patients with CF compared with that of the control group. There was a significant positive correlation between fibrinogen levels and MCF in EXTEM ( r = .72) and INTEM ( r = .76) assays, whereas there was a negative correlation with CFT in EXTEM ( r = -.61) and INTEM ( r = -.67). The results of our study indicated that TEG profiles in patients with CF were more hypercoagulable compared with those of the control group.
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