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Haemorrhagic smallpox. I. Preliminary haematological studies
Bulletin of the World Health Organization
|January 1, 1965
Summary
Smallpox patients with severe bleeding show significant clotting defects, including low platelets and impaired prothrombin activity. These hematological issues are key to understanding hemorrhagic smallpox complications.
Area of Science:
- Hematology
- Infectious Diseases
- Pathophysiology
Background:
- Hemorrhagic diathesis in smallpox patients suggests underlying hematological abnormalities.
- Understanding these defects is crucial for managing severe smallpox cases.
Purpose of the Study:
- To investigate specific hematological defects contributing to hemorrhagic diathesis in smallpox.
- To differentiate coagulation profiles between hemorrhagic and non-hemorrhagic smallpox.
Main Methods:
- Studied 93 smallpox patients (hemorrhagic and non-hemorrhagic forms).
- Performed comprehensive bleeding and coagulation studies.
- Assessed platelet counts, clot retraction, bleeding time, tourniquet test, prothrombin activity, prothrombin complex times, thrombin time, and prothrombin consumption.
Main Results:
- Non-hemorrhagic patients: No significant clotting defects, but some had decreased platelets and clot retraction abnormality.
- Late hemorrhagic form: Consistently showed thrombocytopenia, prolonged bleeding time, abnormal tourniquet test, and clot retraction; some had reduced prothrombin activity.
- Early hemorrhagic form: Severe thrombocytopenia, markedly decreased prothrombin activity, prolonged prothrombin complex and thrombin times (suggesting antithrombin), and impaired prothrombin consumption.
Conclusions:
- Thrombocytopenia and impaired prothrombin consumption are characteristic of hemorrhagic smallpox.
- Severe early hemorrhagic smallpox involves profound coagulation factor deficiencies and potential circulating anticoagulants.
- Hematological defects, particularly thrombocytopenia, are central to the pathophysiology of hemorrhagic smallpox.