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Clotting changes in Cushing's syndrome: elevated factor VIII activity.

R Dal Bo Zanon, L Fornasiero, M Boscaro

    Folia Haematologica (Leipzig, Germany : 1928)
    |January 1, 1983
    PubMed
    Summary

    High cortisol levels in Cushing's syndrome patients increase factor VIII, a clotting protein. This elevation returns to normal after treatment, potentially explaining surgical risks.

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    Area of Science:

    • Endocrinology
    • Hematology
    • Clinical Medicine

    Background:

    • Cushing's syndrome is characterized by elevated cortisol levels.
    • Patients with Cushing's syndrome are at higher risk for thromboembolic events, especially post-surgery.
    • The specific hemostatic abnormalities contributing to these complications are not fully understood.

    Purpose of the Study:

    • To investigate the relationship between cortisol levels and coagulation factors in patients with Cushing's syndrome.
    • To assess changes in factor VIII (antigen, activity, and von Willebrand factor) and other clotting parameters before and after treatment for Cushing's syndrome.
    • To explore the potential role of factor VIII in the thromboembolic complications observed in these patients.

    Main Methods:

    • Investigated 15 patients (13 women, 2 men) with Cushing's syndrome.

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  • Measured plasma and urinary cortisol levels.
  • Assayed factor VIII (antigen, activity, von Willebrand factor) and other coagulation tests.
  • Collected samples pre-treatment and serially for up to 11 months post-treatment.

    • Main Results:

    • Elevated plasma and urinary cortisol and factor VIII levels were observed before treatment.
    • Cortisol and factor VIII levels gradually normalized within 3-4 months after treatment.
    • No significant changes were noted in other coagulation tests.
    • A positive correlation between high plasma cortisol and increased factor VIII production was suggested.

    Conclusions:

    • High cortisol levels in Cushing's syndrome appear to stimulate factor VIII production.
    • Increased factor VIII activity may contribute to the thromboembolic complications seen in these patients.
    • Monitoring and managing factor VIII levels could be important in surgical patients with Cushing's syndrome.