Imbalance of pro- vs. anti-coagulation factors in Chinese patients with Budd-Chiari syndrome and non-cirrhotic portal vein thrombosis.

Hui Chen,Lei Liu,Daiming Fan,Guohong Han,Zhanxin Yin,Xingshun Qi,Chuangye He,Feifei Wu,Zhuoli Zhang

doi:10.1371/journal.pone.0119909

Hui Chen, Lei Liu + Show 7 more

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https://doi.org/10.1371/journal.pone.0119909

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Journal: PloS one	Publication Date: Mar 30, 2015
Citations: 5	License type: CC BY 4.0

Affiliation: Xijing Hospital, Air Force Medical University

Abstract

Background and AimThe coagulation abnormalities in non-cirrhotic Budd-Chiari syndrome (NC-BCS) and non-cirrhotic portal vein thrombosis (NC-PVT) are unclear. We conducted this case-control study to investigate the coagulation profile of NC-BCS and NC-PVT in Chinese patients.MethodsWe measured the levels of factors II, V, VII, VIII, IX, X, XI, XII, protein C (PC), protein S (PS) and antithrombin (AT) in blood samples from 37 NC-BCS patients, 74 NC-PVT patients, and 100 healthy controls. The levels and ratios of pro- and anti-coagulation factors were compared between patients with NC-BCS and healthy controls, between different types of NC-BCS and between NC-PVT and healthy controls.ResultsIn patients with NC-BCS, factor VIII (P<0.001) was significantly elevated; factor V (P<0.001), VII (P<0.001), IX (P = 0.003), X (P<0.001), XI (P<0.001), XII (P<0.001), PC (P<0.001) and AT (P<0.001) were significantly decreased; and no difference was observed for factor II (P = 0.088) and PS (P = 0.199) compared with healthy controls. Factor VIII-to-PC (P = 0.008), factor VIII-to-PS (P = 0.037) and factor VIII-to-AT (P = 0.001) were significantly increased; other ratios were significantly reduced or did not show any difference. No differences were observed between different types of NC-BCS for individual pro- and anti-coagulation factors or the ratios between them. Among patients with NC-PVT, factor VIII (P<0.001) was significantly elevated and other factors were significantly decreased. Factor II-to-PC (P<0.001), factor VIII-to-PC (P<0.001), factor IX-to-PC (P<0.001), factor VIII-to-PS (P<0.001), factor II-to-AT (P<0.001), factor VIII-to-AT (P<0.001) and factor IX-to-AT (P<0.001) were significantly increased; all other ratios for NC-PVT were significantly reduced or did not show any significant difference.ConclusionsNC-BCS and NC-PVT are associated with elevated levels of factor VIII and the decreased levels of PC and AT were probably the most significant features of coagulation imbalance. Additionally, NC-PVT was associated with decreased levels of PS.

Highlights

Coagulation is a highly integrated cellular and humoral process that is balanced by two opposing factors [1]
In patients with non-cirrhotic Budd-Chiari syndrome (NC-Budd-Chiari syndrome (BCS)), factor VIII (P
No differences were observed between different types of NC-BCS for individual pro- and anticoagulation factors or the ratios between them

Summary

Introduction

Coagulation is a highly integrated cellular and humoral process that is balanced by two opposing factors [1]. Most pro- and anti-coagulation factors, with the exception of factor VIII, are synthesized by hepatocytes [2]. The mechanism of clot formation is dependent on the interaction of pro- and anti-coagulation factors [3]. The balance between these factors is crucial for normal hemostasis, and the disturbances of this balance may lead to a thrombotic tendency [4]. The coagulation abnormalities in non-cirrhotic Budd-Chiari syndrome (NC-BCS) and noncirrhotic portal vein thrombosis (NC-PVT) are unclear. We conducted this case-control study to investigate the coagulation profile of NC-BCS and NC-PVT in Chinese patients

Methods

Results

Conclusion