A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Enhanced thrombin generation and depressed anticoagulant function in children with pneumonia
Tekijät: Langstrom S, Peltola V, Petaja J, Ruuskanen O, Heikinheimo M
Kustantaja: WILEY-BLACKWELL
Julkaisuvuosi: 2012
Journal: Acta Paediatrica
Tietokannassa oleva lehden nimi: ACTA PAEDIATRICA
Lehden akronyymi: ACTA PAEDIATR
Numero sarjassa: 9
Vuosikerta: 101
Numero: 9
Aloitussivu: 919
Lopetussivu: 923
Sivujen määrä: 5
ISSN: 0803-5253
DOI: https://doi.org/10.1111/j.1651-2227.2012.02746.x
Tiivistelmä
Aims: To clarify the status of the coagulation system in children with community-acquired pneumonia. Methods: Coagulation activation markers (prothrombin fragment F1 + 2, thrombinantithrombin complexes, D-dimer), the natural anticoagulants (antithrombin, protein C and S) and tissue factor were measured in 28 consecutive children with pneumonia on admission to the hospital. Patients were divided into those with either bacterial-type pneumonia (at least two of the following three criteria: plasma C-reactive protein (CRP) >80 mg/L, white blood cell count >15 x 109/L and alveolar infiltrates on the chest radiograph) or viral-type pneumonia. Results: The majority of the patients (79%) showed elevation of at least one of the three coagulation activation markers. Plasma CRP concentration correlated with F1 + 2 (R = 0.44, p < 0.05) and D-dimer (R = 0.71, p < 0.0001). Patients with bacterial-type pneumonia (n = 17) had higher D-dimer levels (p < 0.05) and lower levels of antithrombin (p = 0.005) and protein C (p = 0.08) than the patients with viral-type pneumonia. Conclusions: Children with community-acquired bacterial-type pneumonia show distinctive changes in their coagulation system. The finding of coagulation system activation and depressed function of natural anticoagulants in uncomplicated pneumonia helps to understand the rapid and unpredictable changes observed in the coagulation status in patients with more severe forms of disease.
Aims: To clarify the status of the coagulation system in children with community-acquired pneumonia. Methods: Coagulation activation markers (prothrombin fragment F1 + 2, thrombinantithrombin complexes, D-dimer), the natural anticoagulants (antithrombin, protein C and S) and tissue factor were measured in 28 consecutive children with pneumonia on admission to the hospital. Patients were divided into those with either bacterial-type pneumonia (at least two of the following three criteria: plasma C-reactive protein (CRP) >80 mg/L, white blood cell count >15 x 109/L and alveolar infiltrates on the chest radiograph) or viral-type pneumonia. Results: The majority of the patients (79%) showed elevation of at least one of the three coagulation activation markers. Plasma CRP concentration correlated with F1 + 2 (R = 0.44, p < 0.05) and D-dimer (R = 0.71, p < 0.0001). Patients with bacterial-type pneumonia (n = 17) had higher D-dimer levels (p < 0.05) and lower levels of antithrombin (p = 0.005) and protein C (p = 0.08) than the patients with viral-type pneumonia. Conclusions: Children with community-acquired bacterial-type pneumonia show distinctive changes in their coagulation system. The finding of coagulation system activation and depressed function of natural anticoagulants in uncomplicated pneumonia helps to understand the rapid and unpredictable changes observed in the coagulation status in patients with more severe forms of disease.
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