Coagulation Disorders By Circulating Anticoagulants

Circulating anticoagulants are usually autoantibodies that certain clotting factors in vivo neutralize (z. B. a autoantibodies to factor VIII or factor V) or the phospholipidgebundene protein in vitro inhibit (antiphospholipid antibodies). The latter sometimes cause bleeding via a bond of in vivo prothrombin-phospholipid complexes.

Circulating anticoagulants are usually autoantibodies that certain clotting factors in vivo neutralize (z. B. a autoantibodies to factor VIII or factor V) or the phospholipidgebundene protein in vitro inhibit (antiphospholipid antibodies). The latter sometimes cause bleeding via a bond of in vivo prothrombin-phospholipid complexes.

(See also coagulation disorders at a glance.) Circulating anticoagulants are usually autoantibodies that certain clotting factors in vivo (eg. As a autoantibodies to factor VIII or factor V) neutralize or the phospholipidgebundene protein in vitro inhibit (antiphospholipid antibodies). The latter sometimes cause bleeding via a bond of in vivo prothrombin-phospholipid complexes. The suspicion of circulating anticoagulants exists when excessive bleeding while either a prolonged PTT or PT occur, after repeating the test with a 1: 1 mixture can not be corrected by normal plasma and patient plasma. Antiphospholipid typically cause thrombosis (the antiphospholipid antibody syndrome). However, in some patients the antibodies bind to prothrombin-phospholipid complexes and thus lead to a hypoprothrombinemia and bleeding. Factor VIII inhibitors to factor VIII allo-antibody develop in about 15-35% of patients with severe hemophilia A as a result of repeated exposure to normal factor VIII molecules during a replacement therapy for hemophilia A. Factor VIII autoantibodies are also formed in addition occasionally in patients without hemophilia, z. As in women after pregnancy as a manifestation of an underlying systemic autoimmune disease or temporarily impaired immune regulation and in elderly patients without overt evidence of an underlying disorder. Patients with factor VIII inhibitors may develop life-threatening bleeding. Plasma containing a factor VIII antibodies, shows a prolonged PTT that does not change upon the addition of normal plasma, or other Factor VIII source in the ratio 1: 1 can be corrected to the patient plasma. The examination is performed immediately after the mixing and is repeated after an incubation period. Therapy in patients without hemophilia, cyclophosphamide, corticosteroids or rituximab for patients with hemophilia recombinant activated factor VII Treatment with cyclophosphamide, corticosteroids or Rituximab (monoclonal CD20 antibody to the lymphocytes), the formation of the autoantibody suppress (e.g. in patients without hemophilia. B . in women after childbirth). The autoantibodies may disappear spontaneously. comprising the treatment of acute bleeding in patients with hemophilia, the Factor VIII allo-antibody or autoantibodies, carried by the recombinant activated factor VII.

Health Life Media Team

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