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Kawasaki R, Sakata A, Hosoda C, Harada S, Soeda T, Nishida Y, Matsumoto N, Tatsumi K, Nogami K, Yoshimura Y, Shima M. The use of infrared thermography for non-invasive detection of bleeding and musculoskeletal abnormalities in patients with hemophilia: an observational study. Thromb J 2023; 21:70. [PMID: 37381012 DOI: 10.1186/s12959-023-00511-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/05/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND In patients with hemophilia (PwH), bleeding often occurs in joints and muscles, and early detection of hemorrhage is important to prevent the onset and progression of mobility impairment. Complex-Image analysis such as ultrasonography, computed tomography, and magnetic resonance imaging are used to detect bleeding. On the other hand, no simple and rapid method to detect the active bleeding has been reported. Local inflammatory responses occur when blood leaks from damaged vessels, and the temperature at the site of active bleeding could be expected to increase in these circumstances, leading to an increase in surrounding skin temperature. Therefore, the purpose of this study was to investigate whether the measurement of skin temperature using infrared thermography (IRT) can be used as a diagnostic aid to detect active bleeding. METHODS Fifteen PwH (from 6 to 82 years old) complaining of discomfort such as pain were examined. Thermal images were obtained simultaneously at the affected sides and comparable unaffected sides. The average skin temperature of the affected side and of the unaffected side were measured. The temperature differences were calculated by subtracting the average skin temperature at the unaffected side from the affected side. RESULTS In eleven cases with active bleeding, the skin temperature at the affected side was more than 0.3 °C higher (0.3 °C to 1.4 °C) compared to the unaffected side. In two cases without active bleeding, there were no significant differences in skin temperature between the affected and unaffected sides. In two cases with previous rib or thumb bone fracture, the skin temperature at the affected side was 0.3 °C or 0.4 °C lower than that of the unaffected side, respectively. In two cases with active bleeding in which longitudinal evaluation was conducted, the difference in skin temperature decreased after hemostatic treatment. CONCLUSION The analysis of skin temperature deference using IRT was a useful supportive tool to readily assess musculoskeletal abnormalities and bleeding in PwH as well as to determine the success of the hemostatic treatment.
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Affiliation(s)
- Ryohei Kawasaki
- Medicinal Biology of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
- Product Research Department, Medical Affairs Division, Chugai Pharmaceutical Co., Ltd., Yokohama, Japan
- Advanced Medical Science of Thrombosis and Hemostasis, Nara Medical University, Kashihara, Japan
| | - Asuka Sakata
- Medicinal Biology of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
| | - Chihiro Hosoda
- Advanced Medical Science of Thrombosis and Hemostasis, Nara Medical University, Kashihara, Japan
| | - Suguru Harada
- Medicinal Biology of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
- Product Research Department, Medical Affairs Division, Chugai Pharmaceutical Co., Ltd., Yokohama, Japan
| | - Tetsuhiro Soeda
- Medicinal Biology of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
- Product Research Department, Medical Affairs Division, Chugai Pharmaceutical Co., Ltd., Yokohama, Japan
| | - Yukiko Nishida
- Medicinal Biology of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
- Project Planning and Coordination Department, Translational Research Division, Chugai Pharmaceutical Co., Ltd., Chuo-ku, Japan
| | - Naoki Matsumoto
- Medicinal Biology of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
- Product Research Department, Medical Affairs Division, Chugai Pharmaceutical Co., Ltd., Yokohama, Japan
| | - Kohei Tatsumi
- Medicinal Biology of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
- Advanced Medical Science of Thrombosis and Hemostasis, Nara Medical University, Kashihara, Japan
| | - Keiji Nogami
- Department of Pediatrics, Nara Medical University, Kashihara, Japan
| | - Yasushi Yoshimura
- Product Research Department, Medical Affairs Division, Chugai Pharmaceutical Co., Ltd., Yokohama, Japan
| | - Midori Shima
- Medicinal Biology of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan.
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Sossa Melo CL, Wandurraga EA, Peña AM, Jiménez SI, Salazar LA, Ochoa ME, Luna-Gonzalez ML, Ortiz ML, Morales K, Ayala-Castillo M, Reyes DL, Chalela CM. Low bone mineral density and associated factors in patients with haemophilia in Colombia. Haemophilia 2018; 24:e222-e229. [DOI: 10.1111/hae.13516] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2018] [Indexed: 01/15/2023]
Affiliation(s)
- C. L. Sossa Melo
- Division of Hematology and Hematopoietic Stem Cell Transplantation; Department of Internal Medicine; School of Medicine; Universidad Autonoma de Bucaramanga; Bucaramanga Colombia
- Hematology and Hematopoietic Stem Cell Transplantation Unit; Clinica Carlos Ardila Lulle; Bucaramanga Colombia
| | - E. A. Wandurraga
- Department of Endocrinology; School of Medicine; Universidad Autonoma de Bucaramanga; Bucaramanga Colombia
| | - A. M. Peña
- Division of Hematology and Hematopoietic Stem Cell Transplantation; Department of Internal Medicine; School of Medicine; Universidad Autonoma de Bucaramanga; Bucaramanga Colombia
- Hematology and Hematopoietic Stem Cell Transplantation Unit; Clinica Carlos Ardila Lulle; Bucaramanga Colombia
| | - S. I. Jiménez
- Division of Hematology and Hematopoietic Stem Cell Transplantation; Department of Internal Medicine; School of Medicine; Universidad Autonoma de Bucaramanga; Bucaramanga Colombia
- Hematology and Hematopoietic Stem Cell Transplantation Unit; Clinica Carlos Ardila Lulle; Bucaramanga Colombia
| | - L. A. Salazar
- Division of Hematology and Hematopoietic Stem Cell Transplantation; Department of Internal Medicine; School of Medicine; Universidad Autonoma de Bucaramanga; Bucaramanga Colombia
- Hematology and Hematopoietic Stem Cell Transplantation Unit; Clinica Carlos Ardila Lulle; Bucaramanga Colombia
| | - M. E. Ochoa
- Department of Public Health; School of Medicine; Universidad Autonoma de Bucaramanga; Bucaramanga Colombia
| | - M. L. Luna-Gonzalez
- Research Department; Universidad Autonoma de Bucaramanga; Bucaramanga Colombia
| | - M. L. Ortiz
- Hematology and Hematopoietic Stem Cell Transplantation Unit; Clinica Carlos Ardila Lulle; Bucaramanga Colombia
| | - K. Morales
- Division of Hematology; Department of Internal Medicine; School of Medicine; Universidad Nacional Autonoma de Mexico; Ciudad de Mexico Mexico
| | - M. Ayala-Castillo
- Division of Hematology and Hematopoietic Stem Cell Transplantation; Department of Internal Medicine; School of Medicine; Universidad Autonoma de Bucaramanga; Bucaramanga Colombia
| | - D. L. Reyes
- Division of Hematology and Hematopoietic Stem Cell Transplantation; Department of Internal Medicine; School of Medicine; Universidad Autonoma de Bucaramanga; Bucaramanga Colombia
| | - C. M. Chalela
- Division of Hematology and Hematopoietic Stem Cell Transplantation; Department of Internal Medicine; School of Medicine; Universidad Autonoma de Bucaramanga; Bucaramanga Colombia
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Seuser A, Kurnik K, Mahlein AK. Infrared Thermography as a Non-Invasive Tool to Explore Differences in the Musculoskeletal System of Children with Hemophilia Compared to an Age-Matched Healthy Group. SENSORS (BASEL, SWITZERLAND) 2018; 18:E518. [PMID: 29419797 PMCID: PMC5855128 DOI: 10.3390/s18020518] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 02/06/2018] [Accepted: 02/07/2018] [Indexed: 11/16/2022]
Abstract
Recurrent joint bleeds and silent bleeds are the most common clinical feature in patients with hemophilia. Every bleed causes an immediate inflammatory response and is the leading cause of chronic crippling arthropathy. With the help of infrared thermography we wanted to detect early differences between a group of clinical non-symptomatic children with hemophilia (CWH) with no history of clinically detected joint bleeds and a healthy age-matched group of children. This could help to discover early inflammation and help implement early treatment and preventative strategies. It could be demonstrated that infrared thermography is sensitive enough to detect more signs of early inflammatory response in the CWH than in healthy children. It seems to detect more side differences in temperature than clinical examination of silent symptoms detects tender points. Silent symptoms/tender points seem to be combined with early local inflammation. Using such a non-invasive and sensor-based early detection, prevention of overloading and bleeding might be achieved.
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Affiliation(s)
- Axel Seuser
- Practice for Rehabilitation, Prevention and Orthopedics, 53225 Bonn, Germany.
| | - Karin Kurnik
- Dr. von Hauner Children's Hospital, University of Munich, 80337 Munich, Germany.
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Lameness associated with tarsal haemarthrosis as the sole clinical sign of idiopathic immune-mediated thrombocytopenia in a dog. Vet Comp Orthop Traumatol 2017; 27:491-5. [DOI: 10.3415/vcot-14-03-0041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 08/26/2014] [Indexed: 11/17/2022]
Abstract
SummaryA four-year-old, male Cocker Spaniel was presented for investigation of pelvic limb stiffness. There was palpable effusion of both tarsi, and analysis of synovial fluid from these joints indicated previous haemorrhage. After further investigation a diagnosis of idiopathic immune-mediated thrombocytopenia was made. The dog responded to treatment with prednisolone and azathioprine. To the authors’ knowledge, this is the first reported case of confirmed haemarthrosis as the sole presenting clinical sign for canine idiopathic immunemediated thrombocytopenia.
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Abstract
Hemophilia A and B are rare, X-linked bleeding disorders resulting from a partial or total deficiency of functionally active coagulation factor VIII or factor IX, respectively. Endogenous factor levels have traditionally been used to characterize the severity of the disorder, with severe hemophilia considered as circulating levels of factor less than 1% of normal. Identifying patients with severe hemophilia is essential to effective treatment, since these patients are at highest risk of spontaneous life or limb-threatening bleeding and disability resulting from repeated joint bleeding and are most likely to benefit from prophylaxis. However, there is variability in bleeding tendency, even among patients with severe hemophilia. This article will review potential modifiers of hemophilia-associated bleeding other than endogenous factor activity, which may influence bleeding tendencies and complications in hemophilic patients considered to have severe hemophilia. These potential modifiers include physiologic factors, such as elements of the hemostatic system; pathophysiologic factors, such as hemophilic arthropathy, associated inflammation, and angiogenesis; and others, such as seasonal variation, body weight, and physical activity.
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Groth MP, Kristensen AT, Øvlisen KA, Tranholm M. Buprenorphine does not impact the inflammatory response in haemophilia A mice with experimentally-induced haemarthrosis. Lab Anim 2014; 48:225-236. [DOI: 10.1177/0023677214524381] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Haemarthrosis is the most common clinical manifestation of haemophilia and is responsible for significant morbidity in haemophilic patients. The murine experimentally-induced knee bleeding model is an important model in haemophilia research but it is currently unknown if the use of analgesia in this model might impact on the inflammatory response. The aim was to investigate the inflammatory response after a needle induced knee bleed in haemophilia A mice treated with buprenorphine or saline. One hundred and sixty mice were randomized into two groups to blindly receive buprenorphine or saline. All the mice were anaesthetized and knee injury was induced by inserting a 30 G needle into the right knee joint. At t = 6, 24, 48 and 72 h, 20 mice from each group were terminated and the following parameters were assessed: change in body weight and joint diameter, visual bleeding score (VBS), white blood counts, haematocrit, platelet concentrations, haemoglobin, plasma haptoglobin and plasma and synovial fluid levels of 23 cytokines. Twenty mice were terminated at t = 0 receiving no injury or treatment to provide baseline measures. Twenty-one cytokines in plasma and 22 cytokines in synovial fluid, joint diameter change, VBS and blood parameters were not significantly altered by the administration of buprenorphine. Slight alterations of plasma haptoglobin at t = 48 h, body weight, plasma and synovial eotaxin and plasma G-CSF were found in buprenorphine-treated mice. We demonstrated that buprenorphine does not overall impact on the inflammatory response, and the use of buprenorphine in the knee bleeding model in haemophilic mice should be continued.
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Affiliation(s)
- MP Groth
- Department of Veterinary Clinical and Animal Sciences, Faculty of Life Sciences, University of Copenhagen, Frederiksberg C, Denmark
- Novo Nordisk A/S, Novo Nordisk Park, Måløv, Denmark
| | - AT Kristensen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Life Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | | | - M Tranholm
- Novo Nordisk A/S, Novo Nordisk Park, Måløv, Denmark
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Abstract
Hemophilia is a hereditary disease in which circulating levels of coagulation factors are lacking, resulting in a propensity toward bleeding. Intra-articular hemorrhages are a hallmark of hemophilia and may lead a cascade of cytokine elaboration and inflammatory-mediated changes, which ultimately result in cartilage loss and arthropathy. Diarthrodial joints, such as the knee, elbow, and ankle, are most commonly affected. This article highlights issues surrounding hemophilic arthropathy of the elbow and focuses on preventive measures, management strategies of the hemophilic elbow, and treatment options for established arthropathy.
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Affiliation(s)
- Julie E Adams
- Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, R200, Minneapolis, MN 55454, USA.
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