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Chiffré-Rakotoarivony D, Diaz-Cau I, Ranc A, Champiat MA, Rousseau F, Gournay-Garcia C, Théron A, Navarro R, Boulot P, Aguilar-Martinez P, Sauguet P, Biron-Andréani C. Bleeding risk in hemophilia A and B carriers: comparison of factor levels determined using chronometric and chromogenic assays. Blood Coagul Fibrinolysis 2024:00001721-990000000-00150. [PMID: 38700721 DOI: 10.1097/mbc.0000000000001305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
BACKGROUND Predicting the bleeding risk in hemophilia A and B carriers (HAC, HBC) is challenging. OBJECTIVE The objectives of this study were to describe the bleeding phenotype in HAC and HBC using the standardized Tosetto bleeding score (BS); to determine whether the BS correlates better with factor levels measured with a chromogenic assay than with factor levels measured with chronometric and thrombin generation assays; and to compare the results in HAC and HBC. METHODS This ambispective, noninterventional study included obligate and sporadic HAC and HBC followed at a hemophilia treatment center between 1995 and 2019. RESULTS AND CONCLUSION The median BS (3, range 0-21 vs. 3.5, range 0-15, P = ns, respectively) and the abnormal BS rate (35.6% vs. 38.2%, P = ns) were not significantly different in 104 HAC and 34 HBC (mean age: 38 years, 6-80 years). However, some differences were identified. The risk of factor deficiency was higher in HBC than HAC. Specifically, Factor VIII activity (FVIII):C/Factor IX activity (FIX):C level was low (<40 IU/dl) in 18.3% (chronometric assay) and 17.5% (chromogenic assay) of HAC and in 47% and 72.2% of HBC ( P < 0.001). Moreover, the FIX:C level thresholds of 39.5 IU/dl (chronometric assay) and of 33.5 IU/dl (chromogenic assay) were associated with very good sensitivity (92% and 100%, respectively) and specificity (80% for both) for bleeding risk prediction in HBC. Conversely, no FVIII:C level threshold could be identified for HAC, probably due to FVIII:C level variations throughout life.
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Affiliation(s)
- Delphine Chiffré-Rakotoarivony
- Hemophilia Treatment Centre, Department of Biological Hematology
- Department of Biological Hematology, Hematology Laboratory
| | | | - Alexandre Ranc
- Department of Biological Hematology, Hematology Laboratory
| | | | | | | | - Alexandre Théron
- Hemophilia Treatment Centre, Department of Biological Hematology
| | - Robert Navarro
- Hemophilia Treatment Centre, Department of Biological Hematology
| | - Pierre Boulot
- Department of Obstetrics and Gynecology, University Hospital, Montpellier, France
| | - Patricia Aguilar-Martinez
- Hemophilia Treatment Centre, Department of Biological Hematology
- Department of Biological Hematology, Hematology Laboratory
| | | | - Christine Biron-Andréani
- Hemophilia Treatment Centre, Department of Biological Hematology
- Department of Biological Hematology, Hematology Laboratory
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Rousseau F, Guillet B, Mura T, Fournel A, Volot F, Chambost H, Suchon P, Frotscher B, Biron-Andréani C, Marlu R, Hezard N, Clayssens S, Boissier E, Blanc-Jouvan F, Chamouni P, Tieulie N, Rugeri L, Borel-Derlon A, de Raucourt E, Martin-Toutain I, Castet S, Lebreton A, Girault S, Helley-Russick D, D’Oiron R, Schved JF, Giansily-Blaizot M. Surgery in rare bleeding disorders: the prospective MARACHI study. Res Pract Thromb Haemost 2023; 7:102199. [PMID: 37867585 PMCID: PMC10585326 DOI: 10.1016/j.rpth.2023.102199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 10/24/2023] Open
Abstract
Background Despite the wide use of bleeding scores and the reliability of clotting factor level measurement, bleeding risk stratification before surgery remains challenging in patients with rare inherited bleeding disorders. Objectives This multicenter observational prospective study assessed in patients with rare coagulation factor deficiency, the perioperative hemostatic management choices by hemostasis experts and the bleeding outcomes after surgery. Methods One hundred seventy-eight patients with low coagulation activity level (factor [F] II, FV, combined FV-FVIII, FVII, FX, or FXI <50%) underwent 207 surgical procedures. The bleeding outcome, Tosetto's bleeding score, and perioperative hemostatic protocols were collected. Results Among the 81 procedures performed in patients with severe factor deficiency (level ≤10%), 27 were done without factor replacement (including 6 in patients at high bleeding risk), without any bleeding event. Factor replacement therapy was used mainly for orthopedic procedures. In patients with mild deficiency, 100/126 surgical procedures were carried out without perioperative hemostatic treatment. In patients with FVII or FXI deficiency, factor replacement therapy was in function of the procedure, bleeding risk, and to a lesser extent previous bleeding history. Tranexamic acid was used in almost half of the procedures, particularly in case of surgery in tissues with high fibrinolytic activity (76.8%). Conclusions The current perioperative hemostatic management of patients with rare bleeding disorders appears to be adapted. Among the 207 procedures, only 6 were associated with excessive bleeding. Our findings suggest that rather than the bleeding score, factor level and surgery type are the most relevant criteria for perioperative factor replacement therapy.
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Affiliation(s)
- Florence Rousseau
- Département d’hématologie biologique, CHU Montpellier, France
- CRC-MHC, CHU Montpellier, France
| | - Benoit Guillet
- Haemophilia Treatment Center, University Hospital, Rennes, France and Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Thibault Mura
- Département d’informatique médicale, CHU Montpellier, CHU Nîmes, Université de Montpellier FR 34090, France
| | - Alexandra Fournel
- Haemophilia Treatment Centre, University Hospital of Besançon, Besançon, France
| | | | | | - Pierre Suchon
- Aix Marseille University, Inserm, Inrae, C2VN, Marseille, France
| | - Brigit Frotscher
- Haemophilia Treatment Centre, University Hospital of Nancy, France
| | | | - Raphaël Marlu
- Hemostasis Unit, CHU Grenoble Alpes, Université Grenoble Alpes, France
| | - Nathalie Hezard
- Laboratoire d’hématologie, CHU Reims, France
- Laboratoire d’hématologie AP-HM Marseille, France
| | | | | | | | | | | | - Lucia Rugeri
- Unité Hémostase Clinique, Hospices Civils de Lyon, France
| | | | | | | | | | - Aurélien Lebreton
- Laboratoire d’hématologie, CHU Clermont Ferrand, Unité de Nutrition Humaine UMR1019, INRAE / Université Clermont Auvergne, Clermont-Ferrand, France
| | | | | | - Roseline D’Oiron
- Centre de référence de l’hémophilie et des maladies hémorragiques constitutionnelles, Hôpital Bicêtre, APHP and Hith, UMR_S1176, INSERM, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Jean-François Schved
- Département d’hématologie biologique, CHU Montpellier, France
- CRC-MHC, CHU Montpellier, France
| | - Muriel Giansily-Blaizot
- Département d’hématologie biologique, CHU Montpellier, France
- Université Montpellier d’excellence, Montpellier, France
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3
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de Mazancourt P, Quélin F, Flaujac C, de Raucourt E, Guillet B, Bauduer F, Ernest V, Beurrier P, Avril A, d'Oiron R, Biron-Andréani C, Meunier S, Dargaud Y. A focus on dominant negative variants in a series of 170 heterozygous FXI-deficient patients. Haemophilia 2023. [PMID: 37252892 DOI: 10.1111/hae.14802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/11/2023] [Accepted: 05/11/2023] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Dominant-negative effects have been described for 10 F11 variants in the literature. AIM The current study aimed at identifying putative dominant-negative F11 variants. MATERIAL AND METHODS This research consisted in a retrospective analysis of routine laboratory data. RESULTS In a series of 170 patients with moderate/mild factor XI (FXI) deficiencies, we identified heterozygous carriers of previously reported dominant-negative variants (p.Ser243Phe, p.Cys416Tyr, and p.Gly418Val) with FXI activities inconsistent with a dominant-negative effect. Our findings also do not support a dominant-negative effect of p.Gly418Ala. We also identified a set of patients carrying heterozygous variants, among which five out of 11 are novel, with FXI activities suggesting a dominant-negative effect (p.His53Tyr, p.Cys110Gly, p.Cys140Tyr, p.Glu245Lys, p.Trp246Cys, p.Glu315Lys, p.Ile421Thr, p.Trp425Cys, p.Glu565Lys, p.Thr593Met, and p.Trp617Ter). However, for all but two of these variants, individuals with close to half normal FXI coagulant activity (FXI:C) were identified, indicating an inconstant dominant effect. CONCLUSION Our data show that for some F11 variants recognized has having dominant-negative effects, such effects actually do not occur in many individuals. The present data suggest that for these patients, the intracellular quality control mechanisms eliminate the variant monomeric polypeptide before homodimer assembly, thereby allowing only the wild-type homodimer to assemble and resulting in half normal activities. In contrast, in patients with markedly decreased activities, some mutant polypeptides might escape this first quality control. In turn, assembly of heterodimeric molecules as well as mutant homodimers would result in activities closer to 1:4 of FXI:C normal range.
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Affiliation(s)
- Philippe de Mazancourt
- UMR1179, Université de Versailles-Saint-Quentin, Montigny le Bretonneux, France
- Laboratoire de Biologie Moléculaire, Hôpital A. Paré, APHP.Paris-Saclay, Boulogne-Billancourt, France
| | - Florence Quélin
- Département de Recherche Clinique, CH Versailles, Le Chesnay, France
| | - Claire Flaujac
- Laboratoire de biologie médicale, secteur hémostase, centre hospitalier de Versailles (André Mignot), Le Chesnay, France
| | - Emmanuelle de Raucourt
- Centre de Ressources et de Compétences Maladies Hémorragiques Constitutionnelles, CH de Versailles, Le Chesnay, France
| | - Benoît Guillet
- Centre de Traitement des maladies hémorragiques, Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Frédéric Bauduer
- Service d'Hématologie, Centre Hospitalier de la Côte Basque, Bayonne, and UMR 5199 PACEA, Université de Bordeaux, Pessac, France
| | - Vincent Ernest
- Laboratoire d'Hématologie, CHU la Timone, Marseille, France
| | | | - Aurélie Avril
- UMR1179, Université de Versailles-Saint-Quentin, Montigny le Bretonneux, France
| | - Roseline d'Oiron
- Centre de Traitement de l'Hémophilie - CRTH - CHU Paris-Sud - Hôpital de Bicêtre, APHP.Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Christine Biron-Andréani
- Centre de Traitement de l'Hémophilie (CTH) Centre de Ressources et de Compétences Maladies Hémorragiques Constitutionnelles (CRC-MHC) - Hôpital St-Eloi, CHU Montpellier, Montpellier, France
| | - Sandrine Meunier
- Hospices civils de Lyon; Unité d'Hémostase Clinique, Hôpital Cardiologique Louis Pradel, CHU de Lyon, Lyon, France
| | - Yesim Dargaud
- Hospices civils de Lyon; Unité d'Hémostase Clinique, Hôpital Cardiologique Louis Pradel, CHU de Lyon, Lyon, France
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4
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Guillet B, Hassoun A, Wibaut B, Harroche A, Biron-Andréani C, Repesse Y, d'Oiron R, Tardy B, Pan Petesch B, Chamouni P, Gay V, Fouassier M, Pouplard C, Martin C, Catovic H, Delavenne X. A French Real-World Evidence Study Evaluating the Efficacy, Safety, and Pharmacokinetic Parameters of rVIII-SingleChain in Patients with Hemophilia A Receiving Prophylaxis. Thromb Haemost 2023; 123:490-500. [PMID: 36758611 PMCID: PMC10113037 DOI: 10.1055/s-0043-1761449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND rVIII-SingleChain is a recombinant factor VIII (FVIII) with increased binding affinity to von Willebrand factor compared with other FVIII products. rVIII-SingleChain is indicated for the treatment and prevention of bleeding episodes in patients with hemophilia A. OBJECTIVES To collect real-world evidence data from patients treated with rVIII-SingleChain to confirm the efficacy and safety established in the clinical trial program and carry out a population pharmacokinetic (PK) analysis. PATIENTS/METHODS This interim analysis includes data, collected between January 2018 - September 2021, from patients treated with rVIII-SingleChain prophylaxis at French Hemophilia Treatment centers. Data on annualized bleeding rates, dosing frequency, and consumption before and after switching to rVIII-SingleChain were recorded. A population PK analysis was also conducted to estimate PK parameters. RESULTS Overall, 43 patients switched to prophylaxis with rVIII-SingleChain either from a previous prophylaxis regimen or from on-demand treatment. Following the switch to rVIII-SingleChain, patients maintained excellent bleed control. After switching to rVIII-SingleChain, most patients maintained or reduced their regimen. Interestingly, a majority of patients treated >2 ×/weekly with a standard half-life FVIII reduced both injection frequency and FVIII consumption with rVIII-SingleChain. A PK analysis revealed a lower clearance of rVIII-SingleChain (1.9 vs. 2.1 dL/h) and a longer half-life both in adolescents/adults (n = 28) and pediatric (n = 6) patients (15.5 and 11.9 hours, respectively vs. 14.5 and 10.3 hours) than previously reported. CONCLUSIONS Patients who switched to rVIII-SingleChain prophylaxis demonstrated excellent bleed control and a reduction in infusion frequency. A population PK analysis revealed improved PK parameters compared with those reported in the clinical trial.
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Affiliation(s)
- Benoit Guillet
- Haemophilia Treatment Center, University Hospital, Rennes, France.,Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Abel Hassoun
- Haemophilia Treatment Center, Simone Veil Hospital, GH Eaubonne-Montmorency, France
| | - Bénédicte Wibaut
- Haemophilia Treatment Centre, National Reference Willebrand Centre, University Hospital, Lille, France
| | - Annie Harroche
- Department of Hematology, Haemophilia Treatment Centre, University Hospital Necker Enfants Malades, Paris, France
| | | | - Yohan Repesse
- Haematology Laboratory and Haemophilia Reference Centre, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Roseline d'Oiron
- CRH, CRC-MHC (Centre de Référence de l'Hémophilie, Centre de Ressource et de Compétence des Maladies Hémorragiques Constitutionnelles), Hôpital Bicêtre, AP-HP, Université Paris-Saclay, Paris, France.,HITh, UMR_S1176, INSERM, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Brigitte Tardy
- Haemophilia Treatment Center, University Hospital, Saint-Etienne, France.,Inserm CIC 1408, Saint-Etienne University Hospital Center, Saint-Etienne, France
| | - Brigitte Pan Petesch
- Haemophilia Treatment Center, Morvan University Hospital, Saint-Etienne Brest, France
| | - Pierre Chamouni
- Haemophilia Treatment Center, University Hospital, Rouen, France
| | - Valérie Gay
- Haemophilia Treatment Center, Hospital, Chambery, France
| | - Marc Fouassier
- Haemophilia Treatment Center, Hôtel-Dieu University Hospital, Nantes, France
| | | | | | | | - Xavier Delavenne
- INSERM, UMR 1059, Dysfonction Vasculaire et de l'Hémostase, Université de Lyon, Saint Etienne, France.,Laboratoire de Pharmacologie - Toxicologie, CHU de Saint-Etienne, Saint-Etienne, France
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5
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Nguyen NAT, Auquier P, Beltran Anzola A, d'Oiron R, Biron-Andréani C, Lienhart A, Rauch A, Baumstarck K, Boucekine M, Milien V, Rosso-Delsemme N, Tabele C, Giraud N, Sannié T, Chambost H, Resseguier N. Occupational integration of adults with severe haemophilia (INTHEMO): A study based on the FranceCoag registry. Haemophilia 2022; 28:962-976. [PMID: 35858674 DOI: 10.1111/hae.14620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Health of people with severe haemophilia (PwSH) improves thanks to the advancements in haemophilia care, giving them more opportunities in occupational integration. However, there is little literature on the occupational integration of PwSH. OBJECTIVES The main objective of our study was to assess the occupational integration of PwSH and to compare it with that of the general population. The secondary objective was to study the association between individual characteristics (sociodemographic, clinical and psycho-behavioural) and occupational integration of PwSH. METHODS A multicentre, non-interventional, cross-sectional study was conducted in 2018-2020 on PwSH, aged over 18 and under 65 years and included in the FranceCoag registry. Measurements included indicators of occupational integration, sociodemographic, clinical and psycho-behavioural characteristics. The indicators of occupational integration were compared with those of the general population, using indirect standardization. The data of the general population were available from the National Institute of Statistics and Economic Studies (INSEE). Determinants of occupational integration were explored using structural equation modelling. RESULTS Of 1262 eligible people, 588 were included. PwSH had a lower employment rate than the general population (standardized ratio, .85; 95% CI, .77-.94). There were more PwSH at tertiary education level than expected (standardized ratio, 1.38; 95% CI, 1.17-1.61). HIV infection, poor physical health and mental health concerns were associated with a higher risk of unemployment in PwSH. CONCLUSION Employment rate of PwSH is lower than that of the general population despite their higher education level. Target interventions focusing on determinants of difficult occupational integration could be helpful for PwSH.
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Affiliation(s)
- Ngoc Anh Thu Nguyen
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France
| | - Pascal Auquier
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France.,FranceCoag Network, Marseille, France
| | - Any Beltran Anzola
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France
| | - Roseline d'Oiron
- Haemophilia Treatment Centre, Bicêtre Hospital, University Hospital of Paris (APHP), Kremlin-Bicêtre, France
| | | | - Anne Lienhart
- Haemophilia Treatment Centre, Hospital Edouard Herriot, University Hospital of Lyon, Bron, France
| | - Antoine Rauch
- Haemophilia Treatment Centre, University Regional Hospital of Lille, Lille, France
| | - Karine Baumstarck
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France.,FranceCoag Network, Marseille, France
| | - Mohamed Boucekine
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France.,FranceCoag Network, Marseille, France
| | - Vanessa Milien
- FranceCoag Network, Marseille, France.,Haemophilia Treatment Centre, Timone Hospital, University Hospital of Marseille (APHM), Marseille, France
| | - Natacha Rosso-Delsemme
- Haemophilia Treatment Centre, Timone Hospital, University Hospital of Marseille (APHM), Marseille, France
| | - Clemence Tabele
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,FranceCoag Network, Marseille, France
| | - Nicolas Giraud
- Association française des hémophiles (AFH), Paris, France
| | - Thomas Sannié
- Association française des hémophiles (AFH), Paris, France
| | - Hervé Chambost
- FranceCoag Network, Marseille, France.,Haemophilia Treatment Centre, Timone Hospital, University Hospital of Marseille (APHM), Marseille, France
| | - Noémie Resseguier
- CEReSS - Health Services and Quality of Life Research, Aix Marseille University, Marseille, France.,Methodological Support Unit for Clinical and Epidemiological Research, University Hospital of Marseille (APHM), Marseille, France
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Lassalle F, Zawadzki C, Harroche A, Biron-Andréani C, Falaise C, Boisseau P, Duployez N, Jeanpierre E, Rauch A, Paris C, Susen S, Goudemand J. The homozygous variant p.Gln1311* in exon 28 of VWF is associated with the development of alloantibodies in 3 unrelated patients with type 3 VWD. Haemophilia 2021; 27:e491-e494. [PMID: 33403757 DOI: 10.1111/hae.14207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/19/2020] [Accepted: 11/03/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Fanny Lassalle
- Pôle de Biologie Pathologie Génétique, Institut d'Hématologie - Transfusion, CHU Lille, Lille, France
| | - Christophe Zawadzki
- Pôle de Biologie Pathologie Génétique, Institut d'Hématologie - Transfusion, CHU Lille, Lille, France
| | | | - Christine Biron-Andréani
- Département d'hématologie biologique, Centre de Ressources et de Compétences Maladies Hémorragiques Constitutionnelles, CHU Montpellier, Montpellier, France
| | - Céline Falaise
- Centre d'Exploration des pathologies Hémorragiques et Thrombotiques (CEHT), Hôpital La Timone, Assistance Publique-Hôpitaux de Marseille (APHM, Marseille, France
| | - Pierre Boisseau
- Laboratoire de génétique moléculaire, CHU Nantes, Nantes, France
| | - Nicolas Duployez
- Pôle de Biologie Pathologie Génétique, Institut d'Hématologie - Transfusion, CHU Lille, Lille, France
| | - Emmanuelle Jeanpierre
- Pôle de Biologie Pathologie Génétique, Institut d'Hématologie - Transfusion, CHU Lille, Lille, France
| | - Antoine Rauch
- Pôle de Biologie Pathologie Génétique, Institut d'Hématologie - Transfusion, CHU Lille, Lille, France
| | - Camille Paris
- Pôle de Biologie Pathologie Génétique, Institut d'Hématologie - Transfusion, CHU Lille, Lille, France
| | - Sophie Susen
- Pôle de Biologie Pathologie Génétique, Institut d'Hématologie - Transfusion, CHU Lille, Lille, France
| | - Jenny Goudemand
- Pôle de Biologie Pathologie Génétique, Institut d'Hématologie - Transfusion, CHU Lille, Lille, France
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7
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Benattar N, Schved JF, Biron-Andréani C. A New Dilution for the Modified APTT-based Assay for Activated Protein C Resistance: Improvement of the Reliability in Patients with a Lupus Anticoagulant. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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8
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Mallol C, Séguret F, Schved JF, Biron-Andréani C. Plastic versus Siliconized Glass Tubes: Evaluation in Current Laboratory Practice. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613908] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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9
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Boutruche S, Biron-Andréani C, Schved JF, Tondeur S. Prevalence of the JAK2 V617F mutation associated with splanchnic vein thrombosis. A 10-year retrospective study. Thromb Haemost 2017. [DOI: 10.1160/th08-07-0451] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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10
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Tardy-Poncet B, Nguyen P, Thiranos JC, Morange PE, Biron-Andréani C, Gruel Y, Morel J, Wynckel A, Grunebaum L, Villacorta-Torres J, Grosjean S, de Maistre E. Argatroban in the management of heparin-induced thrombocytopenia: a multicenter clinical trial. Crit Care 2015; 19:396. [PMID: 26556106 PMCID: PMC4641392 DOI: 10.1186/s13054-015-1109-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 10/17/2015] [Indexed: 11/28/2022]
Abstract
Introduction The aim of this study was to collect data in France in patients with heparin-induced thrombocytopenia who required parenteral anticoagulation and for whom other non-heparin anticoagulant therapies were contraindicated including patients with renal failure, cross-reactivity to danaparoid or at high hemorrhagic risk. Methods A total of 20 patients, of mean age 72 ± 10 years, were enrolled in this open-label, multicenter clinical study. Exploratory statistical data analysis was performed with descriptive interpretation of intra-individual comparisons using simple univariate statistics. Results The diagnosis of HIT was confirmed in 16 subjects by an independent scientific committee. Fourteen patients (70 %) were in an intensive care unit during the course of the study. Patients were treated with argatroban for a mean duration of 8.5 ± 6.1 days. The mean starting dose of argatroban was 0.77 ± 0.45 μg/kg/min. Platelet recovery was rapid. aPTT and anti-IIa activity assays were used to monitor the dose of argatroban. The mean baseline aPTT value was 45.0 ± 9.8 sec and increased to 78.2 ± 35.8 sec two hours after initiating argatroban. At this time mean argatroban concentration was 0.34 ± 0.16 and 0.61 ± 0.28 μg/ml using ECT and TT measurements, respectively. New and/or extended thromboses were reported in 25 % of patients and major bleedings were documented in 15 %. Six patients died due to their underlying medical condition. Conclusion Considering its hepatic elimination and its short half-life, argatroban can be considered as a safe therapeutic option in HIT patients at high hemorrhagic risk and with renal failure, particularly in an ICU setting.
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Affiliation(s)
- Brigitte Tardy-Poncet
- EA 3065, Université Jean-Monnet, INSERM CIC 1408 - FCRIN-INNOVTE - Laboratory of Hematology, University Hospital of St Etienne, St Etienne, France.
| | - Philippe Nguyen
- Laboratory of Hematology, University Hospital of Reims, Reims, France.
| | - Jean-Claude Thiranos
- Department of Cardiovascular Surgery, University Hospitals of Strasbourg, Strasbourg, France.
| | | | | | - Yves Gruel
- Laboratory of Hematology, University Hospital of Tours, Tours, France.
| | - Jérome Morel
- Department of Intensive Care Unit, University Hospital of St Etienne, St Etienne, France.
| | | | - Lelia Grunebaum
- Laboratory of Hematology, University Hospitals of Strasbourg, Strasbourg, France.
| | | | - Sandrine Grosjean
- Intensive Care Medicine, University Hospital of Dijon, Dijon, France.
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11
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Vorjohann S, Fish RJ, Biron-Andréani C, Nagaswami C, Weisel JW, Boulot P, Reyftmann L, de Moerloose P, Neerman-Arbez M. Hypodysfibrinogenaemia due to production of mutant fibrinogen alpha-chains lacking fibrinopeptide A and polymerisation knob 'A'. Thromb Haemost 2010; 104:990-7. [PMID: 20806111 DOI: 10.1160/th10-03-0161] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 07/14/2010] [Indexed: 11/05/2022]
Abstract
Inherited disorders of fibrinogen are rare and affect either the quantity (hypofibrinogenaemia and afibrinogenaemia) or the quality of the circulating fibrinogen (dysfibrinogenaemia) or both (hypodysfibrinogenaemia). Extensive allelic heterogeneity has been found for all these disorders: in congenital afibrinogenaemia for example more than 40 mutations, the majority in FGA , have been identified in homozygosity or in compound heterozygosity. Numerous mutations have also been identified in patients with hypofibrinogenaemia, many of these patients are in fact heterozygous carriers of afibrinogenaemia mutations. Despite the number of genetic analyses performed, the study of additional patients still allows the identification of novel mutations. Here we describe the characterization of a novel FGA intron 2 donor splice-site mutation (Fibrinogen Montpellier II) identified in three siblings with hypodysfibrinogenaemia. Functional analysis of RNA produced by the mutant minigene in COS-7 cells revealed that the mutation led to the in-frame skipping of exon 2. Western blot analysis of COS-7 cells expressing an exon 2 deleted FGA cDNA revealed that an alpha-chain lacking exon 2, which codes in particular for fibrinopeptide A and polymerisation knob 'A', has the potential to be assembled into a hexamer and secreted. Analysis of precipitated fibrinogen from patient plasma showed that the defect leads to the presence in the circulation of alpha-chains lacking knob 'A' which is essential for the early stages of fibrin polymerisation. Fibrin made from purified patient fibrinogen clotted with thrombin displayed thinner fibers with frequent ends and large pores.
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Affiliation(s)
- Silja Vorjohann
- Department of Genetic Medicine and Development, University of Geneva Medical Centre, Geneva, Switzerland.
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12
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Abstract
Coagulation is the complex process by which activation of plasmatic haemostasis proteins ends up with the generation of fibrin. Most of the plasma coagulation proteins are synthesized in hepatocytes. The aim of this chapter is to describe experimental procedures allowing to measure the secretion by primary human hepatocytes and functional activity (including production of fibrillar material from extracellular medium) of haemostasis proteins including factors II, V, VII, VIII, PIVKA-II (protein induced by vitK 1 absence or antagonist II), antithrombin and protein S. In addition, we show how treatments of hepatocyte cultures with vitamin K and/or warfarin affect the secretion of haemostasis proteins. The results demonstrate that primary cultures of human hepatocytes constitute an invaluable model for investigating haemostasis protein expression and activity and therapeutic strategies targeting these proteins.
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13
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Cozza S, Mercier G, Schved JF, Biron-Andréani C. Thrombophilia and transient risk factors for venous thromboembolism in women with distal deep vein thrombosis. Pathophysiol Haemost Thromb 2009; 36:282-4. [PMID: 19996640 DOI: 10.1159/000252826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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14
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Tondeur S, Boutruche S, Biron-Andréani C, Schved JF. Prevalence of the JAK2 V617F mutation associated with splanchnic vein thrombosis. A 10-year retrospective study. Thromb Haemost 2009; 101:787-789. [PMID: 19350131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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15
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Bargnoux AS, Dupuy AM, Biron-Andréani C, Schved JF, Cristol JP. Immunonephelometric determination of fibrinogen on citrated or heparinized plasma: comparison with functional Clauss method. Clin Lab 2005; 51:285-8. [PMID: 15991802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Fibrinogen is routinely determined by functional assay on citrated plasma in the hematology department. However, immunoassay can be performed easily with nephelometric analyzer in the clinical chemistry laboratory allowing automatization. The aim of this study was first to compare the clotting von Clauss method (activity assay) with an immunonephelometric method (antigen assay) on the BN ProSpec (Dade Behring). Moreover, we evaluated the possibility of collecting blood samples on heparin to facilitate blood collection for clinicians and reduce required blood collection volumes for dosages. METHODS In a first step of experiment, the accuracy of immunonephelometric analytical performance was tested on heparinized and citrated tubes. For comparison studies, fibrinogen activity was then determined on citrated tubes in the hematology department and antigen measurement was performed on both citrated and heparinized plasma from 130 consecutive patients. RESULTS As a result, the immunonephelometric method shows reliable performance and clinical sample measurements are not affected by the method used, validating the use of heparinized plasma samples for fibrinogen antigen determination with Dade Behring reagents.
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Affiliation(s)
- A S Bargnoux
- Department of Biochemistry, Lapeyronie Hospital, Montpellier, France
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16
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Biron-Andréani C, Bezat-Bouchahda C, Raulet E, Pichard-Garcia L, Fabre JM, Saric J, Baulieux J, Schved JF, Maurel P. Secretion of functional plasma haemostasis proteins in long-term primary cultures of human hepatocytes. Br J Haematol 2004; 125:638-46. [PMID: 15147380 DOI: 10.1111/j.1365-2141.2004.04957.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study was designed to investigate the ability of long-term primary cultures of adult human hepatocytes to secrete the main haemostasis proteins. Factors II, V, VII, VIII, PIVKA-II (protein induced by vitamin K 1 absence or antagonist II), fibrinogen and antithrombin were quantified in culture medium by immunological methods and by measuring the coagulant activity of factors II, V and VII. All the haemostasis protein antigens except the factor VIII antigen (FVIII:Ag) were found in the culture medium throughout the culture period. The clotting activity of each factor correlated well with antigen level. In addition, fibrinogen and fibrin were detected in the fibrillar material following incubation of the culture medium with thromboplastin. Moreover, adding vitamin K 1 to the culture medium resulted in a significant increase of factors II and VII and a reciprocal decrease of the PIVKA-II, and adding von Willebrand factor resulted in a drastic increase of the level of FVIII:Ag. We conclude that, in our culture system, normal adult human hepatocytes retain their capacity to secrete haemostasis proteins for at least 30 days.
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17
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Biron-Andréani C, Morau E, Schved JF, Hédon B, Dechaud H. Amniotic Fluid Embolism with Haemostasis Complications: Primary Fibrinogenolysis or Disseminated Intravascular Coagulation? Pathophysiol Haemos Thromb 2004; 33:170-1. [PMID: 15170398 DOI: 10.1159/000077826] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2004] [Accepted: 03/09/2004] [Indexed: 11/19/2022]
Abstract
Amniotic fluid embolism (AFE) is characterized by the passage of amniotic fluid (AF) into the maternal circulation during or just after childbirth. AFE is a rare disorder occurring in 1/8,000 to 1/80,000 deliveries but with a maternal morbidity ranging from 26% in a recent report to 86% in earlier ones. In patients who survive, AFE may affect coagulation resulting in severe bleeding. While disseminated intravascular coagulation (DIC) is usually seen in such cases, we reported a case of AFE in which the hemostatic abnormalities were compatible with primary fibrinogenolysis rather than with DIC.
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Affiliation(s)
- C Biron-Andréani
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire, Montpellier, France.
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18
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Biron-Andréani C, Mallol C, Vergnes C, Benattar N, Schved JF. Thrombosis and antiphospholipid antibodies in non-SLE patients: predictive value of antiphosphatidylserine antibodies. Pathophysiol Haemost Thromb 2002; 32:194. [PMID: 12759522 DOI: 10.1159/000070427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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19
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Stepanian A, Biron-Andréani C. [Primary hemostasis exploration]. Ann Biol Clin (Paris) 2001; 59:725-35. [PMID: 11713017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Primary hemostasis exploration involves many tests, but most of them are highly specialized. Meanwhile, a few simple and reliable assays can make possible a first orientation of the diagnosis in a routine laboratory. This review is organized in four parts. It highlights the importance of pre-analytical steps when exploring hemostasis, especially a carefully conducted clinical history and blood collecting conditions. It first presents the tests involved in the global exploration: the platelet count, the bleeding time, the occlusion time and the prothrombin consumption test. Then, this review presents the tests essential for the diagnosis of thrombocytopenia, von Willebrand disease and platelet disorders. Finally, we discussed about the limits and the future of diagnosis in primary hemostasis, and more particularly about endothelial cells and the adhesion proteins that are implicated.
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Affiliation(s)
- A Stepanian
- Laboratoire central d'hématologie, Hôpital Saint-éloi, Montpellier, France
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20
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Biron-Andréani C. [Should thrombophilia be considered in obstetrical complications?]. Gynecol Obstet Fertil 2001; 29:628-31. [PMID: 11680953 DOI: 10.1016/s1297-9589(01)00217-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- C Biron-Andréani
- Laboratoire d'hématologie, hôpital Saint-Eloi, 80, avenue Augustin Fliche, 34295 Montpellier, France.
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21
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Abstract
Acquired haemophilia is a rare but life-threatening bleeding disease that can be observed in males or females at various ages. In the present study, we report on five cases of acquired factor (F) VIII inhibitors diagnosed in the elderly population over a period of 5 years between 1995 and 1999 in our hospital. The median age of the patients at the time of diagnosis was 76.2 years (66-92 years). In all cases, the diagnosis was suggested by mild to severe bleeding with no previous bleeding history. While the absence of associated conditions is frequently reported especially among the elderly, in our series an underlying disease was found in four out of the five cases: kidney tumour (two cases) and autoimmune disease (two cases). The bleeding was controlled in four patients using porcine FVIII (two cases) or recombinant FVIIa (two cases). The inhibitors were completely resolved in two patients (kidney tumour, GoodPasture syndrome) by treatment of the underlying disease. However, three patients died as direct or indirect consequence of having an inhibitor. Our series confirms and extends previous data reporting the complexity and severity of this disorder. Because bleeding is often severe, a prompt and correct diagnosis is required to provide adequate therapeutic options that take the advanced age of the patients into account.
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Affiliation(s)
- S Godreuil
- Haemostasis Unit, Montpellier University Hospital, France
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22
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Biron-Andréani C, Dupeyron G, Mainemer M, Schved JF. Successful use of recombinant factor VIIa in a haemophiliac with inhibitor undergoing cataract surgery. Blood Coagul Fibrinolysis 2001; 12:215-6. [PMID: 11414637 DOI: 10.1097/00001721-200104000-00009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 40-year-old patient with severe haemophilia A and an inhibitor against factor VIII underwent a cataract extraction under local anaesthesia. Recombinant activated factor VII was use to achieve haemostasis. The procedure was successful. Neither bleeding complications nor side effects occurred.
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Affiliation(s)
- C Biron-Andréani
- Laboratory of Haematology, University Hospital Montpellier-Nîmes, Montpellier, France
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23
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Perney P, Biron-Andréani C, Joomaye Z, Fabbro-Peray P, Quénet F, Schved JF, Blanc F. Antiphospholipid antibodies in alcoholic liver disease are influenced by histological damage but not by alcohol consumption. Lupus 2001; 9:451-5. [PMID: 10981650 DOI: 10.1191/096120300678828659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Antiphospholipid antibodies (aPL) have been detected in various liver diseases, particularly cirrhosis. The role of alcoholic consumption per se has been suggested. The aim of our study was to assess the prevalence of aPL in patients with alcoholic liver disease at various states and to correlate the presence of aPL with both liver injury and alcoholic consumption. Three groups were prospectively included. Group A: 74 controls (age- and sex-matched); group B: 46 patients with alcoholic steatosis; group C: 28 patients with alcoholic cirrhosis. For each patient, lupus anticoagulant, anticardiolipin antibodies and anti-beta2-glycoprotein I antibodies were tested. The prevalence of aPL (presence of at least one positive test) was 5% in group A, 20% in group B and 50% in group C (P < 0.04). No correlation appeared between aPL and Child Pugh score in group C. No correlation was found between the presence of aPL and alcohol intake in patients with either steatosis or cirrhosis. Our study confirms that aPL positivity is more frequently encountered in patients with alcoholic liver disease than in controls. Their prevalence increases with the degree of histological damage but not with the level of alcoholic intake.
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Affiliation(s)
- P Perney
- Service de Médecine Interne E, Montpellier, France
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24
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Benattar N, Schved JF, Biron-Andréani C. A new dilution for the modified APTT-based assay for activated protein C resistance: improvement of the reliability in patients with a lupus anticoagulant. Thromb Haemost 2000; 83:967-8. [PMID: 10896260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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25
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Biron-Andréani C, Mallol C, Séguret F, Schved JF. Plastic versus siliconized glass tubes: evaluation in current laboratory practice. Thromb Haemost 2000; 83:800-1. [PMID: 10823290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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