Index. C Calciphylaxis, 41 Cancer-associated VTE anticoagulant therapy administration and monitoring,

Transcription

1 A Abciximab, Acquired von Willebrand disease (AVWD), 67 Activated partial thromboplastin time (aptt), 239 argatroban monitoring, 224 cancer-related VTE, 170 clot detection, 7 lepirudin monitoring, 224 mixing studies, 7 8 prolongation (see also ) APC-R, 13 differential diagnosis, 9, 10 rivaroxaban effect, 242, 245 shortened, 9 Activated protein C (APC), 6 Acute myeloid leukemia, 147 Afibrinogenemia causal mutations, 73 clinical manifestations, 73 homozygous mutations, 73 management, Amniotic fluid embolism (AFE), Amyloid-associated bleeding, Amyloidosis, 43, 96 Anticoagulant therapy cancer-associated VTE administration and monitoring, cancer survival, CANTHANOX trial, 170 CLOT trial, 170 Enoxaparin Clinical Trial, 172 limitations and shortcomings, 170 LITE trial, LMWH monotherapy, 172 LMWH vs. IV UFH and oral VKA, 171 ONCENOX trial, 171 oral (see Oral anticoagulants) Antiphospholipid syndrome (APS) prolonged PTT, thrombophilia, VTE risk, Antiplatelet agents aspirin, dual antiplatelet therapy noncardiac surgery, stent thrombosis, 231, 232 timing of, 232 glycoprotein IIb/IIIa receptors, patients management, 235 percutaneous coronary artery intervention, 231, 232 thienopyridines, 232, 233 ticagrelor, 232, 233 Antithrombin deficiency pregnancy, 256 thrombophilia, VTE risk, 191 Apixaban, 246 ADOPT trial extended thromboprophylaxis, 244 APPRAISE-2 study, 243 coagulation assay, 245 vs. enoxaparin, pharmacokinetics, 245 reversal of, 245 venous thromboembolism, vs. warfarin, 243 Argatroban, 224 Aspirin, B Bernard Soulier syndrome (BSS) bleeding, 90 pregnancy, 252 Bethesda assay, 8 Bivalirudin, Bleeding after surgery clinical presentation, 151, 159 definition, 152 epidemiology, laboratory investigation algorithm for, DIC test, hyperacute analyses, 155 platelet function tests, 154 prolonged TCT, 154 PT/aPTT, 154 vwf test, 155 medical history coagulation factor defect, 152 delayed onset hemorrhage, 152 A. Lichtin and J. Bartholomew (eds.), The Coagulation Consult: A Case-Based Guide, DOI / , Springer Science+Business Media New York

2 272 Bleeding after surgery (cont.) hemophilia, 152 negative bleeding, 153 pictorial bleeding assessment chart, 153 spontaneous bleeding, 152 von Willebrand disease, 152 physical examination, 153 practice guidelines, residual anticoagulant effect, 158 treatment options antifibrinolytic agents, cryoprecipitate, 156 desmopressin, 158 fibrinogen concentrate, 156 for local/regional hemostasis, 155 plasma transfusions, 156 platelet transfusions, 156 prothrombin complex concentrate (PCC), 157 recombinant activated factor VIIa (rfviia), 157 supportive measures, 155 Bruising clinical history amyloidosis, 43 calciphylaxis, 41 Chilblain lupus erythematosus, 44 cryoglobulinemia, 43 ecchymoses, 39 erythema multiforme, 42 erythema nodosum, 40 family history, Henoch Schoelein purpura, 39, 42 leukocytoclastic vasculitis, 41 levamisole-induced vasculitis, 43 lichen aureus, 44 lipodermatosclerosis, 43 livedo reticularis, 44 medication history, 40 mixed drug eruption, 40 painful bruises, 39 petechiae, 39, 40 post operative hematoma, 40 Sweet s syndrome, 41 clinical presentation, 41 laboratory evaluation, 45 prolonged PTT family history, 64 mild FVIII deficiency, 66 screening tests alpha2 -plasmin inhibitor deficiency, 46 amyloidosis, 47 connective tissue disorders, factitious bruising, 47 factor XIII deficiency, 46 scurvy, 48 C Calciphylaxis, 41 Cancer-associated VTE anticoagulant therapy administration and monitoring, cancer survival, CANTHANOX trial, 170 CLOT trial, 170 Enoxaparin Clinical Trial, 172 limitations and shortcomings, 170 LITE trial, LMWH monotherapy, 172 LMWH vs. IV UFH and oral VKA, 171 ONCENOX trial, 171 cancer-related outcomes, clinical presentation, diagnosis, epidemiology of abdominal and visceral venous thrombotic events, 163 chemotherapy-associated hypercoagulability, 165 clinical risk score, 163 malignancies, 164 nonmalignant diseases, 163 solid cancers, 164 surveillance, future perspectives, hypercoagulability, incidence, 162, natural history cancer vs. noncancer patients, 168 cumulative incidence, INR-specific incidence, 168 management, 167 recurrent VTE, 167 prevalence, primary prophylaxis catheter-related upper-extremity VTE, 173 chemotherapy-related VTE, postoperative VTE, , 172, 187 variability of, Cancer chemotherapy, 193 Cardiac device-related thrombosis case studies, 210 clinical manifestations, 209 complications, 209 diagnosis, 209 epidemiology, management, pathophysiology, 209 risk factors, 209 Cardiopulmonary bypass (CPB) heparin-induced thrombocytopenia, 216, 221 platelet dysfunction, 89 thrombocytopenia, 120 Catheter-related thrombosis (CRT) clinical manifestations, 205 complications, 208 diagnosis, epidemiology, 204 pathophysiology, 204 peripherally inserted central catheter, 203 prevention antithrombotic agents, 207 heparin, non-pharmacologic measurement, 207

3 thrombolytic instillation, 208 warfarin, 207 risk factors, Catheter-related upper-extremity VTE, 173 Cell-based model of coagulation extrinsic pathway, 5 FXII (Hageman factor), 5 intrinsic pathway, 5 prothrombinase complex, 5 TF-FVIIa complex, 4 5 thrombin-tm complex, 5 tissue factor, 4 Chemotherapy-associated hypercoagulability, 165 Chemotherapy-related VTE, Chilblain lupus erythematosus, 44 Chronic myeloid leukemia (CML), 141 Clopidogrel, 233 Clotting clot lysis, 6 initiation and propagation cell-based model, 4 5 classic coagulation cascade, 3 clotting factors, 2 3 termination, 5 6 Combined oral contraceptives (COCs), Congenital thrombocytopenia, 106 Congestive heart failure (CHF), 196 Coronary artery bypass grafting, 227 CPB. See Cardiopulmonary bypass (CPB) CRT. See Catheter-related thrombosis (CRT) Cryoglobulinemia, 43 D Dabigatran, 246 clinical trials, 238 coagulation assay, pharmacokinetics, 239 US FDA approval, 237 venous thromboembolism, 238 vs. warfarin, Danaparoid, 226 Deep venous thrombosis (DVT). See also Venous thromboembolism (VTE) incidence of, 188 Paget Schroetter syndrome, 198 patient evaluation, 186 Desirudin, 226 Desmopressin (DDAVP) bleeding after surgery, 158 hemophilia A and B, 63 platelet disorder, 88 von Willebrand disease, 95 Dilute Russell s viper venom test (DRVVT), 17 Dilutional thrombocytopenia ICU settings, 118 platelet counts, 106 Direct thrombin inhibitors (DTIs), 223 Disseminated intravascular coagulation (DIC) diagnosis, 110 heparin-induced thrombocytopenia, 218 ICU settings, 118 pregnancy abortion, 264 fatal hemorrhage, 264 prolonged PT and PTT, temporary hemophilia, 264 Drug-induced thrombocytopenia diagnosis, 109 after solid organ transplantation, Dual antiplatelet therapy (DAPT), , Dysfibrinogenemia, 20, 73 E Ecchymoses, 39 Ehlers Danlos syndrome, 96 Enzyme-linked immunosorbent assays (ELISA), 221 Erythema multiforme, 42 Erythema nodosum, 40 Essential thrombocythemia (ET), Euglobulin lysis time (ELT), 6 F Factor V deficiency plasma transfusion, 156 clinical manifestations, 76 clinical presentation, 74 factor V activation, 75 gene mutations and deletions, management, prothrombinase complex formation, 75 Factor VII deficiency, Factor X deficiency amyloidosis, 96 AL amyloidosis, clinical manifestations, 76 clinical presentation, 74, factor V activation, 75 gene mutations and deletions, management, prothrombinase complex formation, 75 Factor XI deficiency pregnancy, 251 prolonged PTT, 63 Fibrin degradation products (FDPs), 6 Fibrinogen afibrinogenemia, Clauss method, dysfibrinogenemia, 20, 73 fibrin formation and stabilization, 72 PT-derived method, 72 structure, 72 synthesis, 72 thrombin time, 72 Fondaparinux,

4 274 G Gestational thrombocytopenia, 107 Glanzmann thrombasthenia (GT), 90 Gray platelet syndrome (GPS), 91 H HELLP syndrome diagnosis, 111 pregnancy, Hemolytic uremic syndrome (HUS), Hemophilia A and B pregnancy, 251 prolonged PTT desmopressin, 63 diagnosis, 62 factor infusion, positive feedback mechanism, 61 replacement therapy, 62 symptoms, 62 Hemostasis coagulation cascade, 2 laboratory assays activated partial thromboplastin time, 7 anticoagulant effect, 9 Bethesda assay, 8 coagulation factor, 8 International Normalized Ratio, 6 7 mixing studies, 7 8 pathologist role, preanalytic variables, 8 prothrombin time, 6 7, 9, 10 reptilase time, 7 thrombin time (TT), 7 physiology of, 2 6 Henoch Schoelein purpura, 39, 42 Heparin-induced platelet aggregation assay (HIPA), 221 Heparin-induced thrombocytopenia (HIT), 110 cardiac surgery, 227 clinical manifestations deep vein thrombosis, 217 disseminated intravascular coagulation, 218 mortality, 217 vitamin K antagonist, 218 warfarin-induced skin necrosis, warfarin-induced venous limb gangrene, 217 danaparoid, 226 desirudin, 226 diagnosis cardiopulmonary bypass, 221 Cuker and Cines approach, 221, 222 ELISA, 221 HEP, 221 HIPA and SRA, 221 low-molecular-weight heparin, 216, 220, 221 pseudo-heparin-induced thrombocytopenia, 219 4T score system, unfractionated heparin, 216, 220, 221 fondaparinux, ICU settings, incidence of, 216, isolated HIT, 227 management argatroban, 224 bivalirudin, direct thrombin inhibitors, 223 lepirudin, low-molecular-weight heparin, 222 unfractionated heparin, 222 pathogenesis, platelet count post surgery, 227, 228 temporal patterns of, warfarin, 226 Hermansky Pudlak syndrome HPS genes mutation, 91 pregnancy, 252 HIT expert probability (HEP), 221 Hormone replacement therapy (HRT), 193 Hyperhomocysteinemia, 19 20, 191 Hypersplenism, 108 I Immune thrombocytopenic purpura (ITP) platelet flow cytometry, 24 pregnancy, prevalence, 138 Implantable cardiac devices. See Cardiac device-related thrombosis Infection-induced hemophagocytic syndrome, 125 Inflammatory bowel disease, 196 International Normalized Ratio (INR), 6 7 L Lepirudin, Leukocytoclastic vasculitis, 41 Levamisole-induced vasculitis, 43 Lichen aureus, 44 Lipodermatosclerosis, 43 Livedo reticularis, 44 Low-molecular-weight heparin (LMWH) cancer-associated VTE vs. IV UFH and oral VKA, 171 monotherapy, 172 heparin-induced thrombocytopenia, 216, medication-induced thrombocytosis, 140 Lupus anticoagulanthypoprothrombinemia syndrome (LAHS), Lupus anticoagulants (LA) antiphospholipid syndrome, 17 prolonged PTT, prothrombin time, 7 M May Thurner syndrome, 198 Model for end-stage liver disease (MELD) scoring system, 6 7

5 Monoclonal gammopathy of undetermined significance (MGUS), 194 Myelodysplastic syndrome, 108 Myelofibrosis, primary, Myeloproliferative disorders, 194 N Neonatal alloimmune thrombocytopenia (NAIT), Nephrotic syndrome, 196 Non-steroidal anti-inflammatory drugs (NSAIDs), 92 O Obesity, 196 Oral anticoagulants apixaban, 246 ADOPT trial extended thromboprophylaxis, 244 APPRAISE-2 study, 243 coagulation assay, 245 vs. enoxaparin, pharmacokinetics, 245 reversal of, 245 venous thromboembolism, vs. warfarin, 243 dabigatran etexilate, 246 clinical trials, 238 coagulation assay, pharmacokinetics, 239 US FDA approval, 237 venous thromboembolism, 238 vs. warfarin, rivaroxaban, 246 clinical trials, coagulation assays, 242 pharmacokinetics, 242 reversal of, US FDA approval, 240 P Paget Schroetter syndrome, 198 Paroxysmal nocturnal hemoglobinuria, 195 Percutaneous coronary artery intervention (PCI), 231, 232 Petechiae, 39, 40 Pictorial bleeding assessment chart (PBAC), 153 Plasminogen activator inhibitor-1 (PAI-1), 95 Platelet disorders acquired cardiopulmonary bypass, 89 congenital disorders, 88 desmopressin, 88 inherited disorders, platelet aggregation, 88 bleeding disorders, coagulation tests, 87, 88 BSS, 90 factor XIII deficiency, fibrinolytic pathway defects abnormal vascular fragility, alpha-2 antiplasmin, 95 PAI-1 deficiency, 95 Glanzmann thrombasthenia, 90 musculoskeletal bleeding, 87 platelet storage pool disease, 91 pregnancy Bernard Soulier syndrome, 252 Glanzmann s thrombasthenia, 252 Hermansky Pudlak syndrome, 252 immune thrombocytopenic purpura, postpartum hemorrhage, 252 qualitative, 88 Scott syndrome aspirin, 92 clopidogrel and prasugrel, 92 clotting factor abnormalities, 93 coagulation factors, 93 drug-associated platelet dysfunction, 92 herbal and vitamin supplements, 93 medications, 92 NSAIDs, 92 phosphatidyl serine translocation, 91 SSRIs, vwd, Platelet function analysis and screening aggregometry, 23 24, 28 bleeding time, 23 closure time, 23 platelet disorders, 31 platelet flow cytometry, 24, 28 platelet function analyzer (PFA)-100 system, 23 point-of-care (POC) tests, thromboelastography, 24, 29 clot formation, 21 morphologic assessment, 22 platelet structure and activation, preanalytic and analytic variables assay performance monitoring, 22 drugs with antiplatelet activity, 22 timing and specimen handling, Polycythemia vera, Posttransfusional thrombocytopenia, 106 Posttransfusion purpura (PTP), 120 Prasugrel, 233 Preeclampsia, 109 epidemiology, 263 pathophysiology, Pregnancy amniotic fluid embolism, anti-phospholipid antibodies aspirin, 260 CHEST guidelines, 260 coumadin, 260 gene variants detection, 261 neonatal alloimmune thrombocytopenia, platelet antibody identification, 260, 261 prolonged PTT, 259 recurrent pregnancy loss,

6 276 Pregnancy (cont.) bleeding disorders FVII deficiency, FXI deficiency, 251 hemophilia, 251 type 2 VWD, 251 von Willebrand s disease, clotting factor changes, DIC abortion, 264 fatal hemorrhage, 264 prolonged PT and PTT, temporary hemophilia, 264 DVT/PE anticoagulation regimens, diagnosis, eclampsia, 264 HELLP syndrome, platelet disorders Bernard Soulier syndrome, 252 Glanzmann s thrombasthenia, 252 Hermansky Pudlak syndrome, 252 immune thrombocytopenic purpura, postpartum hemorrhage, 252 preeclampsia epidemiology, 263 pathophysiology, thrombophilia antithrombin deficiency, 256 prothrombin gene mutation, 255 screening tests, 255 test, indications, 254 venous stasis, 254 VTE prophylaxis, 255 thrombotic disorders, 254 venous thromboembolism, 195 Primary immune thrombocytopenia, 109 Prolonged partial thromboplastin time (PTT) acquired coagulation disorder antiphospholipid syndrome (APS), clinical presentation, 66 FVIII inhibitor, bruising autoantibody to VWF, 67 clinical presentation, family history, 64 FVIII inhibitory autoantibodies, coagulation cascade, deep vein thrombosis clinical presentation, 68 diagnostic approach, 69 hemostatic defect clinical presentation, 59 contact factor deficiency, 61 erythrocytosis, 60 factor XI deficiency, 63 hemophilia A and B, improper sample handling, 60 neonates and infants, 59 sample contamination, 60 Von Willebrand disease, laboratory evaluation, 57 mixing studies, Prolonged prothrombin time (PT) factor VII bleeding, 53 clotting factor deficiency, 52 deficiency treatment, hemarthroses and intracranial hemorrhage, 53 inhibitors, 55 vitamin K, 53, 54 warfarin, 53, 54 patient PT ISI, 52 pharmacogenomics and warfarin sensitivity, PT measurement, 52 Protein C deficiency thrombophilia, VTE risk, Protein S deficiency thrombophilia, 15 VTE risk, 190 Prothrombin deficiency bleeding, 157 clinical manifestations, 76 clinical presentation, 74 factor V activation, 75 gene mutations and deletions, management, prothrombinase complex formation, 75 Pseudo-heparin-induced thrombocytopenia, 214 Pseudothrombocytopenia, 102 acquired defects, factor V inhibitor, factor X deficiency and inhibitors, LAHS, liver disease, 77 vitamin K deficiency, coagulation cascade, 71, 72 congenital fibrinogen disorders afibrinogenemia, clinical presentation, 71 dysfibrinogenemia, 73 inherited and acquired defects, 72 prothrombin, factor V and X deficiencies clinical manifestations, 76 clinical presentation, 74 factor V activation, 75 gene mutations and deletions, management, prothrombinase complex formation, 75 Pulmonary embolism (PE) incidence of, 188 patient evaluation, 186 risk factors, 187 UEDVT, 208 Q Quebec platelet disorder (QPD), 91

7 R Raloxifene, 193 Refractory anemia with ring sideroblast associated with marked thrombocytosis (RARS-T), Reptilase time (RT), 7 Rivaroxaban, 246 clinical trials, coagulation assays, 242 pharmacokinetics, 242 reversal of, US FDA approval, 240 S Scott syndrome aspirin, 92 clopidogrel and prasugrel, 92 clotting factor abnormalities, 93 coagulation factors, 93 drug-associated platelet dysfunction, 92 herbal and vitamin supplements, 93 medications, 92 NSAIDs, 92 phosphatidyl serine translocation, 91 SSRIs, Scurvy, 48 Selective serotonin reuptake inhibitors (SSRIs), Sepsis, Serotonin release assay (SRA), 221 Sweet s syndrome, 41 Symptomatic venous thromboembolism, 185 Systemic lupus erythematosus (SLE), , 190 T Tamoxifen, 193 Thienopyridines, 233 Thrombin-activatable fibrinolysis inhibitor (TAFI), 5 Thrombocytopenia after solid organ transplantation, diagnostic approach, drug-induced thrombocytopenia, graft-versus-host disease, 126 infection-induced hemophagocytic syndrome, 125 post-transplant immune thrombocytopenia, 126 post-transplant lymphoproliferative disorder, thrombotic microangiopathy, 124 viral infections, alcohol abuse, 108 autoimmune conditions, 108 cardiac surgery, 107 congenital, 106 diagnosis algorithms for, clinical history, 100, 101 clinical work-up, 100 laboratory testing, physical examination, 100 radiological testing, 102 dilutional, disseminated intravascular coagulation, 110 drug-induced, 109 etiologies, 99 gestational, 107 HELLP syndrome, 111 hematologic and solid tumor malignancies, 108 heparin-induced, 110 ICU settings bleeding, clinical presentation, diagnostic approach, 121, 122 dilutional thrombocytopenia, 118 disseminated intravascular coagulation, 118 drug-induced immune thrombocytopenia, epidemiology, 116 extracorporeal circuits, 120 heparin-induced thrombocytopenia, intravascular devices, 120 management, mechanisms and etiologies, mortality, 117 posttransfusion purpura, 120 sepsis, surgery, thrombosis, 117 viral infections, infectious etiologies, laboratory error, 102 liver disease with hypersplenism, 108 management, myelodysplastic syndrome, 108 outpatient setting, 100 posttransfusional, 106 preeclampsia, 109 primary immune thrombocytopenia, 109 pseudothrombocytopenia, 102 TTP/hemolytic uremic syndrome, Thrombocytosis acute myeloid leukemia, 147 clinical presentation, 133 MDS with isolated del(5q), medication-induced thrombocytosis all-trans retinoic acid (ATRA), 140 low-molecular-weight heparin, 140 thrombopoietin agonists, vincristine, myeloproliferative neoplasms chronic myeloid leukemia (CML), 141 essential thrombocythemia (ET), polycythemia vera, primary myelofibrosis, primary, RARS-T, reactive connective tissue disease, infection, iron-deficiency anemia, malignancy, 134 post-splenectomy, post-surgery, systemic lupus erythematosus,

8 278 Thrombophilia acquired and hereditary, , 192 activated protein C resistance, antiphospholipid syndrome, antithrombin deficiency, diagnostic testing, elevated factor VIII, 20 fibrinogen defects, 20 FVL mutation, hyperhomocysteinemia, protein C deficiency, protein S deficiency, 15 prothrombin gene mutation, risk factors, 11 pregnancy antithrombin deficiency, 256 prothrombin gene mutation, 255 screening tests, 255 test, indications, 254 venous stasis, 254 VTE prophylaxis, 255 protein S deficiency, 190 Thrombosis. See also Deep venous thrombosis (DVT) arterial and venous, 189 cardiac device-related case studies, 210 clinical manifestations, 209 complications, 209 diagnosis, 209 epidemiology, management, pathophysiology, 209 risk factors, 209 catheter-related thrombosis clinical manifestations, 205 complications, 208 diagnosis, epidemiology, 204 pathophysiology, 204 peripherally inserted central catheter, 203 prevention, risk factors, thrombocytopenia, 117 Thrombotic thrombocytopenic purpura (TTP), Ticagrelor, 233 Ticlopidine, 233 Tissue factor, 52 Tissue plasminogen activator (tpa), 6 U Upper extremity deep vein thrombosis (UEDVT), Urokinase plasminogen activators (upa), 6 V Venous thromboembolism (VTE) aberrant anatomic structures, 198 apixaban, cancer (see Cancer-associated VTE) dabigatran, 238 hospitalized patients incidence of, 196 Padua risk score, 197 pathophysiology, 185 patient evaluation, 186 risk factors abdominal/thoracic surgery, 188 antiphospholipid antibody syndrome, antipsychotic medications, 193 antithrombin deficiency, 191 arterial and venous thrombosis, 189 atherosclerotic vascular disease, 196 cancer chemotherapy, 193 combined oral contraceptives, congestive heart failure, 196 estrogen-modulating anticancer agents, 193 factor V Leiden mutation, hormonal compounds, 192 hormone replacement therapy, 193 hyperhomocysteinemia, 191 immobilization, 195 inflammatory bowel disease, 196 malignancy, 194 medications, 192 monoclonal gammopathy of undetermined significance, 194 myeloproliferative disorders, 194 nephrotic syndrome, 196 obesity, 196 open abdominal/pelvic surgery, 188 open gynecologic and urologic surgery, 188 orthopedic surgery, 187 paroxysmal nocturnal hemoglobinuria, 195 pregnancy, 195 progestin megestrol acetate, 193 protein C deficiency, protein S deficiency, 190 prothrombin gene mutation, thrombophilia, , 192 transfusions and erythropoiesis-stimulating agents, trauma, 188 travel, symptomatic, 185 Vincristine-induced thrombocytosis, Vitamin K deficiency prolonged prothrombin time (PT), 53, 54 acquired coagulopathy, 78 γ-carboxylation of glutamic acid, 78 liver disease, 79 vs. non-hemostatic functions, posttranslational modification, vitamin K replacement, 79 Vitamin K epoxide reductase complex 1 (VKORC1), 54, 55

9 279 von Willebrand disease (vwd), autoantibody to, 67 estrogen, 94 pregnancy, treatments, W Warfarin, 226 Warfarin-induced skin necrosis (WISN), Warfarin-induced venous limb gangrene, 217