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001-es BibID:BIBFORM060441
Első szerző:Ilonczai Péter (orvos, belgyógyász, haematológus szakorvos)
Cím:Management and outcome of pregnancies in women with antithrombin deficiency : a single-center experience and review of literature / Péter Ilonczai, Zsolt Oláh, Anna Selmeczi, Adrienne Kerényi, Zsuzsanna Bereczky, Róbert Póka, Ágota Schlammadinger, Zoltán Boda
Dátum:2015
Megjegyzések:Women with antithrombin (AT) deficiency have an increased risk for pregnancy-associated venous thromboembolism (VTE) and adverse pregnancy outcome. AT deficiency is a rare thrombophilia with heterogeneous genetic background. Owing to the few cases reported in the literature, management strategies of pregnancy with AT deficiency are inconsistent. Our aim was to examine the type of the genetic defect, management, maternal, and pregnancy outcome in patients with hereditary AT deficiency. Five expectant mothers with AT deficiency were followed in our center to evaluate thrombotic events, and maternal and pregnancy outcomes. AT gene sequencing was performed in all cases, and levels of AT and anti-activated factor X were regularly measured to guide the risk-adopted anticoagulant prophylaxis. Three mothers had homozygous type II heparin-binding site mutations and two had heterozygous type I mutations of the gene encoding AT. Two women had additional factor V Leiden heterozygous mutations. Three maternal VTEs - four healthy newborns and five pregnancy losses - were observed. The risk of patients to VTE and adverse pregnancy outcome was found to associate with the homozygous type II heparin-binding site mutation of the AT gene. High risk of maternal VTE and frequent pregnancy complications were observed to associate with AT deficiency. Our results support the need of individualized, risk-adopted anticoagulant therapy in patients with AT deficiency.
Tárgyszavak:Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
anticoagulant therapy
antithrombin concentrate
antithrombin deficiency
pregnancy
Megjelenés:Blood coagulation and fibrinolysis. - 26 : 7 (2015), p. 798-804. -
További szerzők:Oláh Zsolt (1974-) (belgyógyász) Selmeczi Anna (1982-) (orvos) Kerényi Adrienne (1970-) (laboratóriumi szakorvos) Bereczky Zsuzsanna (1974-) (orvosi laboratóriumi diagnosztika szakorvos) Póka Róbert (1960-) (szülész-nőgyógyász, klinikai onkológus) Schlammadinger Ágota (1971-) (belgyógyász, haematológus) Boda Zoltán (1947-) (belgyógyász, haematologus, klinikai onkológus)
Pályázati támogatás:TÁMOP-4.2.4.A/2-11-1-2012-0001
TÁMOP
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001-es BibID:BIBFORM062383
Első szerző:Kerényi Adrienne (laboratóriumi szakorvos)
Cím:Evaluation of flow cytometric HIT assays in relation to an IgG-specific immunoassay and clinical outcome / Adrienne Kerényi, Ildikó Beke Debreceni, Zsolt Oláh, Péter Ilonczai, Zsuzsanna Bereczky, Béla Nagy Jr., László Muszbek, János Kappelmayer
Dátum:2017
ISSN:1552-4949
Megjegyzések:BACKGROUND:Heparin-induced thrombocytopenia (HIT) is a severe side effect of heparin treatment caused by platelet activating IgG antibodies generated against the platelet factor 4 (PF4)-heparin complex. Thrombocytopenia and thrombosis are the leading clinical symptoms of HIT.METHODS:The clinical pretest probability of HIT was evaluated by the 4T score system. Laboratory testing of HIT was performed by immunological detection of antibodies against PF4-heparin complex (EIA) and two functional assays. Heparin-dependent activation of donor platelets by patient plasma was detected by flow cytometry. Increased binding of Annexin-V to platelets and elevated number of platelet-derived microparticles (PMP) were the indicators of platelet activation.RESULTS:EIA for IgG isotype HIT antibodies was performed in 405 suspected HIT patients. Based on negative EIA results HIT was excluded in 365 (90%) of cases. In 40 patients with positive EIA test result functional tests were performed. Platelet activating antibodies were detected in 17 cases by Annexin V binding. PMP count analysis provided nearly identical results. The probability of a positive flow cytometric assay result was higher in patients with elevated antibody titer. 71% of patients with positive EIA and functional assay had thrombosis.CONCLUSIONS:EIA is an important first line laboratory test in the diagnosis of HIT, however, HIT must be confirmed by a functional test. Annexin V binding and PMP assays using flow cytometry are functional HIT tests convenient in a clinical diagnostic laboratory. The positive results of functional assays may predict the onset of thrombosis. This article is protected by copyright. All rights reserved.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
heparin-induced thrombocytopenia
thrombosis
4T score
flow cytometry
platelet microparticles
Megjelenés:Cytometry Part B-Clinical Cytometry. - 92 : 5 (2017), p. 389-397. -
További szerzők:Bekéné Debreceni Ildikó (1970-) (biológus) Oláh Zsolt (1974-) (belgyógyász) Ilonczai Péter (1977-) (orvos, belgyógyász, haematológus szakorvos) Bereczky Zsuzsanna (1974-) (orvosi laboratóriumi diagnosztika szakorvos) Nagy Béla Jr. (1980-) (labordiagnosztikai szakorvos) Muszbek László (1942-) (haematológus, kutató orvos) Kappelmayer János (1960-) (laboratóriumi szakorvos)
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