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Antithrombin as a marker of severe acute hepatitis B

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Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Acute hepatitis B (AHB) can run a severe course, which sometimes leads to a fulminant disease with acute liver failure (ALF). Pro-coagulation factors are well-established markers of AHB severity, but less is known about the levels of anti-coagulation parameters in AHB.

Methods

In this study, we demonstrate that antithrombin (AT) plasma levels were associated with AHB severity in 161 patients.

Results

Nine (6%) patients had severe AHB (i.e. international normalized ratio [INR] ≥ 1.6 and total bilirubin ≥ 10 mg/dL). Coagulopathy (i.e. INR > 1.2 and/or AT < 80%) was observed in 65 (40%) AHB patients on admission. Low initial plasma AT levels (i.e. < 80%) were observed in 56 (35%) patients. In all, plasma AT levels decreased in 91 (57%) patients during their hospital stay. Both baseline and nadir AT levels were significantly lower in severe than in mild and moderate AHB. Moreover, the concentration of AT negatively correlated with INR, aspartate aminotransferase, and total and conjugated bilirubin levels. Interestingly, nadir AT levels positively correlated with the duration of hospitalization.

Conclusions

These results indicate that plasma AT levels can be used as an additional marker of AHB severity.

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Funding

The study was supported by a project PROGRESS Q26-7 and UNCE 204022.

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Authors and Affiliations

  1. Department of Infectious Diseases, First Faculty of Medicine, Charles University and Military University Hospital, Prague, Czech Republic

    Simona Arientová, O. Beran, P. Chalupa & M. Holub

  2. Department of Infectious and Tropical Diseases, First Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague, Czech Republic

    P. Chalupa & M. Kořínková

Authors
  1. Simona Arientová
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  2. O. Beran
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  3. P. Chalupa
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  4. M. Kořínková
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  5. M. Holub
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Corresponding author

Correspondence to Simona Arientová.

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Conflict of interest

SA, OB, PC, MK, and MH declare that they have no conflict of interest.

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The authors declare that the study was performed in a manner conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Arientová, S., Beran, O., Chalupa, P. et al. Antithrombin as a marker of severe acute hepatitis B. Indian J Gastroenterol 38, 143–149 (2019). https://doi.org/10.1007/s12664-019-00948-5

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  • DOI: https://doi.org/10.1007/s12664-019-00948-5

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