Internal and Emergency Medicine

, Volume 5, Issue 1, pp 7–12

Abnormalities of hemostasis and bleeding in chronic liver disease: the paradigm is challenged

  • Armando Tripodi
  • Massimo Primignani
  • Pier Mannuccio Mannucci
IM - Review

DOI: 10.1007/s11739-009-0302-z

Cite this article as:
Tripodi, A., Primignani, M. & Mannucci, P.M. Intern Emerg Med (2010) 5: 7. doi:10.1007/s11739-009-0302-z

Abstract

Chronic liver disease is characterized by a global hemostatic defect including platelet–vessel wall interaction (primary hemostasis), coagulation and fibrinolysis that may cause abnormalities of the relevant laboratory tests. The causal relationship between abnormal tests and bleeding has been widely accepted, despite the fact that abnormal tests are poorly associated with the timing and incidence of actual bleeding. In this article, we review recent evidence from the literature that disputes the above paradigm, and opens new venues for laboratory/clinical research and patient management in this field.

Keywords

Cirrhosis Acquired coagulation disorders PT APTT Thrombin generation 

Copyright information

© SIMI 2009

Authors and Affiliations

  • Armando Tripodi
    • 1
    • 3
  • Massimo Primignani
    • 2
  • Pier Mannuccio Mannucci
    • 1
  1. 1.Angelo Bianchi Bonomi Hemophilia and Thrombosis CenterUniversity Medical School and IRCCS Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena FoundationMilanItaly
  2. 2.Third Division of Gastroenterology, Department of Internal MedicineUniversity Medical School and IRCCS Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena FoundationMilanItaly
  3. 3.MilanItaly

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