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Acquired Hemostatic Disorders

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Perioperative Hemostasis

Abstract

Acquired hemostatic disorders comprise thrombocytopenia and platelet dysfunction, coagulation factor deficiencies, excessive anticoagulation, and hemorrhagic complications due to antiplatelet drugs, anticoagulation, and thrombolysis. Blood disorders associated with myeloproliferative neoplasms and disseminated intravascular coagulation can cause both bleeding and thrombosis. Heparin-induced thrombocytopenia, antiphospholipid antibody syndrome, and thrombotic microangiopathies are conditions that can cause thrombocytopenia, but they are more frequently responsible for thrombosis than for bleeding.

This chapter sets out diagnostic and management strategies for acquired hemostatic disorders, with a particular emphasis on features that can prove useful in a perioperative context. Antiplatelet and anticoagulant drug complications are presented in Chap. 8.

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References

  • Abdelmalik N, Ruhe HG et al (2008) Effect of the selective serotonin reuptake inhibitor paroxetine on platelet function is modified by a SLC6A4 serotonin transporter polymorphism. J Thromb Haemost 6(12):2168–2174

    Article  PubMed  CAS  Google Scholar 

  • Ahmad F, Solymoss S et al (1996) Characterization of an acquired IgG inhibitor of coagulation factor XIII in a patient with systemic lupus erythematosus. Br J Haematol 93(3):700–703

    Article  PubMed  CAS  Google Scholar 

  • Aird WC, Mark EJ (2002) Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 15–200. A 53-year-old man with a myocardial infarct and thromboses after coronary-artery bypass grafting. N Engl J Med 346(20):1562–1570

    Article  PubMed  Google Scholar 

  • Ang AL, Kuperan P et al (2009) Acquired factor V inhibitor. A problem-based systematic review. Thromb Haemost 101(5):852–859

    PubMed  CAS  Google Scholar 

  • Ataoglu A, Canan F (2009) Mean platelet volume in patients with major depression: effect of escitalopram treatment. J Clin Psychopharmacol 29(4):368–371

    Article  PubMed  CAS  Google Scholar 

  • Baudo F, Caimi T et al (2010) Diagnosis and treatment of acquired haemophilia. Haemophilia 16(102):102–106

    Article  PubMed  CAS  Google Scholar 

  • Baudo F, Collins P et al (2012) Management of bleeding in acquired hemophilia A: results from the European Acquired Haemophilia (EACH2) Registry. Blood 120(1):39–46

    Article  PubMed  CAS  Google Scholar 

  • Boehlen F, Casini A et al (2013) Acquired factor XIII deficiency: a therapeutic challenge. Thromb Haemost 109(3):479–487

    Article  PubMed  CAS  Google Scholar 

  • Bosch J, Thabut D et al (2008) Recombinant factor VIIa for variceal bleeding in patients with advanced cirrhosis: a randomized, controlled trial. Hepatology 47(5):1604–1614

    Article  PubMed  CAS  Google Scholar 

  • Bovill EG, Ershler WB et al (1986) A human myeloma-produced monoclonal protein directed against the active subpopulation of von Willebrand factor. Am J Clin Pathol 85(1):115–123

    PubMed  CAS  Google Scholar 

  • Buclin T, Schmidt PM et al (1992) Acquired factor V inhibitor treated with intravenous immunoglobulins. Schweiz Med Wochenschr 122(51–52):1968–1970

    PubMed  CAS  Google Scholar 

  • Buss DH, Stuart JJ et al (1985) The Incidence of thrombotic and hemorrhagic disorders in association with extreme thrombocytosis: An analysis of 129 cases. Am J Hemato 20:365–372

    Article  CAS  Google Scholar 

  • Cochran KA, Cavallari LH et al (2011) Bleeding incidence with concomitant use of antidepressants and warfarin. Ther Drug Monit 33(4):433–438

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Collins PW (2012) Therapeutic challenges in acquired factor VIII deficiency. Hematology Am Soc Hematol Educ Program 2012:369–374

    PubMed  Google Scholar 

  • Dalton SO, Johansen C et al (2003) Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding: a population-based cohort study. Arch Intern Med 163(1):59–64

    Article  PubMed  CAS  Google Scholar 

  • De Stefano V, Za T et al (2008) Recurrent thrombosis in patients with polycythemia vera and essential thrombocythemia: Incidence, risk factors, and effect of treatments. Haematologica 93:372–380

    Google Scholar 

  • de Raucourt E, Barbier C et al (2003) High-dose intravenous immunoglobulin treatment in two patients with acquired factor V inhibitors. Am J Hematol 74(3):187–190

    Article  PubMed  Google Scholar 

  • Elliott MA, Tefferi A (2005) Thrombosis and haemorrhage in polycythaemia vera and essential thrombocythaemia. Br J Haematol128:275–290

    Article  PubMed  CAS  Google Scholar 

  • Falanga A, Marchetti M et al (2007) V617f Jak-2 Mutation in patients with essential thrombocythemia: relation to platelet, granulocyte, and plasma hemostatic and inflammatory molecules. Exp Hematol 35:702–711

    Article  PubMed  CAS  Google Scholar 

  • Federici AB, Rand JH et al (2000) Acquired von Willebrand syndrome: data from an international registry. Thromb Haemost 84(2):345–349

    PubMed  CAS  Google Scholar 

  • Fenaux P, Simon M et al (1990) Clinical course of essential thrombocythemia in 147 cases. Cancer 66:549–556

    Google Scholar 

  • Franchini M, Lippi G (2011) Acquired factor V inhibitors: a systematic review. J Thromb Thrombolysis 31(4):449–457

    Article  PubMed  CAS  Google Scholar 

  • Franchini M, Lippi G et al (2008) The use of recombinant activated factor vii in platelet-associated bleeding. Hematology 13:41–45

    Article  PubMed  CAS  Google Scholar 

  • Frank RD, Kunz D et al (2002) Acquired von Willebrand disease–hemostatic management of major orthopedic surgery with high-dose immunoglobulin, desmopressin, and continuous factor concentrate infusion. Am J Hematol 70(1):64–71

    Article  PubMed  Google Scholar 

  • Fu YX, Kaufman R et al (1996) Multimodality therapy of an acquired factor V inhibitor. Am J Hematol 51(4):315–318

    Article  PubMed  CAS  Google Scholar 

  • Gines P, Fernandez J et al (2012) Management of critically-ill cirrhotic patients. J Hepatol 56(Suppl 1):S13–S24

    Article  PubMed  CAS  Google Scholar 

  • Huth-Kuhne A, Baudo F et al (2009) International recommendations on the diagnosis and treatment of patients with acquired hemophilia A. Haematologica 94(4):566–575

    Article  PubMed  PubMed Central  Google Scholar 

  • Jeimy SB, Krakow EF et al (2008) An acquired factor V inhibitor associated with defective factor V function, storage and binding to multimerin 1. J Thromb Haemost 6(2):395–397

    Article  PubMed  CAS  Google Scholar 

  • Jervis K, Senthilnathan V et al (2009) Management of a patient with lupus anticoagulant and antiphospholipid syndrome for off-pump coronary artery bypass grafting using the Hepcon system. Anesth Analg 108(4):1116–1119

    Article  PubMed  Google Scholar 

  • Landolfi R, Rocca B et al (1995) Bleeding and thrombosis in myeloproliferative disorders: Mechanisms and treatment. Crit Rev Oncol Hematol 20:203–222

    Article  PubMed  CAS  Google Scholar 

  • Lebrun A, Leroy-Matheron C et al (2008) Successful treatment with rituximab in a patient with an acquired factor V inhibitor. Am J Hematol 83(2):163–164

    Google Scholar 

  • Levi M, Ten Cate H (1999) Disseminated intravascular coagulation. N Engl J Med 341(8):586–592

    Article  PubMed  CAS  Google Scholar 

  • Levi M, de Jonge E et al (2002) The diagnosis of disseminated intravascular coagulation. Blood Rev 16(4):217–223

    Article  PubMed  Google Scholar 

  • Levi M, Toh CH et al (2009) Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. Br J Haematol 145(1):24–33

    Article  PubMed  CAS  Google Scholar 

  • Lisman T, Leebeek FW (2007) Hemostatic alterations in liver disease: a review on pathophysiology, clinical consequences, and treatment. Dig Surg 24(4):250–258

    Article  PubMed  Google Scholar 

  • Lo GK, Juhl D et al (2006) Evaluation of pretest clinical score (4T’s) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings. J Thromb Haemost 4(4):759–765

    Article  PubMed  CAS  Google Scholar 

  • Luo YY, Zhang GS (2011) Acquired factor XIII inhibitor: clinical features, treatment, fibrin structure and epitope determination. Haemophilia 17(3):393–398

    Article  PubMed  Google Scholar 

  • Luo Y, Zhang G et al (2010) Acquired factor XIII inhibitor in monoclonal gammopathy of undetermined significance: characterization and cross-linked fibrin ultrastructure. Ann Hematol 89(8):833–834

    Article  PubMed  Google Scholar 

  • Maddox JM, Anderson JA et al (2005) Management of acquired von Willebrand’s syndrome in a patient requiring major surgery. Haemophilia 11(6):633–637

    Article  PubMed  CAS  Google Scholar 

  • Mannucci PM, Tripodi A (2012) Hemostatic defects in liver and renal dysfunction. Hematology Am Soc Hematol Educ Program 2012:168–173

    PubMed  Google Scholar 

  • Michiels JJ, Budde U et al (2001) Acquired von willebrand syndromes: clinical features, aetiology, pathophysiology, classification and management. Best Pract Res Clin Haematol 14:401–436

    Article  PubMed  CAS  Google Scholar 

  • Miesbach W (2005) Rituximab in the treatment of factor XIII inhibitor possibly caused by Ciprofloxacin. Thromb Haemost 93(5):1001–1003

    PubMed  CAS  Google Scholar 

  • Milner GR, Holt PJ et al (1977) Practolol therapy associated with a systemic lupus erythematosus-like syndrome and an inhibitor to factor XIII. J Clin Pathol 30(8):770–773

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Moore RA, Adel N et al (2011) High incidence of thromboembolic events in patients treated with cisplatin-based chemotherapy: a large retrospective analysis. J Clin Oncol 29(25):3466–3473

    Article  PubMed  CAS  Google Scholar 

  • Otis PT, Feinstein DI et al (1974) An acquired inhibitor of fibrin stabilization associated with isoniazid therapy: clinical and biochemical observations. Blood 44(6):771–781

    PubMed  CAS  Google Scholar 

  • Pivalizza EG, Escobar MA (2008) Thrombelastography-guided factor VIIa therapy in a surgical patient with severe hemophilia and factor VIII inhibitor. Anesth Analg 107(2):398–401

    Article  PubMed  Google Scholar 

  • Prandoni P, Falanga A et al (2005) Cancer and venous thromboembolism. Lancet Oncol 6(6):401–410

    Article  PubMed  Google Scholar 

  • Provan D, Stasi R et al (2010) International consensus report on the investigation and management of primary immune thrombocytopenia. Blood 115(2):168–186

    Article  PubMed  CAS  Google Scholar 

  • Reikvam H, Tiu RV (2012) Venous thromboembolism in patients with essential thrombocythemia and polycythemia vera. Leukemia 26(4):563–571

    Article  PubMed  CAS  Google Scholar 

  • Roberts LN, Patel RK et al (2010) Haemostasis and thrombosis in liver disease. Br J Haematol 148(4):507–521

    Article  PubMed  CAS  Google Scholar 

  • Sarma A, Horne MK 3rd (2006) Venlafaxine-induced ecchymoses and impaired platelet aggregation. Eur J Haematol 77(6):533–537

    Article  PubMed  Google Scholar 

  • Selleng K, Warkentin TE et al (2007) Heparin-induced thrombocytopenia in intensive care patients. Crit Care Med 35(4):1165–1176

    Article  PubMed  CAS  Google Scholar 

  • Silberstein LE, Abrahm J et al (1987) The efficacy of intensive plasma exchange in acquired von Willebrand’s disease. Transfusion 27(3):234–237

    Article  PubMed  CAS  Google Scholar 

  • Stasi R (2012) How to approach thrombocytopenia. Hematology Am Soc Hematol Educ Program 2012:191–197

    PubMed  Google Scholar 

  • Tartaglia AP, Goldberg JD et al (1986) Adverse effects of antiaggregating platelet therapy in the treatment of polycythemia vera. Semin Hematol 23:172–176

    PubMed  CAS  Google Scholar 

  • Taylor FB Jr, Toh CH et al (2001) Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost 86(5):1327–1330

    PubMed  CAS  Google Scholar 

  • Thachil J, Toh CH (2012) Current concepts in the management of disseminated intravascular coagulation. Thromb Res 129(Suppl 1):S54–S59

    Article  PubMed  CAS  Google Scholar 

  • Tiede A, Rand JH et al (2011) How I treat the acquired von Willebrand syndrome. Blood 117(25):6777–6785

    Article  PubMed  CAS  Google Scholar 

  • Tjonnfjord GE (2004) Activated prothrombin complex concentrate (FEIBA) treatment during surgery in patients with inhibitors to FVIII/IX: the updated Norwegian experience. Haemophilia 10(Suppl 2):41–45

    Article  PubMed  CAS  Google Scholar 

  • Tribl B, Knobl P et al (1995) Rapid elimination of a high-titer spontaneous factor V antibody by extracorporeal antibody-based immunoadsorption and immunosuppression. Ann Hematol 71(4):199–203

    Article  PubMed  CAS  Google Scholar 

  • Tripodi A, Mannucci PM (2011) The coagulopathy of chronic liver disease. N Engl J Med 365(2):147–156

    Article  PubMed  CAS  Google Scholar 

  • Trouillas P, von Kummer R (2006) Classification and pathogenesis of cerebral hemorrhages after thrombolysis in ischemic stroke. Stroke 37:556–561

    Google Scholar 

  • Vanderschueren S, De Weerdt A et al (2000) Thrombocytopenia and prognosis in intensive care. Crit Care Med 28(6):1871–1876

    Article  PubMed  CAS  Google Scholar 

  • Wada H, Thachil J et al (2013) Guidance for diagnosis and treatment of DIC from harmonization of the recommendations from three guidelines. J Thromb Haemost 11(11):2078–2079

    Google Scholar 

  • Warkentin TE (2011) How I diagnose and manage HIT. Hematology Am Soc Hematol Educ Program 2011:143–149

    Article  PubMed  Google Scholar 

  • William BM (2008) Adjunctive role for recombinant activated factor VII in the treatment of bleeding secondary to a factor V inhibitor. Blood Coagul Fibrinolysis 19(4):327–328

    Article  PubMed  Google Scholar 

  • Wolanskyj AP, Schwager SM et al (2006) Essential thrombocythemia beyond the first decade: life expectancy, long-term complication rates, and prognostic factors. Mayo Clin Proc 81:159–166

    Google Scholar 

  • Zvetkova E, Antonova N et al (2010) Platelet morphological, functional and rheological properties attributable to addictions. Clin Hemorheol Microcirc 45(2–4):245–251

    PubMed  CAS  Google Scholar 

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Correspondence to Anne Angelillo-Scherrer .

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Barelli, S., Blum, S., Angelillo-Scherrer, A. (2015). Acquired Hemostatic Disorders. In: Marcucci, C., Schoettker, P. (eds) Perioperative Hemostasis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55004-1_7

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  • DOI: https://doi.org/10.1007/978-3-642-55004-1_7

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