ACTIVATED PARTIAL THROMBOPLASTIN TIME AND FIBRINOGEN IN PEDIATRIC NEPHROTIC SYNDROME DURING RELAPSE AND REMISSION

Authors

  • Trianita Tarigan Department of Clinical Pathology, Faculty of Medicine, University North Sumatera/Adam Malik General Hospital Medan, Indonesia.
  • Adi Koesoema Aman Department of Clinical Pathology, Faculty of Medicine, University North Sumatera/Adam Malik General Hospital Medan, Indonesia.
  • Oke Rina Ramayani Department of Child Health Science, Medical Faculty, University North Sumatera/Adam Malik General Hospital Medan, Indonesia

DOI:

https://doi.org/10.24293/ijcpml.v24i3.1410

Keywords:

Nephrotic syndrome, activated partial thromboplastin time, fibrinogen

Abstract

         Nephrotic Syndrome (NS) is a complicated kidney disease disorder, one of the most important complications is thromboembolism which can affect the circulation, either arterial or venous in both pediatric and adult patients. Patients at risk of thromboembolism should have an angiography examination for diagnosis. There have been several studies conducted on patients with a nephrotic syndrome showing the risk of thromboembolism. This study included twelve patient of pediatric nephrotic syndrome consisting of males and females. The patient experiences a period of relapse and became a remission. Patients participating in the study were 3 to 17 years old. There were significant differences in fibrinogen in which the fibrinogen content of NS patients in children at relapse was higher compared with the time of remission (390.08 ± 164.87 vs. 273.17 ± 150.56; p=0.042). There was no significant difference in Activated Partial Thromboplastin Time (APTT) results in SN patients in relapse compared to remission (34.17 ± 5.65 vs. 30.08 ± 8.49; p=0.236). The high levels of fibrinogen in the relapse period indicate the presence of hypercoagulable state, along with other examinations such as high cholesterol and low albumin. In this study, there was no significant difference in APTT among SN patients during relapse compared with remission while in the fibrinogen examination a significant difference was found. Therefore, fibrinogen examination is important to be analyzed in order to avoid SN complications.

 

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References

Ozkaya O, Bek K, Fisgin T, Aliyazicioglu Y, Sultansuyu S, et al. Low protein Z levels in children with nephritic syndrome. Pediatric Nephrology. 2006; 21(8): 1122-6. [Pubmed: 16810511].

Kerlin BA, Neal BB, Beng F, Shuang Z, Amy L, et al. Epidemiology and risk factors for thromboembolic complications of childhood nephrotic syndrome: A Midwest Pediatric Nephrology Consortium (MWPNC) Study. J.Pediatric. 2009; 155(1): 105-110. Doi:10.1016/j.jpeds.2009.01.070.

Mahmodi BK, ten K, Min K, Waanders F, Veeger Nic JGM, et al. High absolute risks and predictors of venous, and arterial thromboembolic events in patients with nephrotic syndrome. Circulation. 2008; 117: 224-30. Doi:10.1161/CIRCULATIONAHA.107.716951.

Yalcinkaya F, Tumer N, Gorgani AN, Ekim M, Cakar N. Hemostatic parameters in childhood nephrotic syndrome. (Is there any difference in protein C Levels between steroid sensitive and resistant group?). Int Urol Nephrol.1995; 27(5): 43-7. [PMID: 8775051].

Ueda N, Kawaguchi S, Niinomi Y, Nonoda T, Matsumoto J, Ohnishi M, Yasaki T. Effect of corticosteroid on coagulation factor in children with nephrotic syndrome. Pediatric Nephrology. 1987; 1(3): 286-9. [PMID: 3153290].

Citak A. Emre S, Sairin A, Bilge I, Nayir A. Hemostatic problems and thromboembolic complication in nephrotic children. Pediatric Nephrology. 2000; 138–42. [PBID: 10684364].

Gangakhedkar A, Wong W, Pitcher LA. Cerebral thrombosis in childhood nephrosis. J. Paediatr Child Health. 2005; 41(4): 221 – 224. DOI: 10.1111/j.1440-1754.2005.00592.

Mittal A, Kailash CA, Sumita S, Archana A, Binit S. Platelet functions and coagulation changes in indian children with nephrotic syndrome. Journal of Clinical and Diagnostic Research. 2013; 1647-50. DOI:10.7860/JCDR/2013/5488.3229.

McClelland FIHP, Hay CHM, Bell GM. Arterial thrombosis in nephrotic syndrome. Postgrad Med J; 1994; 70(830): 905-9. [Pubmed: 2398016].

Cook NS and Ubben D. Fibrinogen as a major risk factor in cardiovascular disease. Trends Pharmacol Sci. 1990; 11(11): 444-51. [PMID: 2267668].

Zwaginga JJ, Koors HA, Sixma JJ, Rabelink AJ. Thrombus formation and platelet vassel wall interaction in the nephritic syndrome under flow conditions. J Clin Invest.1994; 93: 204-11. DOI:10.1172/JCI116947.

Remuzzi G, Mecca G, Marches D, Livio M, Da Gaetano U, et al. Platelet hyperaggregability and the nephritic syndrome. Thromb Res. 1979; 16(3-4): 345-54. DOI: 10.1016/0049-3848(79)90082-3.

Yoshida N, Aoki N. Release of arachidonic acid from human platelet aggregability in normal subjet as well as in those with nephritic syndrome. Blood. 1978; 52: 969-77.

Bennet A. Cameron JS. Platelet hyperaggregability in nehrotic syndrome which is not dependent on arachidonic acid metabolism or on albumin concentration. Clin Nephrol. 1987; 182-8. [PMID : 3107859].

Rani AS. A Study of PT, APTT, Fibrinogen and urinary protein-creatinin ratio in pediatric patients with nephrotic syndrome. International Journal of Contemporary Pediatrics. 2014; 1(2): 89-93. DOI: 10.5455/2349-3291.ijep20140805

Gbadegesin R, Willliam ESWE. Nephrotic syndrome. In: Geary DF and Fransz S. Comprehensive pediatric nephrology. Philadelphia, Elsevier Inc, 2008; 205 – 218.

Farid FA, Ahmed AM, Hanas MA and Rania SB. Tissue factor pathway inhibitor in pediatric patients with nephrotic syndrome. Europe PMC Funders Group. SAJCH. 2011; 5(4): 107-111.

Lijfering, WM, Rosendaal FR, Cannegieter SC. Risk factors for venous thrombosis – current understand from an epidemiological point of view. Br J Haematol. 2010; 149(6): 824-33. DOI: 10.111/j.1365-2141.2010.08206.

Wasilewska A, Walentyna MZZ, Barbara T and Beata Z. Relationship of serum interleukin-7 concentration and the coagulation state in children with nephrotic syndrome. Pediatric International. 2005; 47: 424-429. DOI: 10.111/j.1442-200x.2005.02078.

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Submitted

2018-12-10

Accepted

2018-12-10

Published

2018-07-01

How to Cite

[1]
Tarigan, T., Aman, A.K. and Ramayani, O.R. 2018. ACTIVATED PARTIAL THROMBOPLASTIN TIME AND FIBRINOGEN IN PEDIATRIC NEPHROTIC SYNDROME DURING RELAPSE AND REMISSION. INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY. 24, 3 (Jul. 2018), 272–275. DOI:https://doi.org/10.24293/ijcpml.v24i3.1410.

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