Activation of the coagulation system occurs within rather than outside cutaneous haemangiomas

Abstract

Antovic J, Bakic M, Milicevic R, Gojkovic G, Blomback M. Activation of the coagulation system occurs within rather than outside cutaneous haemangiomas. Acta Paediatr 2001; 90: 1137-1140 Haemangiomas are the commonest tumours of infancy. They can become even more serious if followed by consumption coagulopathy and even life-threatening in cases of Kasabach-Merritt syndrome, with thrombocytopeni a and haemorrhage. Data exist concerning systemic coagulation abnormalities in children with haemangiomas but to our knowledge there are no data on local consumption coagulopathy in haemangioma per se. We examined blood coagulation and brinolysis parameters in blood withdrawn from haemangioma blood vessels and blood withdrawn from the systemic vein in 14 children with cutaneous haemangiomas (3M, 11F; age range 3 mo to 10 y). Compared with controls, signi cant decreases in brinogen levels, FVII activity, antithrombin and plasmin inhibitor levels and increases in international normalized ratio (INR) and D-dimer levels were observed in the blood samples withdrawn directly from haemangioma blood vessels. Fibrinogen and antithrombin levels in samples withdrawn from systemic veins were reduced in relation to control values whilst INR values increased, but within normal ranges. D-dimer levels were increased in peripheral blood. The brinogen level was signi cantly lower and the INR and D-dimer levels were signi cantly higher in blood samples from haemangiomas compared to systemic blood. Clinical signs of systemic disseminated intravascular coagulation were not observed. Conclusions:Our results suggest a strong local activation and local consumption coagulopathy in haemangioma, along with less conspicuous but observable systemic changes in coagulation and brinolysis parameters, although without signs of consumptive coagulopathy. These systemic changes could be a re ection of intra-lesion coagulation activation although there is no evidence to suggest truly systemic disseminated intravascular coagulation.

Neonatal thrombocytopenia: A review. II. Non-immune thrombocytopenia; platelet transfusion

“…[55][56][57] Thrombocytopenia takes place through platelet sequestration or destruction inside the tumor mass, and the presence of a DIC process is common. 58,59 It may coexist with anemia, as a result of bleeding or red blood cell trapping and destruction inside the tumor mass. 60 Treatment should consider that hemangiomas tend to solve spontaneously, so potential risks should be assessed.…”

Trombocitopenia neonatal: Revisión. II. Trombocitopenias no inmunes; transfusión de plaquetas

“…[55][56][57] El mecanismo de la trombocitopenia es por secuestro o destrucción plaquetaria dentro de la masa tumoral, y es frecuente la existencia de un proceso de CID. 58,59 Puede coexistir anemia, como consecuencia del sangrado o por atrapamiento y destrucción eritrocitaria dentro de la masa tumoral. 60 Respecto al tratamiento, se debe considerar que los hemangiomas tienen tendencia a remitir espontáneamente, por lo que deben evaluarse sus riesgos potenciales.…”

Successful conservative treatment for massive uterine bleeding with non-septic disseminated intravascular coagulation after termination of early pregnancy in a woman with huge adenomyosis: case report

“…Disseminated intravascular coagulation (DIC) is a coagulopathy that can occur in a large number of clinical conditions, including malignant tumors and obstetrical events [1][2][3][4][5]. However, few cases of DIC have been reported in benign diseases, especially intrauterine diseases [6][7][8]. Adenomyosis is a benign gynecological condition in which endometrial tissue or endometrial-like tissue develops within the uterine myometrium [9][10][11].…”