Review: Infectious Diseases and Coagulation Disorders

Abstract

Infection, both bacterial and nonbacterial, may be associated with coagulation disorders, resulting in disseminated intravascular coagulation and multiorgan failure. In the last few decades a series of in vivo and in vitro studies has provided more insight into the pathogenetic mechanisms and the role of cytokines in these processes. Because of the growing interest in this field, the complexity of the subject, and the fact that many physicians must deal with a variety of infections, current data are reviewed on the association between infectious diseases and the coagulation system. Novel therapeutic intervention strategies that will probably become available in the near future are mentioned, along with those of special interest for infectious disorders for which only supportive care can be given.

Activated Partial Thromboplastin Time, Prothrombin Time, Thrombin Time and Platelet Count Study in HIV Seropositive Subjects at Nnamdi Azikiwe Teaching Hospital Nnewi

“…The PT and APTT were significantly higher in HIV-positive subjects (ART and Non-ART) compared to the values obtained in the HIV-negative subjects (controls) in this study and is in consonance with previous independent studies of van Gorp et al [19]; Omoregie et al [20]; Okoroiwu et al [21]; Obeagu and Obeagu, [22]. These studies reported that PT and APTT were significantly higher in HIV-positive patients.…”

“…This is in consonance with previous studies by van Gorp et al [19], Kasthuri et al [25]; Omoregie et al [20] and Okoroiwu et al [21]. They independently reported that platelet count were significantly lower in HIV-positive subjects when compared to HIV-negative controls.…”

“…Moreover, HIV infection results in liver derangement, immune dysregulation, and presence of anticardiolipin antibodies (aCL) and lupus anticoagulant (LA). These anomalies (endothelial damage and activation of clotting factors, liver derangement, (aCL and LA) may account for the higher PT and APTT values observed in HIV-positive subjects [19,24]. However, the differences in duration of ART and gender did not affect both parameters (PT and APTT) as observed in this study.…”

Microscopic Polyangiitis Associated with Marked Systemic Bleeding Tendency Caused by Disseminated Intravascular Coagulation

“…Although these findings strongly suggest that ANCA-associated vasculitis often presents with DIC, few reports have described cases such as the present case (15). It is well known that infectious diseases, both from bacterial and nonbacterial infection, are often associated with a coagulation disorder, resulting in DIC and multiorgan failure (16). However, in the present case, a severe infectious disease which could have induced DIC was not obviously present because of the low level of endotoxin, low grade fever and no positive cultures in urine, sputum, stool and blood specimen.…”

Decrease in antithrombin III and prothrombin serum levels contribute to coagulation disorders during leptospirosis

“…Infection-associated stimulation of the coagulation cascade may lead to a varied spectrum of clinical effects, from a clinically unimportant increase in laboratory markers to severe thrombo-haemorrhage syndromes, such as DIC (van Gorp et al, 1999). The pathophysiology of sepsis-associated DIC is very complex and has been exhaustively examinated.…”