The clinical significance of a shortened activated partial thromboplastin time in patients with connective tissue disease

Habe, Koji; Wada, Hideo; Mizutani, Kazuki; Matsushima, Yoshiaki; Kondo, Makoto; Yamanaka, Keiichi

doi:10.1007/s10067-021-05781-w

Cited by 4 publications

(1 citation statement)

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“…Several investigators have confirmed the correlation between D-dimer levels and rheumatoid arthritis activity indices through retrospective data mining [ 26 ]. In addition to its predictive value for the diagnosis of VTE in CTD patients [ 27 ], it has been shown that D-dimer level is also a valid serologic index for assessing disease activity in some CTD patients [ 28 , 29 ]. D-dimer can be used as one of the effective monitoring indicators during the suppression of hypercoagulability due to immune activity with glucocorticoids.…”

Section: Vte Associated With the Systemic Inflammatory Responsementioning

confidence: 99%

Under the dual effect of inflammation and pulmonary fibrosis, CTD-ILD patients possess a greater susceptibility to VTE

Jiang,

Jia,

Dong

2024

Thrombosis J

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As an autoimmune disease, the persistent systemic inflammatory response associated with connective tissue disease (CTD) is involved in the development of venous thromboembolism (VTE). However, clinical data showed that the risk of VTE in patients differed between subtypes of CTD, suggesting that different subtypes may have independent mechanisms to promote the development of VTE, but the specific mechanism lacks sufficient research at present. The development of pulmonary fibrosis also contributes to the development of VTE, and therefore, patients with CTD-associated interstitial lung disease (CTD-ILD) may be at higher risk of VTE than patients with CTD alone or patients with ILD alone. In addition, the activation of the coagulation cascade response will drive further progression of the patient’s pre-existing pulmonary fibrosis, which will continue to increase the patient’s risk of VTE and adversely affect prognosis. Currently, the treatment for CTD-ILD is mainly immunosuppressive and antirheumatic therapy, such as the use of glucocorticoids and janus kinase-inhibitors (JAKis), but, paradoxically, these drugs are also involved in the formation of patients’ coagulation tendency, making the clinical treatment of CTD-ILD patients with a higher risk of developing VTE challenging. In this article, we review the potential risk factors and related mechanisms for the development of VTE in CTD-ILD patients to provide a reference for clinical treatment and prevention.

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