Thromboembolic Complications, Heparin Treatment and Increase in Coagulation Factors in Cushing's Syndrome

Sjöberg, Hans; Blombäck, Margareta; Granberg, Per‐Ola

doi:10.1111/j.0954-6820.1976.tb06697.x

Cited by 76 publications

(21 citation statements)

References 24 publications

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“…Increased levels of serum factor VIII, von Willebrand factor (vWF), plasminogen, tissue plasminogen activator (t-PA) antigen and PAI-1 activity has been observed in the patients with Cushing's syndrome as compared to healthy controls (11)(12)(13). Conversely, in another study patients with Cushing's syndrome had mean PAI-1, t-PA and vWF-Ag levels insignificantly different from those found in the controls (15).…”

Section: Recent Clinical Studies Have Indicated Various Abnormalitiesmentioning

confidence: 95%

“…Increased levels of PAI-I, t-PA, vWF-Ag, II, V, VIII, IX, XIII clotting factors, and depletion of antithrombin-III have been reported (4,(11)(12)(13). In a small series of patients with the active disease Fatti et al…”

Section: Some Studies Focused On Coagulation and Fibrinolysis Parametmentioning

confidence: 96%

“…and fibrinolysis parameters which may be responsible for the increased risk of thromboembolism in patients with hypercortisolism (11)(12)(13)(14)(15). Increased levels of serum factor VIII, von Willebrand factor (vWF), plasminogen, tissue plasminogen activator (t-PA) antigen and PAI-1 activity has been observed in the patients with Cushing's syndrome as compared to healthy controls (11)(12)(13).…”

Section: Recent Clinical Studies Have Indicated Various Abnormalitiesmentioning

confidence: 99%

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Hypercoagulability in Cushing’s syndrome: the role of specific haemostatic and fibrinolytic markers

Kaštelan

Dušek

Kraljević

et al. 2009

Endocr

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Objective: Hypercoagulability is a commonly described complication in patients with Cushing's syndrome. Recent clinical studies have indicated various abnormalities of coagulation and fibrinolysis parameters which may be related to that phenomenon. The aim of this study was to investigate the mechanisms underlying the hypercoagulable state in patients with Cushing's syndrome. Research methods and procedures:A wide range of serum markers involved in the processes of blood coagulation and fibrinolysis was measured in a group of 33 patients with Cushing's syndrome and 31 healthy controls. No participant was taking medication which could influence the result or had known diseases, except hypertension and diabetes, which could affect blood coagulation or fibrinolysis parameters.

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Section: Recent Clinical Studies Have Indicated Various Abnormalitiesmentioning

confidence: 95%

Section: Some Studies Focused On Coagulation and Fibrinolysis Parametmentioning

confidence: 96%

Section: Recent Clinical Studies Have Indicated Various Abnormalitiesmentioning

confidence: 99%

See 1 more Smart Citation

Hypercoagulability in Cushing’s syndrome: the role of specific haemostatic and fibrinolytic markers

Kaštelan

Dušek

Kraljević

et al. 2009

Endocr

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“…Several small reports have reported an increased incidence of both venous and arterial thrombotic events in patients with active Cushing's syndrome (61)(62)(63)(64)(65)(66)(67)(68), underlining the existence of a prothrombotic state in this condition. To date, a number of studies have experimentally explored the effects of acute hypercortisolism on the coagulation and fibrinolytic systems (1).…”

Section: Cushing's Syndromementioning

confidence: 99%

Hemostatic abnormalities in endocrine and metabolic disorders

Franchini¹,

Lippi²,

Manzato³

et al. 2010

European Journal of Endocrinology

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The hemostatic balance is a complex system where the delicate equilibrium is regulated by several factors, including hormones. This review summarizes current knowledge of the effects of most frequent endocrine and metabolic diseases (such as hypothyroidism, hyperthyroidism, Cushing's syndrome, GH-related pituitary dysfunctions, pituitary prolactin-producing adenomas, polycystic ovary syndrome, primary hyperparathyroidism, and metabolic syndrome) on coagulation and fibrinolysis. Overt hypothyroidism appears to be associated with a bleeding tendency, whereas all other endocrine diseases appear to be associated with a thrombotic tendency. Globally, the disorders of coagulation and fibrinolysis usually range from mild to moderate, and, rarely, to severe laboratory abnormalities (for example, bleeding diathesis in overt hypothyroidism mainly due to an acquired von Willebrand's disease type 1). Further larger and high-quality studies are needed to provide more definitive information on the effects of endocrine disorders on coagulation and fibrinolysis.

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“…1). In addition to plasma VWF and factor VIII, some studies have shown higher levels of other coagulation factors such as factors IX, XI, and XII [5,6,7,8,9,10,11,12,13,14,15,16]. …”

Section: Quantitative Alterations: Increased Clotting Factors and Impmentioning

confidence: 99%

Coagulopathy in Cushing’s Syndrome

et al. 2010

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A hypercoagulable state and its consequent increased incidence of thromboembolic complications are reported in patients with Cushing’s syndrome (CS). These alterations are related to cortisol excess that induces prothrombotic changes in blood by several and complex mechanisms including increased levels of clotting factors, mainly factor VIII and von Willebrand factor (VWF) and impaired fibrinolytic capacity. However, it has recently been observed that the increase in VWF levels is not a constant feature of CS and that VWF response to glucocorticoids is genetically determined and depends on the presence of particular polymorphisms in the VWF gene promoter. The risk of venous thromboembolism is moreover enhanced in patients with CS by additional endogenous and exogenous risk factors such as obesity, bed rest, surgery and invasive diagnostic procedures like inferior petrosal sinus (IPS) sampling. In line with all these data, patients with active CS should be treated as having a prothrombotic disorder and undergo antithrombotic prophylaxis during IPS sampling. Special care should be taken in the immediate perioperative period in order to avoid thromboembolic events. In the absence of prospective randomized trials, preventive antithrombotic treatment (best with heparin) during IPS sampling and low-dose heparin treatment early after surgery should be suggested.

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Thromboembolic Complications, Heparin Treatment and Increase in Coagulation Factors in Cushing's Syndrome

Cited by 76 publications

References 24 publications

Hypercoagulability in Cushing’s syndrome: the role of specific haemostatic and fibrinolytic markers

Hypercoagulability in Cushing’s syndrome: the role of specific haemostatic and fibrinolytic markers

Hemostatic abnormalities in endocrine and metabolic disorders

Coagulopathy in Cushing’s Syndrome

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