COAGULATION DEFECTS IN CHRONIC URTICARIA · Hospital Universitari i Politècnic La Fe, Valencia....
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COAGULATION DEFECTS IN CHRONIC URTICARIA. M.A.Pérez-Gómez, R. López-Salgueiro, M. Díaz, R. Almero, A. Giner, F. España, D. Hernández Allergy Department. Hospital Universitari i Politècnic La Fe, Valencia. Patients with chronic urticaria (CU) show some alterations of the coagulation components. The role of these findings is still unknown, being the expression of a pro-inflammatory effect or representing a defect in the coagulation cascade. The thrombin generation test (TGT) is a global assay that measures the overall tendency of a plasma sample to form thrombin after the initiation of coagulation. Patients with a history of swelling showed increased levels of thrombin compared with patients without it. This finding shows an increase in the coagulation potential of patients with oedema, but the clinical relevance is still under evaluation. BACKGROUND : To perform TGT in plasma of patients actively suffering from CU and to find out if the results have a relation with the type or severity of urticaria, the presence of comorbidities or with other analytical parameters. We performed an observational, descriptive study in 22 adult patients diagnosed with CU and 8 healthy controls. All patients were informed and accepted to participate. A broad spectrum of blood tests and the autologous serum skin test (ASST) helped to classify the urticaria as autoimmune, and rule out other conditions. The severity of the disease was evaluated by the questionnaire Urticaria Severity Score (USS). Plasma was collected to analyze TG There were not any statistically significant differences between the severity index and the results of the TGT. However, we observed a tendency to a hypercoagulable pattern in patients with severe CU (10/22). Patients with a history of oedema (50%), showed a higher thrombin peak- height and an increased area under the curve. Patients with previous symptoms of oedema showed higher levels of thrombine than patients without oedema. The difference was more pronounced when compared with healthy controls. We couldn’t find any differences between TGT and other analytical or clinical parameters. OBJECTIVE : METHOD : RESULTS : CONCLUSIONS 0 500 1000 1500 2000 2500 3000 1 2 3 4 5 6 7 8 ETP PATIENTS ETP IN CONTROLS 0 500 1000 1500 2000 2500 3000 1 2 3 4 5 6 7 8 9 10 11 ETP PATIENTS ETP IN PATIENT WITH OEDEMA 0 500 1000 1500 2000 2500 3000 1 2 3 4 5 6 7 8 9 10 11 ETP PATIENTS ETP IN PATIENT WITHOUT OEDEMA 23% 32% 45% TYPE OF URTICARIA Allergy Autoimmune Idiopathic 0 50 100 150 200 250 300 350 1 2 3 4 5 6 7 8 9 10 11 PEAK PATIENTS PEAK IN PATIENT WITH OEDEMA 55% 27% 14% 4% URTICARIA SEVERITY SCORE mild moderate mod-sev severe 0 50 100 150 200 250 300 350 1 2 3 4 5 6 7 8 9 10 11 PEAK PATIENTS PEAK IN PATIENT WITHOUT OEDEMA 0 50 100 150 200 250 300 350 1 2 3 4 5 6 7 8 PEAK PATIENTS PEAK IN CONTROLS In relation to this presentation, I declare that there are no conflicts of interest CONTROLS
Transcript of COAGULATION DEFECTS IN CHRONIC URTICARIA · Hospital Universitari i Politècnic La Fe, Valencia....
COAGULATION DEFECTS IN CHRONIC URTICARIA. M.A.Pérez-Gómez, R. López-Salgueiro, M. Díaz, R. Almero, A. Giner, F. España, D. Hernández
Allergy Department. Hospital Universitari i Politècnic La Fe, Valencia.
Patients with chronic urticaria (CU) show some alterations of the coagulation components. The role of these findings is still unknown, being the
expression of a pro-inflammatory effect or representing a defect in the coagulation cascade. The thrombin generation test (TGT) is a global assay
that measures the overall tendency of a plasma sample to form thrombin after the initiation of coagulation.
Patients with a history of swelling showed increased levels of thrombin compared with patients without it. This finding shows an increase in the
coagulation potential of patients with oedema, but the clinical relevance is still under evaluation.
BACKGROUND:
To perform TGT in plasma of patients actively suffering from CU and to find out if the results have a
relation with the type or severity of urticaria, the presence of comorbidities or with other analytical
parameters.
We performed an observational, descriptive study in 22
adult patients diagnosed with CU and 8 healthy
controls. All patients were informed and accepted to
participate. A broad spectrum of blood tests and the
autologous serum skin test (ASST) helped to classify
the urticaria as autoimmune, and rule out other
conditions. The severity of the disease was evaluated
by the questionnaire Urticaria Severity Score (USS).
Plasma was collected to analyze TG
There were not any statistically significant differences between the severity index and the results
of the TGT. However, we observed a tendency to a hypercoagulable pattern in patients with
severe CU (10/22). Patients with a history of oedema (50%), showed a higher thrombin peak-
height and an increased area under the curve. Patients with previous symptoms of oedema
showed higher levels of thrombine than patients without oedema. The difference was more
pronounced when compared with healthy controls. We couldn’t find any differences between
TGT and other analytical or clinical parameters.
OBJECTIVE:
METHOD:
RESULTS:
CONCLUSIONS
0
500
1000
1500
2000
2500
3000
1 2 3 4 5 6 7 8
ETP
PATIENTS
ETP IN CONTROLS
0
500
1000
1500
2000
2500
3000
1 2 3 4 5 6 7 8 9 10 11
ETP
PATIENTS
ETP IN PATIENT WITH OEDEMA
0
500
1000
1500
2000
2500
3000
1 2 3 4 5 6 7 8 9 10 11
ETP
PATIENTS
ETP IN PATIENT WITHOUT OEDEMA
23%
32%
45%
TYPE OF URTICARIA
Allergy
Autoimmune
Idiopathic
0
50
100
150
200
250
300
350
1 2 3 4 5 6 7 8 9 10 11
PEAK
PATIENTS
PEAK IN PATIENT WITH OEDEMA
55% 27%
14% 4%
URTICARIA SEVERITY SCORE mild
moderate
mod-sev
severe
0
50
100
150
200
250
300
350
1 2 3 4 5 6 7 8 9 10 11
PEAK
PATIENTS
PEAK IN PATIENT WITHOUT OEDEMA
0
50
100
150
200
250
300
350
1 2 3 4 5 6 7 8
PEAK
PATIENTS
PEAK IN CONTROLS
In relation to this presentation, I declare that there are no conflicts of interest
CONTROLS
