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Hamostaseologie 2011; 31(S 01): S64-S68
DOI: 10.1055/s-0037-1619753
Original article
Schattauer GmbH

Patients with isolated prolonged in vitro bleeding time

Clinical symptomsKlinische Symptomatik von Patienten mit isoliert verlängerter In-vitro-Blutungszeit
S. Alesci
1   Haemophilia Center, Goethe University Hospital, Frankfurt, Germany
,
M. Stein
1   Haemophilia Center, Goethe University Hospital, Frankfurt, Germany
,
K. Scholz
1   Haemophilia Center, Goethe University Hospital, Frankfurt, Germany
,
B. Llugaliu
1   Haemophilia Center, Goethe University Hospital, Frankfurt, Germany
,
G. Asmelash
1   Haemophilia Center, Goethe University Hospital, Frankfurt, Germany
,
W. Miesbach
1   Haemophilia Center, Goethe University Hospital, Frankfurt, Germany
› Author Affiliations
Further Information

Publication History

received: 15 March 2011

accepted: 13 May 2011

Publication Date:
28 December 2017 (online)

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Summary

In patients with isolated prolonged in vitro bleeding time there is no standardised treatment concept. With this study we characterized the extent of bleeding symptoms.

Patients, methods All diagnoses known to cause prolonged in vitro bleeding time (PFA-100) (epinephrine-cartridge >160 s, ADP-cartridge > 120 s) have been excluded, such as platelet function disorders, effects of medications, nutrition or von Willebrand disease. 75 patients (77%, n = 58 women; 23%, n = 17 men, median age 46 (16–81) years were included. All bleeding symptoms have been stored in a databank with help of a comprehensive questionnaire.

Results 78% (n = 54) of all patients reported of having had an operation, 69.8% (n = 37) of them described postoperative bleedings (p = 0.0373). 13.5% (n = 5) of the 54 could remember having been randomly treated by the administration of a transfusion and only 2.7% (n = 1) were treated by substitution of von Willebrand factor. 71% (n = 51) patients indicated haematoma (p = 0.8116). About 33.8% (n = 24) patients had gum bleeding and 40.8% (n = 29, p = 0.7808) patients reported bleeding after the dentist. 41.4% (n = 29) patients suffered under frequent epistaxis (p = 0.0212). There was no correlation between prolonged epinephrine bleeding time to VWF : Ag (rho = 0.16) nor to VWF : RCo (rho = 0.12) nor between prolonged epinephrine and ADP bleeding time (rho = 0.01) nor to ROTEM® analysis.

Conclusion Patients with isolated prolonged PFA are mainly women and can be affected by all kinds of bleedings while haematoma is the main symptom. VWD might not be causal

Zusammenfassung

Für Patienten mit isoliert verlängerter In-vitro- Blutungszeit existiert bisher kein einheitliches Behandlungskonzept, da die Ätiologie unklar ist. Die Patienten berichten über Blutungssymptome, die wir mit dieser Studie unter Anwendung eines Fragebogens evaluieren wollen.

Patienten, Methoden Patienten mit bekannten Ursachen einer isoliert verlängerten In-vitro-Blutungszeit (PFA 100) (Epinephrin-cartridge >160 s, ADP-cartridge > 120 s) wie Thrombozytenfunktionsstörungen, Medikamenten- und Nahrungsmitteleffekt oder mit einem von-Willebrand-Syndrom wurden ausgeschlossen. 75 Patienten (77%, n = 58 Frauen; 23%, n = 17 Männer), mittleres Alter 46 (16–81) Jahre konnten eingeschlossen und in einer Datenbank gespeichert werden.

Ergebnisse 78% (n = 54) der Patienten wurden operiert, davon beschrieben 69,8% (n = 37) postoperative Blutungen (p = 0,0373). 13,5% (n = 5) der 54 Patienten konnten sich erinnern, eine Transfusion bekommen zu haben, nur ein Patient (2,7%) wurde mit einem von-Willebrand-Faktor- Präparat behandelt. 71% (n = 51) Patienten berichteten über eine Hämatomneigung (p = 0,8116). 33,8% (n = 24) der Patienten hatten Zahnfleischbluten und 40,8% (n = 29, p = 0,7808) berichteten über Blutungen nach Zahneingriffen. 41,4% (n = 29) Patienten litten unter häufiger Epistaxis (p = 0,0212). Es bestand weder eine Korrelation zwischen der verlängerten Epinephrin-Blutungszeit und dem VWF : Ag (rho = 0,16) noch zu VWF : RCo (rho = 0,12) und ebenfalls nicht zwischen der Epinephrin and ADP-Blutungszeit (rho = 0,01) oder zu ROTEM®-Daten.

Schlussfolgerung Patienten, häufig Frauen, mit isoliert ver längerter In-vitro-Blutungszeit sind von mehreren Blutungstypen betroffen. Hauptsymptom scheint Hämatomneigung zu sein und ein VWS ist nicht ursächlich.

Schlüsselwörter

Verlängerte In-vitro-Blutungszeit - Thrombelastographie - Blutungssymptome

Keywords

Prolonged in vitro bleeding time - thrombelasto graphy - bleedings
 

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