Profile of Patients with Thrombosis Evaulauted in a Tertiary Care Centre
Indian Journal of Pathology and Oncology
Venous and Arterial thrombosis are common diseases with an annual incidence of 1 in 1000 per year (1). Several risk factors have been identified like increased levels of coagulation factors -factor VIII,IX,XI,II and fibrinogen which are cumulatively explored by APTT(activated partial thromboplastin time). Elevated factor VIII levels are identified as an independent risk Antiphospholipid antibody syndrome, paroxysymal nocturnal hemoglobinuria, sickle cell disease are also associated with strong
... ciated with strong tendency for thrombosis. Objectives: (A) To examine the risk factors involved in the pathogenesis of thrombosis in Indian population. (B) To investigate the significance of these risk factors in incidence of venous and arterial thrombosis. Materials: Blood samples were collected from patients presenting with clinical picture of arterial or venous thrombosis for routine tests. The following tests were done on the samples: complete blood count, sickling test, Ham's acidified serum test, Sucrose lysis test, prothrombin time, activated partial thromboplastin time, lupus anticoagulant assay (dRVVT based), Factor VIII:C assay, anti cardiolipin antibody Results: 310 cases were analysed. 124 patients(40.0%) had presented with proximal and dsital venous thrombosis, 68 patients with recurrent abortions (21.9%), 38 CASES(12.7%) ischemic heart disease and 43 cases (14.3%)with cerebrovascular disease, There were 11 cases of vasculitis (3.7%),10 cases of arterial thrombosis and 16 cases of pulmonary thromboembolism (5.3%). Increased factor VIII: c levels was the commonest risk factor identified followed by Antiphospholipid antibody (23.5%) and shortened APTT. No risk factors were identified in 50.6 % of the cases. There was one case each of sickle cell anemia and paroxysymal nocturnal hemoglobinuria who presented with pulmonary embolism and portal vein thrombosis respectively. Conclusion: The commonest risk factor identified was increased factor VIII: C levels, The presence of antiphospholipid antibodies was found to be linked with ischemic heart disease and venous and arterial thrombosis. There was also a very significant association between the presence of antiphospholipid antibodies, lupus anticoagulant and anticardiolipin antibodies with recurrent abortions. There was a correlation between the shortening of APTT and incidence of venous thromboembolism in this study. This study also showed that APTT is not an optimal screening test for detecting lupus anticoagulants.