Activation of coagulation system and d-dimer levels in children with acute leukemia
Journal Title: Paediatrica Indonesiana - Year 2014, Vol 54, Issue 4
Abstract
Background D-dimer is a molecule as result of breaking downof excessive fibrin formation from the activation of coagulationsystem. There is evidence of increased activation of coagulation inpatients with acute leukemia which was showed by the incrementof d-dimer levels.Objective To evaluate the incidence of activation of coagulationsys tem in children with acute leukemia before receivingchemotherapy.Method This cross-sectional study was performed at Dr. CiptoMangunkusumo Hospital. All newly-diagnosed children with acuteleukemia were included in this study, prior to their receiving anychemotherapy treatment. Blast count, prothrombin time (PTI),activated partial thromboplastin time (APTf), and D-dimer levelswere examined after the diagnosis was confirmed by morphology andimmunophenotyping studies on bone marrow specimens.Results Out of 22 subjects, 13 subjects had increased D-dimervalues. The median D-dimer level of this elevated group was 1,000(range 500-14, 700) n gfmL. In the acute myeloblastic leukemia(AML) patients, activation of coagulation was found in 7 out of 8subjects. The median D-dimer levels was 950 (range 100-14, 700)ng/mL. In the acute lymphocytic leukemia (ALL) patients, 6 outof 14 subjects had increased activation of coagulation with medianD-dimer level of 300 (range 100-3,800) ngfmL. Nine out of 10subjects with blast cells on peripheral blood smear had a medianD-dimer level of 1,000 (range 500-3,800) ng/mL. Both PT andAPTT were found normal in all subjects.Conclusion Activation of coagulation sys tem occurs at thetime of diagnosis as shown by increased D-dimer levels. Thecharacteristics of activation of coagulation system are differentbetween ALL and AML subjects, as well as between subj ects withpositive and negative blast counts on peripheral blood smears.Despite the increased activation of coagulation, PT and APTfremain normal.
Authors and Affiliations
Harun Wijaya, Novie Chozie, Badriul Hegar
Selenium and functional constipation in children
Background Constipation is a common problem in children, with approximately 90 to 95% of constipation cases having functional constipation. Oxidative stress may be a causative factor in gastrointestinal diseases, alleved...
Efficacy of sputum induction from lower respiratory tract in children
Background Although sputum is a good specimen for variousexaminations, such as cytology and microbiological culture,sputum induction (SI) is not a routine procedure in children.Objective To identify the efficacy of SI to...
Evidence based case report: Pyridoxine supplementation in children with pervasive developmental disorders
Pervasive developmental disorders (PDD)is defined as a neurodevelopmental disorder,c haract erized by social withdrawal,communication deficits, and repetitivebehaviors. PDD include autistic disorder, Rett'ssyndrome, chil...
Relationship between serum cystatin-C and urinary neutrophil gelatinase-associated lipocalin in septic children
Background Sepsis may lead to acute kidney injury (AKI)in patients treated in pediatric intensive care units (PICU).Currently, serum creatinine is used as a biomarker for thediagnosis of AKI. However, it is not a sensiti...
Early allergy symptoms in infants aged 0-6 months on breast milk substitutes
Background Atopic diseases are common in children and a serious health problem worldwide. Atopic dermatitis, food allergies, asthma and allergic rhinitis, have been described as the natural progression of allergic diseas...