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Revista del Nacional (Itauguá)

versão impressa ISSN 2072-8174

Resumo

VERA BAEZ, Lidia Del Pilar  e  BORDON ALVAREZ, Deisy. Laboratory diagnosis of hemorrhagic coagulopathies in patients of the National Hospital of Itauguá. Rev. Nac. (Itauguá) [online]. 2017, vol.9, n.2, pp.46-66. ISSN 2072-8174.  https://doi.org/10.18004/rdn2017.0009.02.046-066.

Introduction:

hemostasis is the set of systems that work in concert to maintain the integrity of blood vessels and blood flow; alteration can trigger thrombotic disorders or bleeding, depending on the nature of the fault

Objective:

describe hemorrhagic coagulopathy registered in the Medical Laboratory Department diagnosis at the National Hospital of Itauguá, from July 2014 to December 2015, obtain frequency and demographics, age, sex, origin and classify coagulopathy in to deficiencies of coagulation factors of the extrinsic pathway, intrinsic pathway, and common pathway; suspicion acquired inhibitors and von Willebrand's disease.

Material and Methods:

the design was an observational, descriptive, retrospective cross sectional study; being including patients of both sexes, all ages, referred by hematologists.

Results:

77 patients with hemorrhagic coagulopathies, were female 43 male and 34 female, from 1 to 75 years, median age of 18 years; 31% (24/77) with factor VII deficiency, all mild, ages 7 to 75, 1 / 500,000 appears. In the intrinsic pathway, the factor VIII deficiency or hemophilia A, was the most observed 29% (22/77) severe majority (13/22), while Factor IX deficit, Hemophilia B, in 5% of patients (4/77). 85% Hemophilia A, and 15% Hemophilia B, ages 1 to 64 years, median age of 13.5 years, all male; no FXI and FXII deficiencies were recorded in the study period.Of the final common pathway, 3 patients with hipofibrinogenemia were found, 1 probable dysfibrinogenaemia, 1 deficiency of FII, 2 FV and FX 2, 2 were adult and the rest were pediatric; these deficiencies are rare, FI, V and X of 1 / 1,000,000 and FII 1 / 2,000,000 people. Fifteen patients with suspected inhibitors adquired, two of them with anti-FVIII specific inhibitor, and probable interference inhibitors. The first von Willebrand, factor deficiency was confirmed in a woman of 47 years.

Conclusions:

among the most frequent hemorrhagic coagulation disorders, we found hemophilia A and B, followed by deficiencies of factor VII and probable interference inhibitors both cases of specific inhibitors of factor VII were found in patients with severe Hemophilia A. Some patients were diagnosed in adulthood, reflecting how late the diagnosis is sometimes reached in our country.

Palavras-chave : coagulopathy; laboratory diagnosis; deficiency of coagulation factors; extrinsic; intrinsic pathway von Willebrand disease..

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