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1.
PLoS Negl Trop Dis ; 8(10): e3214, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25299654

RESUMEN

BACKGROUND: During a dengue outbreak on the Caribbean island Aruba, highly elevated levels of ferritin were detected in dengue virus infected patients. Ferritin is an acute-phase reactant and hyperferritinaemia is a hallmark of diseases caused by extensive immune activation, such as haemophagocytic lymphohistiocytosis. The aim of this study was to investigate whether hyperferritinaemia in dengue patients was associated with clinical markers of extensive immune activation and coagulation disturbances. METHODOLOGY/PRINCIPAL FINDINGS: Levels of ferritin, standard laboratory markers, sIL-2R, IL-18 and coagulation and fibrinolytic markers were determined in samples from patients with uncomplicated dengue in Aruba. Levels of ferritin were significantly increased in dengue patients compared to patients with other febrile illnesses. Moreover, levels of ferritin associated significantly with the occurrence of viraemia. Hyperferritinaemia was also significantly associated with thrombocytopenia, elevated liver enzymes and coagulation disturbances. The results were validated in a cohort of dengue virus infected patients in Brazil. In this cohort levels of ferritin and cytokine profiles were determined. Increased levels of ferritin in dengue virus infected patients in Brazil were associated with disease severity and a pro-inflammatory cytokine profile. CONCLUSIONS/SIGNIFICANCE: Altogether, we provide evidence that ferritin can be used as a clinical marker to discriminate between dengue and other febrile illnesses. The occurrence of hyperferritinaemia in dengue virus infected patients is indicative for highly active disease resulting in immune activation and coagulation disturbances. Therefore, we recommend that patients with hyperferritinaemia are monitored carefully.


Asunto(s)
Trastornos de la Coagulación Sanguínea/inmunología , Citocinas/sangre , Dengue/sangre , Dengue/inmunología , Ferritinas/sangre , Adulto , Biomarcadores/sangre , Trastornos de la Coagulación Sanguínea/complicaciones , Brasil , Estudios de Cohortes , Dengue/complicaciones , Virus del Dengue/inmunología , Brotes de Enfermedades , Femenino , Humanos , Interleucina-18/sangre , Masculino , Persona de Mediana Edad , Países Bajos
2.
Thromb Res ; 130(3): 355-60, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22542366

RESUMEN

INTRODUCTION: The puerperium is the period of highest risk for thrombosis during a woman's reproductive life and it is an important time for initiating an effective contraceptive method in order to increase intergestational interval. Thus, the objective of the present study was to evaluated the effects of the etonogestrel (ENG)-releasing contraceptive implant inserted immediately postpartum on maternal hemostasis markers during the first six weeks of delivery. MATERIALS AND METHODS: Forty healthy women aged 18 to 35 years-old were randomized to receive either the ENG-releasing implant 24-48 h after delivery (implant group; n=20) or nothing (control group) until the sixth postpartum week. Blood samples were collected at 24-48 h and at 6 weeks after delivery, and hemostatic variables, including fibrinogen, coagulation factors, protein C, free protein S, antithrombin, α2-antiplasmin, plasminogen activator inhibitor 1, thrombin-antithrombin complex (TAT), prothrombin fragment (PF)1+2, and D-dimers, as well as normalized activated protein C sensitivity ratio (nAPCsr), thrombin time, activated partial thromboplastin time, and prothrombin time were evaluated. RESULTS: Insertion of the ENG-releasing contraceptive implant did not change the physiological reduction in overall coagulation (TAT and PF1+2) and fibrinolysis (D-dimer) markers, or nAPCsr. Reductions in factors II, VII, X and fibrinogen and increases in factor V were greater in the control than in the implant group. Clotting factors remained within normal limits throughout the study. CONCLUSION: The ENG-releasing contraceptive implant inserted immediately postpartum did not have negative effects on physiological variations of the hemostatic system during the first 6 weeks postpartum.


Asunto(s)
Coagulación Sanguínea/efectos de los fármacos , Desogestrel/administración & dosificación , Desogestrel/efectos adversos , Trastornos Puerperales/sangre , Trastornos Puerperales/prevención & control , Trombosis/sangre , Trombosis/prevención & control , Adolescente , Anticonceptivos Femeninos/administración & dosificación , Anticonceptivos Femeninos/efectos adversos , Preparaciones de Acción Retardada/administración & dosificación , Preparaciones de Acción Retardada/efectos adversos , Implantes de Medicamentos , Femenino , Hemostasis/efectos de los fármacos , Humanos , Periodo Posparto/sangre , Periodo Posparto/efectos de los fármacos , Trastornos Puerperales/diagnóstico , Trombosis/inducido químicamente , Resultado del Tratamiento , Adulto Joven
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