Analysis of biological phenotypes from 42 patients with inherited factor VII deficiency: can biological tests predict the bleeding risk?
Haematologica
; 89(6): 704-9, 2004 Jun.
Article
em En
| MEDLINE
| ID: mdl-15194538
ABSTRACT
BACKGROUND AND OBJECTIVES:
Inherited factor VII (FVII) deficiency is a rare bleeding disorder characterized by a poor relationship between reported FVII clotting activity (FVIIC) and bleeding tendency. Our study was aimed at defining biological parameters that are possibly predictive for bleeding risk in this condition. DESIGN ANDMETHODS:
Forty-two FVII-deficient patients (FVIIC <30%) were classified into two opposite clinical groups defined as severe and non-or-mild bleeders. For each patient, plasma samples were collected and then investigated for FVIIC (using a sensitive method and human recombinant thromboplastin as the reagent), FVII antigen, activated FVII coagulant activity (FVIIaC) and the free-form of tissue factor pathway inhibitor.RESULTS:
None of these tests could be used as highly accurate predictors of bleeding. Nevertheless, both FVIIC and FVIIaC differed significantly between the two clinical groups. Using ROC-curve analysis, two critical values of 8% and 3mIU/mL for FVIIC and FVIIaC, respectively, could be proposed to discriminate between severe bleeders and non-or-mild bleeders. INTERPRETATION ANDCONCLUSIONS:
A highly accurate diagnostic test for predicting bleeding tendency in inherited FVII deficiency still eludes definition, highlighting the fact that factors other than FVII itself interfere with the expression of bleeding phenotypes in this condition. Nevertheless, potential critical values using sensitive FVIIC and FVIIaC methods may be useful in clinical laboratories for FVII-deficient patients. Those patients with FVIIC levels higher than 8% FVIIC or FVIIaC higher than 3 mIU/mL, with no other hemostatic defect, seem to have a minimal risk of severe bleeding. Extended clinical studies are needed to support these findings.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fator VII
/
Deficiência do Fator VII
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article