Platelet Functions and Coagulation Changes in Indian Children with Nephrotic Syndrome
Introduction: Only little is known on the effect of the platelet function in the paediatric nephrotic syndrome. The earlier studies which had been done on hypercoagulability have mainly featured the secondary forms of the nephrotic syndrome and the data on the minimal change type of disease is l...
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| Format: | Article |
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JCDR Research and Publications Private Limited
2013-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/3229/33-%205488_PF1(M)_E(C)_F(T)_PF1(PRP)_PFA(PR)_PF3_(PUH)_B.pdf |
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| author | Aliza Mittal Kailash Chandra Aggarwal Sumita Saluja Archana Aggarwal Binit Sureka |
| author_facet | Aliza Mittal Kailash Chandra Aggarwal Sumita Saluja Archana Aggarwal Binit Sureka |
| author_sort | Aliza Mittal |
| collection | DOAJ |
| description | Introduction: Only little is known on the effect of the platelet
function in the paediatric nephrotic syndrome. The earlier studies
which had been done on hypercoagulability have mainly featured
the secondary forms of the nephrotic syndrome and the data on
the minimal change type of disease is limited.
We therefore, made an effort to study the platelet functions and
the coagulation profile in children with the nephrotic syndrome,to
find the relationship between the steroid response and the
coagulation profile, and to look for the correlation between
thromboembolism and the hypercoagulable states.
Methodology: Twenty nine children with the steroid responsive
nephrotic syndromewere studied to see the platelet aggregation
and the coagulation parameters and their response to the steroid
therapy. Doppler studies were done for the renal vein and the
inferior vena cava (IVC) thrombus.
Results: It was seen that an increased aggregability of the
platelets occurred with Adenosine diphosphate (ADP) and
collagen (out of the four agonists, ADP, Collagen, Ristocetin and
Arachidonic acid) which were used as agonists for the assay.
We also observed that the Partial thromboplastin time (PTT) had
become prolonged and a significant decline in the high values
of the procoagulant proteins (Protein C and Protein S) was
seen after the steroid therapy and when the children went into
remission. These findings were suggestive of a reversibility of the
changes in the steroid responsive nephrotic syndrome with the
steroid therapy.
One child was found to have thrombosis of the inferior vena
cava (IVC) on Doppler studies, which resolved with treatment
subsequently.
Conclusions: An increased platelet aggregability contributes
to the hypercoagulable states, that may increase the incidence
of thrombosis in such patients. Although the incidence of such
complications is very low, in a given child with the hypercoagulable
states, Doppler may be used to look for any evidence of a latent
thrombus and, an early intervention could be instituted. A change
in the coagulation parameters points to the reversibility of the
changes which are produced in a diseased state. |
| first_indexed | 2024-12-13T15:44:36Z |
| format | Article |
| id | doaj.art-065abdcc5d7f4ce892c2f53b36c9fe60 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-13T15:44:36Z |
| publishDate | 2013-08-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-065abdcc5d7f4ce892c2f53b36c9fe602022-12-21T23:39:44ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2013-08-01781647165010.7860/JCDR/2013/5488.3229Platelet Functions and Coagulation Changes in Indian Children with Nephrotic SyndromeAliza Mittal0Kailash Chandra Aggarwal1Sumita Saluja2Archana Aggarwal3Binit Sureka4Senior Resident, Department of Paediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.Head of Department, Department of Paediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.Associate Professor, Department of Hematology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.Consultant, Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.Senior Resident, Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.Introduction: Only little is known on the effect of the platelet function in the paediatric nephrotic syndrome. The earlier studies which had been done on hypercoagulability have mainly featured the secondary forms of the nephrotic syndrome and the data on the minimal change type of disease is limited. We therefore, made an effort to study the platelet functions and the coagulation profile in children with the nephrotic syndrome,to find the relationship between the steroid response and the coagulation profile, and to look for the correlation between thromboembolism and the hypercoagulable states. Methodology: Twenty nine children with the steroid responsive nephrotic syndromewere studied to see the platelet aggregation and the coagulation parameters and their response to the steroid therapy. Doppler studies were done for the renal vein and the inferior vena cava (IVC) thrombus. Results: It was seen that an increased aggregability of the platelets occurred with Adenosine diphosphate (ADP) and collagen (out of the four agonists, ADP, Collagen, Ristocetin and Arachidonic acid) which were used as agonists for the assay. We also observed that the Partial thromboplastin time (PTT) had become prolonged and a significant decline in the high values of the procoagulant proteins (Protein C and Protein S) was seen after the steroid therapy and when the children went into remission. These findings were suggestive of a reversibility of the changes in the steroid responsive nephrotic syndrome with the steroid therapy. One child was found to have thrombosis of the inferior vena cava (IVC) on Doppler studies, which resolved with treatment subsequently. Conclusions: An increased platelet aggregability contributes to the hypercoagulable states, that may increase the incidence of thrombosis in such patients. Although the incidence of such complications is very low, in a given child with the hypercoagulable states, Doppler may be used to look for any evidence of a latent thrombus and, an early intervention could be instituted. A change in the coagulation parameters points to the reversibility of the changes which are produced in a diseased state.https://jcdr.net/articles/PDF/3229/33-%205488_PF1(M)_E(C)_F(T)_PF1(PRP)_PFA(PR)_PF3_(PUH)_B.pdfnephrotic syndromeplatelet aggregationdeep vein thrombosishypercoagulable statecoagulation profile |
| spellingShingle | Aliza Mittal Kailash Chandra Aggarwal Sumita Saluja Archana Aggarwal Binit Sureka Platelet Functions and Coagulation Changes in Indian Children with Nephrotic Syndrome Journal of Clinical and Diagnostic Research nephrotic syndrome platelet aggregation deep vein thrombosis hypercoagulable state coagulation profile |
| title | Platelet Functions and Coagulation Changes in Indian Children with Nephrotic Syndrome |
| title_full | Platelet Functions and Coagulation Changes in Indian Children with Nephrotic Syndrome |
| title_fullStr | Platelet Functions and Coagulation Changes in Indian Children with Nephrotic Syndrome |
| title_full_unstemmed | Platelet Functions and Coagulation Changes in Indian Children with Nephrotic Syndrome |
| title_short | Platelet Functions and Coagulation Changes in Indian Children with Nephrotic Syndrome |
| title_sort | platelet functions and coagulation changes in indian children with nephrotic syndrome |
| topic | nephrotic syndrome platelet aggregation deep vein thrombosis hypercoagulable state coagulation profile |
| url | https://jcdr.net/articles/PDF/3229/33-%205488_PF1(M)_E(C)_F(T)_PF1(PRP)_PFA(PR)_PF3_(PUH)_B.pdf |
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