Acquired coagulopathy

Acquired defects of factors II, V, VII, IX and X

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Acquired defects of factors II, V, VII, IX and X arise in advanced liver diseases, [vitamin K]] deficiency/inhibition.

• Absorption disorder of vit. K: obstructive jaundice, malabsorption syndrome (pancreatic / intestinal origin),
• coumarin preparations act as inhibitors of vit. K (warfarin, see figure),
• in liver diseases, the production of f. II, VII, IX, X, V decreases gradually; u go ahead conditions complex disorder of hemostasis + in addition thrombocytopenia (with splenomegaly), increased fibrinolytic activity (portocaval anastomoses + ↓ detoxification capabilities of the liver),
• in liver diseases, hemorrhagic conditions of varying severity, threat to hl. bleeding into the GIT.

Therapy

• Lack of vit. K / overdose of coumarin → administration of vit. K (Kanavit),
• at hep. replacement disease: K-plasma, prothrombin complex concentrates, fresh frozen plasma,
• antifibrinolytics + glucocorticoids.

Links

References

• KLENER, Pavel, et al. Vnitřní lékařství. 3. edition. 2006. ISBN 80-7262-430-X.

Related articles

• Cirkulující antikoagulancia WikiSkripta. Cirkulující antikoagulancia - WikiSkripta [online]. [cit. online]. <https://www.wikiskripta.eu/w/Cirkuluj%C3%ADc%C3%AD_antikoagulancia>.

• Poruchy hemostázy WikiSkripta. Poruchy hemostázy - WikiSkripta [online]. [cit. online]. <https://www.wikiskripta.eu/w/Poruchy_hemost%C3%A1zy>.

Acquired defects of factors II, V, VII, IX and X arise in advanced liver diseases, [vitamin K]] deficiency/inhibition.

• Absorption disorder of vit. K: obstructive jaundice, malabsorption syndrome (pancreatic / intestinal origin),
• coumarin preparations act as inhibitors of vit. K (warfarin, see figure),
• in liver diseases, the production of f. II, VII, IX, X, V decreases gradually; u go ahead conditions complex disorder of hemostasis + in addition thrombocytopenia (with splenomegaly), increased fibrinolytic activity (portocaval anastomoses + ↓ detoxification capabilities of the liver),
• in liver diseases, hemorrhagic conditions of varying severity, threat to hl. bleeding into the GIT.

Therapy

• Lack of vit. K / overdose of coumarin → administration of vit. K (Kanavit),
• at hep. replacement disease: K-plasma, prothrombin complex concentrates, fresh frozen plasma,
• antifibrinolytics + glucocorticoids.

Circulating anticoagulants

Circulating anticoagulants are agents with an anticoagulant effect; they appear in the blood under pathological circumstances.

• (Allo-/auto)antibodies against coagulation factor (hl. against f. VIII);
• antiphospholipid antibodies (eg. in SLE, antiphospholipid syndrome);
• fibrin/fibrinogen cleavage products during activated fibrinolysis;
• pathologically produced substances of a heparin nature;
• paraprotein in monoclonal gammopathy;

Source

References

• KLENER, P. – ET AL.,. Vnitřní lékařství. 3. edition. 2006. ISBN 80-7262-430-X.

Related Articles

• Poruchy hemostázy WikiSkripta. Poruchy hemostázy - WikiSkripta [online]. [cit. online]. <https://www.wikiskripta.eu/w/Poruchy_hemost%C3%A1zy>.

• Warfarin WikiSkripta. Warfarin - WikiSkripta [online]. [cit. online]. <https://www.wikiskripta.eu/w/Warfarin>.

• Antikoagulancia WikiSkripta. Antikoagulancia - WikiSkripta [online]. [cit. online]. <https://www.wikiskripta.eu/w/Antikoagulancia>.