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DOI: 10.1055/s-0038-1650390
Elevated Levels of Markers of Endothelial Cell Damage and Markers of Activated Coagulation in Patients with Systemic Necrotizing Vasculitis
Publication History
Received: 28 April 1995
Accepted after resubmission29 January 1996
Publication Date:
11 July 2018 (online)
Summary
Activation of coagulation and endothelial cell damage was studied in 47 patients with small vessel vasculitis [Wegener’s granulomatosis (WG) and microscopic polyangiitis (MP)] by measurement of throm-bin-antithrombin III complexes (TAT), fibrin-D-dimers (D-dimers), von Willebrand-factor (vWF) concentration and plasma thrombomodulin (TM) levels. There was a close correlation between disease activity (DA) in patients with WG or MP and markers of endothelial cell damage (correlation TM/DA r = 0.46 for WG and r = 0.43 for MP) and activated coagulation (correlation TAT/DA r = 0.58 for WG and r = 0.55 for MP).
Elevation of the markers of activated haemostasis and endothelial cell damage was reversed when remission was obtained by specific treatment. The markers studied were particularly helpful in cases where measurement of antineutrophil cytoplasmatic antibodies (ANCA) did fail to assess disease activity.
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References
- 1 van der Woude FJ, Rasmussen N, Lobatto S, Permin H, van der Giessen M, Wiik A, van Es L, van der Hem G. Autoantibodies against neutrophils and monocytes: tool for diagnosis and marker of disease activity in Wegener’s granulomatosis. Lancet 1985; i: 425-429
- 2 Falk R, Jennette J. Anti-neutrophil cytoplasmic autoantibodies with specificity for myeloperoxidase in patients with systemic vasculitis and idiopathic necrotizing and crescentic glomerulonephritis. New Engl J Med 1988; 318: 1651-1657
- 3 Andrassy K, Ritz E. Clinical significance of the ANCA test for diagnosis of systemic necrotizing vasculitis. Contr Nephrol 1991; 94: 22-30
- 4 Kallenberg CGM, Mulder AHL, Cohen Tervaert JW. Antineutrophil cytoplasmic antibodies: a still-growing class of autoantibodies in inflammatory disorders. Am J Med 1992; 93: 675-682
- 5 Luqmani RA, Bacon PA, Moots RJ, Janssen BA, Pall A, Emery P, Savage C, Adu D. Birmingham vasculitis activity score (BVAS) in systemic necrotizing vasculitis. Q J Med 1994; 87: 671-678
- 6 Hunder GG, Conn DL. Necrotizing vasculitis. In: Textbook of rheumatology Kelley W, Harris ED, Ruddy S, Sledge CB. eds Saunders Co; 1981: 1165-1188
- 7 Ishii H, Uchiyama H, Kazama M. Soluble thrombomodulin antigen in conditioned medium is increased by damage of endothelial cells. Thromb Haemost 1991; 65: 618-623
- 8 Leavitt RY, Fauci AS, Bloch DA, Michel BA, Hunder GG, Arend WP, Calabrese LH, Fries JF, Lie JT, Lightfoot RW, Masi AT, Me Shane DJ, Mills JA, Stevens MB, Wallace SL, Zvaifler NJ. The American college of rheumatology 1990 criteria for the classification of Wegeners granulomatosis. Arthritis Rheum 1990; 33: 1101-1107
- 9 Jennette JC, Falk RJ, Andrassy K, Bacon PA, Churg J, Gross WL, Hagen EC, Hoffmann GS, Hunder GG, Kallenberg CGM, Me Cluskey RT, Sinico RA, Rees AJ, van Es LA, Waldherr R, Wiik A. Nomenclature of systemic vasculitides: proposal of an international conference. Arthritis Rheum 1994; 37: 187-192
- 10 Savage C, Winearls C, Evans D, Rees AJ, Lockwood C. Microscopic polyarteritis: presentation, pathology and prognosis. Quart J Med 1985; 56: 467-483
- 11 Wohlwill P. Uber die nur mikroskopisch erkennbare Form der Periarteriitis nodosa. Virchows Arch 1923; 246: 377-411
- 12 Andrassy K, Erb A, Koderisch J, Waldherr R, Ritz E. Wegenes granulomatosis with renal involvement: patient survival and correlation between initial renal function, renal histology, therapy and renal outcome. Clin Nephrol 1991; 35: 139-147
- 13 Hergesell O, Andrassy K, Geberth S, Nawroth P, Gabath S. Plasma thrombomodulin levels are dependent on renal function. Thromb Res 1993; 72: 455-458
- 14 Kelton J, Powers P, Julian J, Boland V. Sex-related differences in platelet aggregation: influence of hematocrit. Blood 1980; 56: 38-41
- 15 Gross WL, Schmitt WH, Csemok E. ANCA associated diseases: immuno-diagnostic and pathogenetic aspects. Clin Exp Immunol 1993; 91: 1-12
- 16 Speiser W, Mallek R, Koppensteiner R, Stuempflen A, Kapiotis S, Minar E, Ehringer H, Lechner K. D-dimer and TAT measurement in patients with deep venous thrombosis: utility in diagnosis and judgement of anticoagulant treatment effectiveness. Thromb Haemost 1990; 64: 196-201
- 17 Gabazza EC, Osamu T, Yamakami T, Ibata H, Sato T, Sato Y, Shima T. Correlation between clotting and collagen metabolism markers in rheumatoid arthritis. Thromb Haemost 1994; 71: 199-202
- 18 Hampton KK, Chamberlain A, Menon DK, Davies JA. Coagulation and fibrinolytic activity in Behcets disease. Thromb Haemost 1991; 66: 292-294
- 19 Federici AR, Fox RI, Espinoza LR, Zimmerman TS. Elevation of von Willebrand factor is independent of erythrocyte sedimentation rate and persists after glucocorticoid treatment in giant cell arteritis. Arthritis Rheum 1984; 27: 1046-1049
- 20 Kalheh M, Osborn I, Le Roy E. Increased factor VIH/von Willebrands factor antigen and von Willebrands factor activity in scleroderma and in Raynauds phenomenon. Ann int Med 1981; 94: 482-484
- 21 Harker LA, Slichter SJ, Scott CR, Ross R. Homocystinemia: vascular injury and arterial thrombosis. N Engl J Med 1974; 291: 537-543
- 22 Takano S, Kimura S, Ohdama S, Aoki N. Plasma thrombomodulin in health and disease. Blood 1990; 76: 2024-2029
- 23 Semau T, Wilhelm C, Seyfert U, Gabath S, Henkels M, Amiral J, Bergis KH, Ziegler R, Wahl P, Nawroth PP. Thrombomodulin ist ein Marker fur mikrovaskulare, aber nicht fur makrovaskulare Endothelzellschadigung. Vasa 1995; 24: 347-353
- 24 Hamada H, Ishii H, Sakyo K, Horie S, Nishiki K, Kazama M. The epidermal growth factor-like domain of recombinant human thrombomodulin exhibits mitogenic activity for Swiss 3T3 cells. Blood 1995; 86: 225-233
- 25 Nilsson J, Elgue G, Wallin M, Hamsten A, Blomback M. Correlation between plasma levels of growth factors and von Willebrand factor. Thromb Res 1989; 54: 125-132