Thrombophilia and Outcome in Severe Infection and Sepsis

Jorrit-Jan Hofstra; Marcel Schouten; Marcel Levi

doi:10.1055/s-2007-985757

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2007; 33(6): 604-609
DOI: 10.1055/s-2007-985757

Thrombophilia and Outcome in Severe Infection and Sepsis

Jorrit-Jan Hofstra¹ ^, ² , Marcel Schouten¹ ^, ³ ^, ⁴ , Marcel Levi¹

¹Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
²Laboratory of Experimental Intensive Care and Anesthesiology
³Center for Infection and Immunity Amsterdam (CINIMA)
⁴Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

Abstract

ABSTRACT

Thrombophilia is associated with a prohemostatic state and consequently with an increased tendency to develop thrombosis. In severe infection and sepsis, activation of coagulation frequently occurs, which contributes to the development of multiple organ dysfunction. Hypothetically, patients with thrombophilia may suffer from more severe coagulopathy in the presence of severe infection or sepsis, which may result in a more serious clinical course and an unfavorable outcome. This article reviews experimental and clinical evidence regarding such a relationship, with a particular focus on deficiencies of natural anticoagulant proteins (protein C and antithrombin), the factor V Leiden mutation, and genetic variation in the fibrinolytic system.

KEYWORDS

Thrombophilia - sepsis - infection - coagulation - protein C - antithrombin - factor V Leiden - plasminogen activator inhibitor type 1

Full Text

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Marcel LeviM.D. Ph.D.

Department of Medicine (F-4), Academic Medical Center, University of Amsterdam

Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

Email: m.m.levi@amc.uva.nl