Dynamic evaluation of hemostasis in the acute phase of Kawasaki disease using comprehensive coagulation functional assays.

• Material Type: 博士論文
• Title: Dynamic evaluation of hemostasis in the acute phase of Kawasaki disease using comprehensive coagulation functional assays.
• Author/Editor: Yoshizawa, Hiroyuki; Nogami, Keiji; Matsumoto, Tomoko; Tsujii, Nobuyuki; Sakai, Toshiyuki; Takase, Toshio; Tanaka, Ichiro; Shima, Midori
• Author Heading: Yoshizawa, Hiroyuki; Nogami, Keiji; Matsumoto, Tomoko; Tsujii, Nobuyuki; Sakai, Toshiyuki; Takase, Toshio; Tanaka, Ichiro; Shima, Midori
• Publication, Distribution, etc.: Elsevier
• Publication Date: 2019-02
• Publication Date (W3CDTF): 2019-02
• Alternative Title: 包括的凝固機能検査による急性期川崎病における止血動態の評価
• Periodical title: Thrombosis research
• No. or year of volume/issue: 174
• Volume: 174
• Pages: 76-83
• ISSN (Periodical Title): ISSN : 0049-3848
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2019-12-05
• Dissertation Number: 乙第1441号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Kawasaki disease; Clot waveform analysis; Thrombin generation; Plasmin generation; Intravenous immunoglobulin therapy
• Target Audience: 一般
• Note (General): type:Thesis; Introduction: Kawasaki disease (KD) is a systemic vasculitis involving coronary arteries, sometimes resulting in aneurysms and myocardial infarction. Hyper-coagulability in the acute-phase of KD is indicated in some circumstances based on changes of individual clotting factors. Comprehensive coagulation assays, clot waveform analysis (CWA) and thrombin/plasmin generation assay (T/P-GA), have been developed to assess physiological hemostasis, but these techniques have not been applied in KD. Methods: We utilized both assays to analyze coagulation function in KD children (n = 42) prior to intravenous-immunoglobulin (IVIG) treatment (Pre), 1-week (1W) and 1-month (1M) post-IVIG. Results: In CWA, the clot time (CT) pre-treatment was prolonged, and was significantly shortened at 1W and 1M. However, the maximum coagulation velocity (|min1|) and acceleration (|min2|) were ~2-fold greater relative to controls, indicating an overall hypercoagulable tendency. These parameters were related to fibrinogen concentration, and were decreased at 1W and declined to normal at 1M. In T/P-GA, the endogenous potentials of thrombin and plasmin were greater relative to control at each of three time-points, and measurements at 1W were greater than those Pre-treatment. The ratios of TG and PG relative to control were similar, however, suggesting well-balanced dynamic coagulation and fibrinolysis. In non-responders to IVIG, the |min1| and |min2| measurements were greater than those in responders at 1W and 1M, suggesting that non-responders remained hypercoagulable after primary treatment. Conclusion: The coagulation data observed in KD were consistent with hypercoagulability, although fibrinolytic function appeared to be well-balanced. Comprehensive assays of this nature could provide valuable information on coagulation potential in KD.; 博士（医学）・乙第1441号・令和元年12月5日; Copyright © 2018 Elsevier Ltd. All rights reserved.; identifier:Thrombosis research Vol.174 p.76-83 (2019 Feb); identifier:00493848; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3697; identifier:Thrombosis research, 174: 76-83
• Source: fulltext; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3697/1/01%e4%b9%991441%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3697/2/02%e4%b9%991441%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3697/3/03%e4%b9%991441%e6%9c%ac%e6%96%87.pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1016/j.thromres.2018.12.016
• Periodical Title (NCID): AA00863148; https://ci.nii.ac.jp/ncid/AA00863148
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU