Download PDF
Thromb Haemost 1985; 54(02): 518-520
DOI: 10.1055/s-0038-1657887
Original Article
Schattauer GmbH Stuttgart

Further Studies on the Hypercoagulable State of Patients with Cushing’s Syndrome

G M Patrassi
The Institute of Medical Semeiotics, University of Padua Medical School, Padua, Italy
,
R Dal Bo Zanon
The Institute of Medical Semeiotics, University of Padua Medical School, Padua, Italy
,
M Boscaro
The Institute of Medical Semeiotics, University of Padua Medical School, Padua, Italy
,
S Martinelli
The Institute of Medical Semeiotics, University of Padua Medical School, Padua, Italy
,
A Girolami
The Institute of Medical Semeiotics, University of Padua Medical School, Padua, Italy
› Author Affiliations
Further Information

Publication History

Received 21 January 1985

Accepted 03 June 1985

Publication Date:
18 July 2018 (online)

  PDF Download  Permissions and Reprints

Summary

Factors XII, XI, IX and VIII, plasminogen and alpha2-antiplasmin levels were found to be increased in a group of patients affected by Cushing’s syndrome. High activity of these coagulation factors could be due to their increased release and synthesis mediated by cortisol. A significant correlation between the main arterial pressure and either factor VIII antigen, ristocetin cofactor or factor XII activity was found. Moreover a similar correlation between factor XII activity and either factor VIII antigen or ristocetin cofactor was seen. In conclusion, the presence of a hypercoagulable state in Cushing’s syndrome seems confirmed. Synergic release of factor XII and factor VIII from endothelium could be due to high blood vessel tone secondary to hypercorticism. Finally, decreased fibrinolytic activity was suspected according to plasminogen and alpha2-antiplasmin increase.

Keywords

Cushing’s syndrome - Hypercoagulable state - Hypertension
 

  • References

  • 1 Isacson S. Effect of Prednisone on the coagulation and fibrinolytic systems. Scand J Haematol 1970; 7: 212-216
    PubMedGoogle Scholar
  • 2 Cosgriff SW. Thromboembolic complications associated with A.C.T.H. and cortisone therapy. JAMA 1951; 147: 924-926
    CrossrefPubMedGoogle Scholar
  • 3 Chatterjea JB, Salomon L. Antagonist effect of A.C.T.H. and cortisone on the anticoagulant activity of ethyl biscoumacetate. Br Med J 1954; 2: 790-792
    CrossrefPubMedGoogle Scholar
  • 4 Ozsoylu S, Strauss HS, Diamond LK. Effects of corticosteroids on coagulation of the blood. Nature 1962; 195: 1214-1215
    CrossrefPubMedGoogle Scholar
  • 5 Pezzulich RA, Mannix H. Immediate complications of adrenal surgery. Ann Surg 1970; 172: 125-130
    PubMedGoogle Scholar
  • 6 Blichert-Toft M, Bagerskov A, Lockwood K, Hasner E. Operative treatment, surgical approach, and related complications in 195 operations upon the adrenal glands. Surg Gynecol Obstet 1972; 135: 261-266
    PubMedGoogle Scholar
  • 7 Dal Bo Zanon R, Fornasiero L, Boscaro M, Cappellato G, Fabris F, Girolami A. Increased factor VIII associated activities in Cushing’s syndrome: a probable hypercoagulable state. Thromb Haemostas 1982; 47: 116-117
    PubMedGoogle Scholar
  • 8 Sjöberg HE, Blombäck M, Granberg PO. Thromboembolic complications, heparin treatment and increase in coagulation factors in Cushing’s syndrome. Acta Med Scand 1976; 199: 95-98
    PubMedGoogle Scholar
  • 9 Chakrabarti R, Fearnley GR, Hocking ED. Effect of corticosteroid therapy on fibrinolysis in patients with inflammatory and noninflammatory conditions. Br Med J 1964; 1: 534-537
    CrossrefPubMedGoogle Scholar
  • 10 Gader AMA. The potentiating effect of cortisone (Prednisone) on the fibrinolytic and clotting factor VIII responses to intravenous infusion of adrenaline in man. Haemostasis 1982; 12: 353-356
    PubMedGoogle Scholar
  • 11 Hoyer LW. The factor VIII complex: structure and function. Blood 1981; 58: 1-13
    PubMedGoogle Scholar
  • 12 Landaburu RH, Castellanos DE. Further evidence of a humoral control of factor VIII plasma levels. Thrombos Diathes Haemorrh 1973; 30: 460-470
    PubMedGoogle Scholar
  • 13 Girolami A, Sticchi A, Barbui T, Bareggi G. Factor VIII immunological assay. An evaluation of several methods using whole plasma. Blut 1974; 29: 309-316
    CrossrefPubMedGoogle Scholar
  • 14 Hardisty RM, Macpherson JC. A one-stage factor VIII (antihaemophilic globulin) assay and its use on venous and capillary plasma. Thrombos Diathes Haemorrh 1962; 7: 215-229
    PubMedGoogle Scholar
  • 15 Macfarlane DE, Stibbe J, Kirby EP, Zucker MB, Grant RA, Macpherson J. A method for assaying von Willebrand factor (Ristocetin Cofactor). Thromb Haemostas 1975; 34: 306-308
    PubMedGoogle Scholar
  • 16 Patrassi GM, Vettor R, Padovan D, Girolami A. Contact phase of coagulation in Diabetes mellitus. Europ J Clin Invest 1982; 12: 307-311
    CrossrefPubMedGoogle Scholar
  • 17 Soria C, Soria J, Samama MM. Dosage du plasminogène à l’aide d’un substrat chromogène tripeptidique. Pathol Biol 1976; 24: 725-729
    PubMedGoogle Scholar
  • 18 Teger-Nilsson AC, Friberger P, Gyzander E. Antiplasmin determination by means of a chromogenic tripeptide substrate. In: Davidson F, Rowan RW, Samama MM, Desnoyers PC. (Eds.) New York: Raven Press; 1978: 305 313
    Google Scholar
  • 19 Boscaro M, Karbowiak I, Mantero F. Radioimmunoassay of free urinary cortisol: clinical applications. J Nucl Med Allied Sci 1977; 21: 61-62
    PubMedGoogle Scholar
  • 20 Girolami A, Cliffton EE. Hypercoagulable state induced in humans by the intravenous administration of purified ellagic acid. Thrombos Diathes Haemorrh 1967; 17: 165-175
    PubMedGoogle Scholar
  • 21 Girolami A, Scarpa R, Solimbergo B. Tromboflebiti migranti ed ipercoagulabilità ematica da probabile attivazione del sistema fattore Hageman-PTA. Cardiol Prat 1968; 19: 17-23
    PubMedGoogle Scholar
  • 22 Cliffton EE, Girolami A, Agostino D. The effect of ellagic acid on the thrombin-induced haemorrhagic syndrome in the rat. Blood 1966; 28: 253-257
    PubMedGoogle Scholar
  • 23 Huges A, McVerry BA, Wilkinson L, Goldstone AH, Lewis D, Bloom A. Diabetes, a hypercoagulable state? Haemostatic variables in newly diagnosed type 2 diabetic patients. Acta Haematol 1983; 69: 254-259
    CrossrefPubMedGoogle Scholar
  • 24 Boneu B, Durand D, Connillon F, Charlet JP, Bierme R, Sue GM. Increased level in factor VIII complex in severe arterial hypertension. Haemostasis 1978; 7: 332-338
    PubMedGoogle Scholar
  • 25 Simmons PS, Miles JM, Gerich JE, Haymond MW. Increased proteolysis. An effect of increases in plasma cortisol within the physiological range. J Clin Invest 1984; 73: 412-420
    CrossrefPubMedGoogle Scholar
  • 26 Patrassi GM, Fallo F, Martinelli S, Mantero F, Boeri G, Girolami A. The contact phase of blood coagulation and renin activation in essential hypertension before and after captopril. Eur Heart J 1984; 5: 561-567
    CrossrefPubMedGoogle Scholar