Pesquisas

Veja as pesquisas, artigos e posters realizados pelo Laboratório de Hemostasia.

Quality laboratory issues in bleeding disorders

M. ADCOCK, J. MAMMEN, S. C. NAIR and S. A. DE LIMA MONTALVAO

The haemostasis laboratory plays a critical role in the care of patients with hereditary or acquired bleeding disorders. Given this pivotal function in providing patient care, it is of utmost importance that the laboratory provides high quality and accurate test results. Proper performance of internal quality control (QC) for each assay performed, and active participation in external quality assessment schemes…

A longitudinal evaluation of anti-FVIII antibodies demonstrated IgG4 subclass is mainly correlated with high-titre inhibitor in haemophilia A patients

S. A. L. MONTALVAO, A. C. TUCUNDUVA, L. H. SIQUEIRA, A. L. A. SAMBO, S. S. MEDINA and M. C. OZELO

The development of inhibitory antibodies against factor VIII (FVIII), also called inhibitors, can occur in approximately 25 a 30% of haemophilia A patients after repeated infusions of FVIII protein [1–3]. The inhibitor presence is a major complication, leading to a significant increase in the morbidity, and resulting in a negative impact in the quality of life of the…

Clinical implications of the detection of antibodies directed against domain 1 of β2-glycoprotein 1 in thrombotic antiphospholipid syndrome

Silmara Montalvão, Priscila Soares Elídio, Sabrina da Silva Saraiva, Bruna de Moraes Mazetto, Marina Pereira Colella, Erich Vinícius de Paula, Simone Appenzeller, Joyce Annichino-Bizzacchi, Fernanda Andrade Orsi, MD, PhD

Antiphospholipid syndrome (APS) is an autoimmune thrombotic disease  characterized by clinical manifestations of vascular thrombosis or pregnancy morbidity and persistent antiphospholipid antibodies (aPL) in serum, such as: lupus anticoagulant (LAC), IgM/IgG anticardiolipin (aCL) or IgG anti-β2 glycoprotein 1 (aβ2GP1)…

Diagnosis of Scott syndrome in patient with bleeding disorder of unknown cause

Mariane C. Flores-Nascimento, Fernanda L.A. Orsi, Ana P. Yokoyama, Fernanda G. Pereira, Irene Lorand-Metze, Erich V. De Paula, Vagner Castro and Joyce M. Annichino-Bizzacchi

Scott Syndrome is a rare bleeding disorder caused by a less-active phosphatidylserine transporter. Because of this, the phosphatidilserine remains sequestered in the inner leaflet of the platelets, compromising the formation of the tenase and prothrombinase complexes and impairing the thrombin generation, resulting in hemorrhagic complications [1–3]…

Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias

F. L. B. Ferreira, M. P. Colella, S. S. Medina, C. Costa-Lima, M. M. L. Fiusa, L. N. G. Costa, F. A. Orsi, J. M. Annichino-Bizzacchi, K. Y. Fertrin, M. F. P. Gilberti, M. C. Ozelo & E. V. De Paula

The differential diagnosis of thrombocytopenias includes a variety of conditions such as hematologic malignancies, bone marrow failure (BMF), hypersplenism, immune thrombocytopenia (ITP), microangiopathic hemolytic anemias and hereditary macrothrombocytopenia (HM)…

Heat treatment of samples improve the performance of the Nijmegen–Bethesda assay in hemophilia A patients undergoing immune tolerance induction

Silmara Aparecida de Lima Montalvão, Alini Camargo Tucunduva, Andrea Luísa de Almeida Sambo, Erich Vinicius De Paula, Samuel de Souza Medina, Margareth Castro Ozelo

The assessment of inhibitory antibodies against factor (F) VIII or IX is critical for hemophilia care in the clinical setting. The firstmethod for inhibitor evaluation, Bethesda assay, was described by Kasper in 1975 [1], and later Verbruggen proposed the Nijmegen modification [2]. Currently…

Home management of INR in the public health system: feasibility of self-management of oral anticoagulation and long-term performance of individual POC devices in determining INR

Sabrina da Silva Saraiva, Fernanda Andrade Orsi, Marcos Pereira Santos, Tania Machado, Silmara Montalvao, Carolina Costa-Lima, Erich Vinıcius de Paula, Marina Pereira Colella, Joyce Annichino-Bizzacchi

Point-of-care (POC) devices for prothrombin time-international normalized ratio (INR) tests may be used to the control warfarin oral anticoagulation through different strategies: central-based management, patient self-testing (PST) and patient self-management…

Impairment of thrombin generation in the early phases of the host response of sepsis

Susan K. Picoli-Quaino, BSc, Brunna E. Alves, MD, PhD, Vanessa B. Faiotto, BSc, Silmara A.L. Montalvao, BSc, Carmino A. De Souza, MD, PhD, Joyce M. Annichino-Bizzacchi, MD, PhD, Erich V. De Paula, MD, PhD

According to the current model of the interplay between hemostasis and inflammation, the early phase of the host response to sepsis is characterized by a series of procoagulant changes that, in some patients, eventually develop into the clinical and laboratory syndrome of disseminated…

Increased ADAMTS13 activity in patients with venous thromboembolism

Bruna M. Mazetto, Fernanda L. Orsi, Aline Barnabé, Érich V. De Paula, Mariane C. Flores-Nascimento, Joyce M. Annichino-Bizzacchi

Venous thromboembolism (VTE) is a result of the interaction of genetic and acquired factors [1]. However, at least 30% of VTE episodes are idiopathic. High levels of inflammatory markers and coagulation factors, such as factor VIII (FVIII) and von Willebrand factor (VWF), have been associated with…

Increased adhesive properties of neutrophils and inflammatory markers in venous thromboembolism patients with residual vein occlusion and high D-dimer levels

Kiara C.S. Zapponi, Bruna M. Mazetto, Luis F. Bittar, Aline Barnabé, Fernanda D. Santiago-Bassora, Erich V. De Paula, Fernanda A. Orsi, Carla F. Franco-Penteado, Nicola Conran, Joyce M. Annichino-Bizzacchi

Venous thromboembolism (VTE) comprises deep venous thrombosis (DVT) and pulmonary embolism (PE). VTE is a common multifactorial disease with an annual incidence of 1–3:1000 in the general population [1,2]. Its pathogenesis depends on the interaction of genetic…

Laboratory evaluation of patients with undiagnosed bleeding disorders

Graziela Silveira Araujo Alves, Fernanda Andrade Orsi, Fernanda Dutra Santiago-Bassora, Susan Kelly Picoli Quaino, Silmara Aparecida Lima Montalvao, Erich Vinicius de Paula and Joyce M. Annichino-Bizzacchi

The evaluation of patients with a bleeding tendency represents a challenge for clinicians and hematologists. At least half of the patients remain undiagnosed because they may present normal laboratory results, despite of the wide range of tests performed [1–3]. The causes of undiagnosed bleeding disorders…

Performance of a point-of-care device in determining prothrombin time in an anticoagulation clinic

Marina P. Colella, Maiara M.L. Fiusa, Fernanda L.A. Orsi, Erich V. de Paula and Joyce M. Annichino-Bizzacchi

Vitamin K antagonists (VKAs), such as warfarin, are currently the most widely used drugs for oral anticoagulation. The anticoagulant effect of VKAs has to be
monitored by the prothrombin time (PT), using as a parameter the international normalized…

Performance of a point-of-care device in determining prothrombin time in supra-therapeutic INRs

V. A. M. HASHIMOTO, E. V. DE PAULA, M. P. COLELLA, M. M. LUZ FIUSA, S. A. L. MONTALVAO, T. F. G. S. MACHADO, F. A. ORSI, J. M. ANNICHINO-BIZZACCHI

Vitamin K antagonists (VKAs), mainly represented by warfarin, remain one of the most often used class of drugs. However, due to the peculiar pharmacokinetic
and pharmacodynamic profile of these agents, laboratory monitoring of the prothrombin time…

Polymorphisms and Mutations in vWF and ADAMTS13 Genes and Their Correlation With Plasma Levels of FVIII and vWF in Patients With Deep Venous Thrombosis

Luis Fernando Bittar, Erich Vinıcius de Paula, MD, PHD, Tayana B. T. Mello, MD, PHD, Lucia H. Siqueira, Fernanda L. A. Orsi, MD, PHD, and Joyce M. Annichino-Bizzacchi, MD, PHD

Deep venous thrombosis (DVT) is a multifactorial disease, and increased levels of coagulation factor VIII (FVIII) had been demonstrated as risk factor for first1 and recurrent2,3 episodes of DVT. The main determinants of FVIII in plasma are the von Willebrand factor (vWF)…

Prevalence of the MTHFR C677T Mutation in Fertile and Infertile Women

Adriana de Góes Soligo, Ricardo Barini, Joyce Maria Annichino-Bizzacchi

The C677T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene has been investigated for the past 20 years. However, the importance of this mutation as a risk factor for the occurrence of thrombosis remains controversial…

Severe Post-thrombotic Syndrome is Associated With Higher Levels of Factor VIII

Luis Fernando Bittar, MSc, Erich V. de Paula, MD, PhD, Silmara A. L. Montalvao, MSc, Tayana B.T. Mello, MD, PhD, and Joyce M. Annichino-Bizzacchi, MD, PhD

Deep venous thrombosis (DVT) is a multifactorial disease, and increased levels of coagulation factor VIII (FVIII) have been established as a risk factor for DVT.1-4 The main determinants of FVIII in plasma are the von Willebrand factor (VWF) and the ABO blood group…

Simultaneous bleeding and thrombosis in superwarfarin poisoning

Erich Vinicius De Paula, Silmara Aparecida Lima Montalvao, Paulo Roberto Madureira, Ronan Jose Vieira, Joyce Maria Annichino-Bizzacchi, Margareth Castro Ozelo

Superwarfarin poisoning causes a severe acquired coagulation disorder that, despite its frequency, severity and specific therapeutic implications, still goes largely unrecognized by physicians. Hematologists are often called to evaluate these patients, but unawareness of…

Allergic reaction in a cohort of haemophilia A patients using plasma-derived factor VIII (FVIII) concentrate is rare and not necessarily triggered by FVIII

S. A. L. MONTALVAO, A. C. TUCUNDUVA, L. H. SIQUEIRA, A. L. A. SAMBO, S. S. MEDINA and M. C. OZELO

Allergic manifestations, including anaphylactic reaction, are well-known complications in haemophilia B, and are implicated in the higher risk of inhibitor
development [1]. Nevertheless, allergic reactions in haemophilia A (HA) were…