Acquired coagulopathies

Acquired defects of factors II, V, VII, IX and X.
Acquired defects of factors II, V, VII, IX and X arise in advanced liver diseases, vitamin K deficiency / inhibition.

• Vitamin K absorption disorder: obstructive jaundice, malabsorption syndrome (pancreatic / intestinal origin),

• coumarin preparations act as vitamin K inhibitors (warfarin, see fig.),

• in liver diseases, the production of f. II, VII, IX, X, V gradually decreases; in progress. conditions complex hemostasis disorder + thrombocytopenia (in splenomegaly), increased fibrinolytic activity (portocaval anastomoses + ↓ liver detoxification ability),

• in liver diseases, bleeding conditions of various severity, endangerment of the capital. bleeding into the GIT.

Therapy

• Lack of vit. K / coumarin overdose → supplementation of vit. K (Kanavit),

• in liver diseases – substitution therapy.: K-plasma, prothrombin complex concentrates, fresh frozen plasma,

• antifibrinolytics + glucocorticoids.

Circulating anticoagulants
Circulating anticoagulants are agents with an anticoagulant effect; they appear in the blood under pathological circumstances.

• (Allo- / auto) antibodies against coagulation factor (mainly against VIII);

• antiphospholipid antibodies (eg. in SLE, antiphospholipid syndrome);

• fibrin / fibrinogen cleavage products during activated fibrinolysis;

• pathologically generated substances of heparin nature;

• paraprotein in monoclonal gammopathy;

Související články

 * Poruchy hemostázy
 * Warfarin
 * Antikoagulancia