Coagulation parameters and plasma total homocysteine levels in Behcet's disease.
Behcet's disease (BD) is a multisystemic inflammatory disorder of unknown etiology that is sometimes associated with thrombosis in addition to systemic manifestations. However, the mechanism of hypercoagulability is not known. We evaluated the coagulation and fibrinolytic activities and the plasma total homocysteine levels of Korean BD patients in two cross-sectional studies. In the first study regarding coagulation and fibrinolytic activities, the levels of fibrinogen and von Willebrand factor (vWF) antigen were significantly higher in the BD patients than in the healthy controls (387.7+/-24.3 versus 240.6+/-8.8 mg/dl, p<0.001, and 131.9+/-8.8 versus 105.2+/-0.3%, p<0.01, respectively). The level of antithrombin III (AT III) was significantly lower in the BD patients (92.8+/-3.2 versus 106.3+/-2.6%, p<0.005). No differences were observed in the levels of plasminogen, protein C, or protein S activities. Activated protein C (APC) resistance was not observed in any BD patients. In the second study, the plasma total homocysteine levels of patients with a history of thrombosis (11.9+/-3.0 micromol/l) or disease activity (12.5+/-3.8 micromol/l) were found to be significantly higher than those of the controls (9.2+/-2.6 micromol/l, p<0.05, both). The plasma homocysteine concentrations in the thrombosis patients were positively correlated with plasma vWF levels; a relationship which suggests injury of the vascular endothelium (Spearman coefficient=0.857, p<0.01). Therefore, coagulation abnormality did not contribute to thrombotic complications, and higher levels of homocysteine may play a role in the hypercoagulablity of BD patients.
Lee
Yun Jong
YJ
Department of Internal Medicine, Clinical Research Institute, College of Medicine, Seoul National University, Seoul, Republic of Korea. yn35@chollian.net
Kang
Seong Wook
SW
Yang
Jong In
JI
Choi
Young-Mi
YM
Sheen
Donghyuk
D
Lee
Eun Bong
EB
Choi
Sang-Woon
SW
Song
Yeong Wook
YW
D000328:Adult; D001528:Behcet Syndrome / Q000097:blood* / Q000150:complications; D001777:Blood Coagulation; D019774:Blood Coagulation Factor Inhibitors / Q000032:analysis; D001779:Blood Coagulation Factors / Q000032:analysis; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007723:Korea; D008297:Male; D010958:Plasminogen / Q000032:analysis; D019851:Thrombophilia / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D013927:Thrombosis / Q000209:etiology
D019774:Blood Coagulation Factor Inhibitors; D001779:Blood Coagulation Factors; D006710:Homocysteine; D010958:Plasminogen