[Activation of fibrynolysis in children with chronic B or C hepatitis].
Fibrinolysis is involved in numerous systemic processes, including inflammation and tissue remodeling. Up to date researchers focused on hemostasis problems in patients with cirrhosis. There are little data about fibrynolysis in patient with chronic viral hepatitis. The aim of the study was to evaluate selected fibrinolytic parameters in children with chronic B or C hepatitis.


METHODS
98 children aged 4 to 17 years (27F, 71M) with histopatologically confirmed chronic B or C hepatitis were included in the study. The control group consisted of 51 children median aged 12.5 years (25F, 26M) on strict gluten-free diet at least 5 years because of coeliac disease. In platelet-poor plasma obtained from all children selected fibrinolytic parameters were determined: fibrinogen level (Hemolab Fibrinomat bioMerieux S.A.), plasminogen activity (Berichrom-Plasminogen Behring), tissue plasminogen activator antigen level (t-PA) (Imulyse t-PA Biopool), plasminogen activator inhibitor 1 level (PAI-1) (Imulyse PAI-1 Biopool), plasmin-alpha2-antiplasmin complex level (PAP) (Enzygnost PAP micro) oraz D-dimer level (Vidas D-Dimer bioMérieux S.A.).


RESULTS
In children with chronic viral hepatitis statistically significant lower fibrinogen level (p<0.03) and PAI-1 level (p<0.0001) and higher t-PA level (p<0.0001) in comparison to control group were found. In children with chronic B hepatitis significant lower PAI-1 level (p<0.0001) and higher PAP level (p<0.0001) than in controls were observed. In children with chronic C hepatitis statistically significant lower PAI-1 level (p<0.0001) and fibrinogen level (p<0.005) and higher PAP level (p<0.0001) and t-PA level (p<0.03) were found. There were no differences in fibrinolytic parameters levels between children with B and C hepatitis.


CONCLUSIONS
Activation of fibrinolysis, especially plasminogenesis seems to be present in children with chronic viral hepatitis independently on type of hepatotropic virus.
Michalska
Kinga
K
Katedra i Klinika Pediatrii Alergologii i Gastroenterologii Akademii Medycznej w Bydgoszczy.
Szaflarska-Popławska
Anna
A
Dymek
Grazyna
G
Kotschy
Maria
M
D000293:Adolescent; D000933:Antifibrinolytic Agents / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products; D005340:Fibrinogen / Q000378:metabolism; D005341:Fibrinolysin / Q000378:metabolism; D005342:Fibrinolysis; D019694:Hepatitis B, Chronic / Q000378:metabolism*; D019698:Hepatitis C, Chronic / Q000378:metabolism*; D006801:Humans; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D011044:Poland; D010959:Tissue Plasminogen Activator / Q000378:metabolism; D000979:alpha-2-Antiplasmin / Q000378:metabolism
D000933:Antifibrinolytic Agents; D005338:Fibrin Fibrinogen Degradation Products; D017395:Plasminogen Activator Inhibitor 1; D000979:alpha-2-Antiplasmin; C036309:fibrin fragment D; C037742:plasmin-plasmin inhibitor complex; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator; D005341:Fibrinolysin