title: [Hemostasis alterations in sickle cell syndrome].
abstract: Sickle cell syndrome (SCS) includes a group of congenital hemolytic anemias associated to the presence of hemoglobin S, which is characterized by acute pain episodes and progressive damage of different organs. Some patients with sickle cell syndrome have shown, when compared with healthy individuals, an increased risk of presenting stroke, pulmonary hypertension, avascular necrosis of joints, acute chest syndrome and pregnancy complications, associated to a hypercoagulable state induced by alterations in different components of hemostasis, such as changes that include activation of the endothelium, platelet activity, coagulation and fibrinolytic systems. This paper compiles hemostasis disorders, associated with thrombotic manifestations, reported until now in sickle cell syndrom. These patients have an increase in activation markers of the coagulation system, such as prothrombin fragment 1.2, thrombin-antithrombin complex, etc., depletion of natural anticoagulant proteins, abnormal activation of the fibrinolytic system and increased tissue factor expression. Similarly, abnormal expression of glycoproteins and increased adhesion and platelet aggregation have been reported. All these alterations produce a hypercoagulable state, which induces, among other things, the appearance of thrombotic complications. In view of the importance of controlling the different complications that can occur in patients with sickle cell syndrome, we recommend the implementation, in diagnosis and monitoring studies, of the evaluation of the different components of the hemostatic system, identifying alterations at an early stage and applying effective treatments to prevent thrombotic complications.
authors: Diego
authors: D
authors: Higuera
authors: Martha
authors: M
authors: Bravo
authors: Belsy
authors: B
authors: Guerrero
mesh_terms: D051722:ADAM Proteins / Q000097:blood; D000071120:ADAMTS13 Protein; D000755:Anemia, Sickle Cell / Q000097:blood*; D001798:Blood Proteins / Q000032:analysis; D015815:Cell Adhesion Molecules / Q000097:blood; D055252:Cell-Derived Microparticles; D004913:Erythrocytes, Abnormal; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005341:Fibrinolysin / Q000032:analysis; D005342:Fibrinolysis; D006487:Hemostasis; D006801:Humans; D007378:Interleukins / Q000097:blood; D010446:Peptide Fragments / Q000032:analysis; D015539:Platelet Activation; D011516:Prothrombin / Q000032:analysis; D012306:Risk; D013923:Thromboembolism / Q000209:etiology; D019851:Thrombophilia / Q000209:etiology*; D000979:alpha-2-Antiplasmin / Q000032:analysis; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D001798:Blood Proteins; D015815:Cell Adhesion Molecules; D005338:Fibrin Fibrinogen Degradation Products; D007378:Interleukins; D010446:Peptide Fragments; D000979:alpha-2-Antiplasmin; C036309:fibrin fragment D; C037742:plasmin-plasmin inhibitor complex; C045879:prothrombin fragment 1.2; D014841:von Willebrand Factor; D011516:Prothrombin; D005341:Fibrinolysin; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human