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A Journal on Internal Medicine

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Panminerva Medica 2000 March;42(1):7-9

language: English

Evaluation of haemostatic parameters and circadian variations of the haemostatic system in patients with systemic sclerosis and Raynaud’s phenomenon

Trifiletti A., Bartolone S., Scamardi R., Pizzoleo M. A., Sottilotta G., Larosa D., Barbera N.

From the Department of Internal Medicine University of Messina, Italy


Background. Systemic scler­osis (SSc) is a mul­ti­systemic dis­ease char­ac­ter­ized by pro­life­ra­tion and ­swelling of endo­the­lial ­cells and ­other dis­or­ders. Raynaud’s phe­nom­enon (RP) is a dis­tur­bance, ­with ­unknown path­o­gen­esis, ­that may be a pre­cursor to SSc. The aim of ­this ­study was to inves­ti­gate pos­sible alter­a­tions in the haem­os­tatic ­system and to ­examine ­whether ­there is a cir­ca­dian vari­a­tion in haem­os­tatic var­i­ables at ­the initial ­stage of SSc.
Methods. In 20 ­patients ­with RP (in all ­patients sec­on­dary to SSc) and in 10 con­trols the ­levels of throm­bo­mod­ulin (TM), ­beta-thromboglobulin (β-TG), D-dimer (DD), ­tissue-­type plas­mi­nogen acti­vator (t-PA) and plas­mi­nogen acti­vator-inhib­i­thor (PAI-1) ­were meas­ured in ­venous ­plasma sam­ples ­taken at 9.00 and 14.00.
Results. Only TM ­levels ­were ­found to be ­higher in ­patients ­than in con­trols. Moreover the PAI-I ­levels, in the ­patient ­group, ­showed a sig­nif­i­cant cir­ca­dian ­rhythm (­with ­peak ­values at 9.00). No sig­nif­i­cant cir­ca­dian vari­a­tions for the ­other param­e­ters ­were ­detected.
Conclusions. These ­data ­seem to indi­cate ­that in ­patients ­with RP ­there is an endo­the­lial ­damage ­reflected by a sig­nif­i­cant ele­va­tion of the TM ­plasma ­level and a cir­ca­dian vari­a­tion in ­plasma PAI-1, ­which was ­higher in the ­morning. This obser­va­tion may be an ­area ­worth ­exploring for its impor­tance poten­tial in the knowl­edge of Raynaud’s phe­nom­enon.

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