Enhanced thrombin generation and depressed anticoagulant function in children with pneumonia
Article first published online: 25 JUN 2012
© 2012 The Author(s)/Acta Pædiatrica © 2012 Foundation Acta Pædiatrica
Volume 101, Issue 9, pages 919–923, September 2012
How to Cite
Långström, S., Peltola, V., Petäjä, J., Ruuskanen, O. and Heikinheimo, M. (2012), Enhanced thrombin generation and depressed anticoagulant function in children with pneumonia. Acta Paediatrica, 101: 919–923. doi: 10.1111/j.1651-2227.2012.02746.x
- Issue published online: 3 AUG 2012
- Article first published online: 25 JUN 2012
- Accepted manuscript online: 30 MAY 2012 10:17AM EST
- Received 5 March 2012; revised 29 April 2012; accepted 21 May 2012.
- Coagulation system;
- Protein C
Aims: To clarify the status of the coagulation system in children with community-acquired pneumonia.
Methods: Coagulation activation markers (prothrombin fragment F1 + 2, thrombin–antithrombin complexes, D-dimer), the natural anticoagulants (antithrombin, protein C and S) and tissue factor were measured in 28 consecutive children with pneumonia on admission to the hospital. Patients were divided into those with either bacterial-type pneumonia (at least two of the following three criteria: plasma C-reactive protein (CRP) >80 mg/L, white blood cell count >15 × 109/L and alveolar infiltrates on the chest radiograph) or viral-type pneumonia.
Results: The majority of the patients (79%) showed elevation of at least one of the three coagulation activation markers. Plasma CRP concentration correlated with F1 + 2 (R = 0.44, p < 0.05) and D-dimer (R = 0.71, p < 0.0001). Patients with bacterial-type pneumonia (n = 17) had higher D-dimer levels (p < 0.05) and lower levels of antithrombin (p = 0.005) and protein C (p = 0.08) than the patients with viral-type pneumonia.
Conclusions: Children with community-acquired bacterial-type pneumonia show distinctive changes in their coagulation system. The finding of coagulation system activation and depressed function of natural anticoagulants in uncomplicated pneumonia helps to understand the rapid and unpredictable changes observed in the coagulation status in patients with more severe forms of disease.