Sequential Changes in Factor VIII and Platelets Preceding Deep Vein Thrombosis in Patients with Spinal Cord Injury

Ennio C. Rossi*, David Green, Joel S. Rosen, Stewart M. Spies, James S.T. Jao

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

97 Scopus citations

Abstract

Summary. The relationships between factor VIII associated activities, platelet function, and venous thrombosis were studied in 18 patients with lower limb paralysis following acute spinal cord injury (SCI). Deep vein thrombosis (DVT) was detected in 13 patients (72%). Eight of the 13 thromboses were documented between 6 and 8 d following injury while the other five episodes were noted on days 11 (two), 13,18 and 22. The detection of thrombosis was preceded by marked increases in VIIIR:Ag and VIII:RCoF whereas VIII:C was only marginally increased. The platelet aggregation response to collagen was hyperactive by the sixth day while the platelet aggregate ratio (PAR) did not become abnormal until after DVT was detected. These studies suggest a chronology in the series of events leading to DVT in patients with lower limb paralysis following SCI. Initial elevations in VIIIR:Ag and VIII:R‐CoF are followed in sequence by increased platelet responsiveness to collagen, the occurrence of DVT, and the appearance of circulating platelet aggregates. Conceivably, VIIIR:Ag elaborated by endothelial cells alters platelet reactivity and provides an important determinant for venous thrombosis.

Original languageEnglish (US)
Pages (from-to)143-151
Number of pages9
JournalBritish Journal of Haematology
Volume45
Issue number1
DOIs
StatePublished - May 1980

ASJC Scopus subject areas

  • Hematology

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