Other acquired conditions
| Defect . | Associated conditions . | Clinical picture . | Reference . |
|---|---|---|---|
| Lupus anticoagulant hypoprothrombinemia syndrome (LA-HS) | Lupus anticoagulant associated with prolonged PT and low levels of FII (due to the accelerated clearance of the prothrombin-antiprothrombin antibody complexes) | Mild or severe bleeding; more frequent in the pediatric age | 43,44 |
| Heparin-like syndrome | Associated with multiple myeloma, mastocytosis, acute monoblastic anemia, solid tumors, HIV infection Diagnosis is based on prolonged APTT, normalized by protamine sulphate in the absence of heparin therapy | Mild or severe bleeding | 45-47 |
| Vitamin C deficiency (scurvy) | Malabsorption, alcoholism, or malnutrition, and elderly Normal coagulation test Multifactorial normocytic nonregenerative anemia with iron, vitamin B9, and B12 deficiencies associated with systemic inflammation | Diffuse superficial hematomas without vascular or coagulation disorders | 48 |
| Vitamin K | Intestinal malabsorption, fasting, alcoholism, and drugs (warfarin, high dose of vitamin E, cephalosporins, anticonvulsants) Diagnosis is suggested after an international normalized ratio ≥4 or a prolonged PT with normal platelet count and fibrinogen level | The classic form occurs between 24 hours to 7 days of life and is more often idiopathic; the late form occurs between the second week and the sixth month of life The hemorrhagic manifestations mainly involve not only GI tract and skin, but also the central nervous system in the late forms | 49 |
| DIC | Generalized activation of the hemostatic system triggered by various conditions and leading to an excessive deposition of fibrin in the microcirculation followed by the lysis by plasmin Associated with an extremely high number of clinical conditions: bacterial and viral infection, neoplasms, obstetric complication, vascular abnormalities, liver disease, pancreatitis, hypothermia | May be acute with a predominantly hemorrhagic diathesis or chronic with a predominantly microthrombotic picture | 10 |
| Liver disease | Decreased synthesis of coagulation factors, deficiency of vitamin K, dysfibrinogemias, hyperfibrinolysis due to decreased synthesis of inhibitors such as antiplasmines and thrombocytopenia | Most of the hemorrhages observed in advanced hepatopathies are caused by esophageal varices, GI tract bleeding, and surgery | 50 |
| Defect . | Associated conditions . | Clinical picture . | Reference . |
|---|---|---|---|
| Lupus anticoagulant hypoprothrombinemia syndrome (LA-HS) | Lupus anticoagulant associated with prolonged PT and low levels of FII (due to the accelerated clearance of the prothrombin-antiprothrombin antibody complexes) | Mild or severe bleeding; more frequent in the pediatric age | 43,44 |
| Heparin-like syndrome | Associated with multiple myeloma, mastocytosis, acute monoblastic anemia, solid tumors, HIV infection Diagnosis is based on prolonged APTT, normalized by protamine sulphate in the absence of heparin therapy | Mild or severe bleeding | 45-47 |
| Vitamin C deficiency (scurvy) | Malabsorption, alcoholism, or malnutrition, and elderly Normal coagulation test Multifactorial normocytic nonregenerative anemia with iron, vitamin B9, and B12 deficiencies associated with systemic inflammation | Diffuse superficial hematomas without vascular or coagulation disorders | 48 |
| Vitamin K | Intestinal malabsorption, fasting, alcoholism, and drugs (warfarin, high dose of vitamin E, cephalosporins, anticonvulsants) Diagnosis is suggested after an international normalized ratio ≥4 or a prolonged PT with normal platelet count and fibrinogen level | The classic form occurs between 24 hours to 7 days of life and is more often idiopathic; the late form occurs between the second week and the sixth month of life The hemorrhagic manifestations mainly involve not only GI tract and skin, but also the central nervous system in the late forms | 49 |
| DIC | Generalized activation of the hemostatic system triggered by various conditions and leading to an excessive deposition of fibrin in the microcirculation followed by the lysis by plasmin Associated with an extremely high number of clinical conditions: bacterial and viral infection, neoplasms, obstetric complication, vascular abnormalities, liver disease, pancreatitis, hypothermia | May be acute with a predominantly hemorrhagic diathesis or chronic with a predominantly microthrombotic picture | 10 |
| Liver disease | Decreased synthesis of coagulation factors, deficiency of vitamin K, dysfibrinogemias, hyperfibrinolysis due to decreased synthesis of inhibitors such as antiplasmines and thrombocytopenia | Most of the hemorrhages observed in advanced hepatopathies are caused by esophageal varices, GI tract bleeding, and surgery | 50 |