Influence of whole body exposure to cold on blood coagulation and fibrinolysis factors in the plasma of patients with collagen diseases.

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The plasma concentrations of Factor VIII related antigen (F VIII R: Ag), tissue plasminogen activator (tPA), thrombomodulin (TM), β-thromboglobulin (β-TG), platelet factor 4 (PF4) and fibrinopeptide A (FPA) in 35 patients with collagen diseases (17 systemic lupus erythematosus-SLE, 11 progressive systemic sclerosis-PSS, 7 rheumatoid arthritis-RA) were measured before and after the whole body exposure to cold at 4°C to compare the differences in reaction to cold, especially between those groups with and without Raynaud's phenomenon.The mean concentration of F VIII R: Ag was revealed to be higher (p<0.01) in those patients than in healthy controls even before the cold exposure and regardless of Raynaud's phenomenon, and this alteration was more prominent in PSS. The mean basal levels of TM, β-TG, and PF-4, though ranged within normal, were also higher (p<0.01) in the patients compared with controls.The mean level of F VIII R: Ag in the patients with Raynaud's phenomenon was significantly increased (p<0.05) after the cold exposure than in their counterparts, and this increment was greater in SLE.From these results, it is conceivable that patients with collagen diseases, especially those presenting with Raynaud's phenomenon, are in a subclinical thrombotic state, so a consideration of prophylactic antithrombotic therapy would be suggested for them along with conventional one.
日本臨床免疫学会の論文