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Hypercoagulability in Cushings patients study

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Hypercoagulability in Cushing?s syndrome: the role of specific haemostatic and fibrinolytic markers

Journal Endocrine

Publisher Humana Press Inc.

ISSN 0969-711X (Print) 1559-0100 (Online)

Category Original Article

DOI 10.1007/s12020-009-9186-y

Subject Collection Medicine

SpringerLink Date Tuesday, April 21, 2009

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Original Article

Hypercoagulability in Cushing?s syndrome: the role of specific haemostatic and fibrinolytic markers

Darko Kastelan1 , Tina Dusek1, Ivana Kraljevic1, Ozren Polasek2, Zlatko Giljevic1, Mirsala Solak3, Silva Zupancic Salek4, Jozo Jelcic1, Izet Aganovic1 and Mirko Korsic1


(1) Division of Endocrinology, Department of Internal Medicine, University Hospital Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia

(2) Department of Medical Statistics, Epidemiology and Medical Informatics, Andrija Stampar School of Public Health, Zagreb University School of Medicine, Zagreb, Croatia

(3) University Hospital for Pulmonary Diseases, Zagreb, Croatia

(4) Division of Haematology, Department of Internal Medicine, University Hospital Zagreb, Zagreb, Croatia


Received: 14 January 2009 Accepted: 26 March 2009 Published online: 21 April 2009


Abstract Objective Hypercoagulability is a commonly described complication in patients with Cushing?s syndrome. Recent clinical studies have indicated various abnormalities of coagulation and fibrinolysis parameters which may be related to that phenomenon. The aim of this study was to investigate the mechanisms underlying the hypercoagulable state in patients with Cushing?s syndrome. Research methods and procedures A wide range of serum markers involved in the processes of blood coagulation and fibrinolysis was measured in a group of 33 patients with Cushing?s syndrome and 31 healthy controls. No participant was taking medication which could influence the result or had known diseases, except hypertension and diabetes, which could affect blood coagulation or fibrinolysis parameters. Results Patients with Cushing?s syndrome had higher levels of clotting factors II (P = 0.003), V (P < 0.001), VIII (P < 0.001), IX (P < 0.001), XI (P < 0.001) and XII (P = 0.019), protein C (P < 0.001), protein S (P < 0.001), C1-inhibitor (P < 0.001) and plasminogen activator inhibitor-1 (PAI-1) (P = 0.004). The activity of fibrinolytic markers, plasminogen (P < 0.001), antithrombin (P < 0.001) and antithrombin antigen (P = 0.001) was also increased in the patient group. Conclusion The study has demonstrated hypercoagulability in patients with Cushing?s syndrome manifest as increased prothrombotic activity and compensatory activation of the fibrinolytic system. We propose the introduction of thromboprophylaxis in the preoperative and early postoperative periods, combined with a close follow-up in order to prevent possible thromboembolic events in patients with Cushing?s syndrome.

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Trish, thanks for the article, I hope everyone will get checked for this.


I do need to say that being hypercoagulable has made many doctors afraid of me. The good Dr. F did not blink an eye, bless his heart. so please be aware.



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Thank you for sharing Trish!


Yes, Teresa, many dr.'s don't want to operate on someone like "US". I'm actually surprised though but VERY happy that there aren't more people on here dx'd with it. It is a life threatening problem. Like you Teresa, my DVT came out of the blue. It doesn't hurt to get tested.



Hugs, Mar

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