ADAMTS-13, von Willebrand factor and related parameters in severe sepsis and septic shock

Kremer Hovinga, J A; Zeerleder, S; Kessler, P; Romani de Wit, T; van Mourik, J A; Hack, C E; ten Cate, H; Reitsma, P H; Wuillemin, W A; Lämmle, B (2007). ADAMTS-13, von Willebrand factor and related parameters in severe sepsis and septic shock. Journal of thrombosis and haemostasis, 5(11), pp. 2284-90. Oxford: Blackwell 10.1111/j.1538-7836.2007.02743.x

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BACKGROUND: Insufficient control of von Willebrand factor (VWF) multimer size as a result of severely deficient ADAMTS-13 activity results in thrombotic thrombocytopenic purpura associated with microvascluar thrombosis and platelet consumption, features not seldom seen in severe sepsis and septic shock. METHODS: ADAMTS-13 activity and VWF parameters of 40 patients with severe sepsis or septic shock were compared with those of 40 healthy controls of the same age and gender and correlated with clinical findings and sepsis outcome. RESULTS: ADAMTS-13 activity was significantly lower in patients than in healthy controls [median 60% (range 27-160%) vs. 110% (range 63-200%); P < 0.001]. VWF parameters behaved reciprocally and both VWF ristocetin cofactor activity (RCo) and VWF antigen (VWF:Ag) were significantly (P < 0.001) higher in patients compared with controls. Neither ADAMTS-13 activity nor VWF parameters correlated with disease severity, organ dysfunction or outcome. However, a contribution of acute endothelial dysfunction to renal impairment in sepsis is suggested by the significantly higher VWF propeptide and soluble thrombomodulin levels in patients with increased creatinine values as well as by their strong positive correlations (creatinine and VWF propeptide r(s) = 0.484, P < 0.001; creatinine and soluble thrombomodulin r(s) = 0.596, P < 0.001). CONCLUSIONS: VWF parameters are reciprocally correlated with ADAMTS-13 activity in severe sepsis and septic shock but have no prognostic value regarding outcome.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
UniBE Contributor:	Kremer Hovinga Strebel, Johanna Anna, Lämmle, Bernhard
ISSN:	1538-7933
ISBN:	17764538
Publisher:	Blackwell
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:54
Last Modified:	02 Mar 2023 23:22
Publisher DOI:	10.1111/j.1538-7836.2007.02743.x
PubMed ID:	17764538
Web of Science ID:	000250718300017
URI:	https://boris.unibe.ch/id/eprint/22897 (FactScience: 37613)