E. Andre et al., HEMORHEOLOGICAL AND HEMOSTATIC PARAMETERS IN CHILDREN WITH NEPHROTIC SYNDROME UNDERGOING STEROID-THERAPY, Nephron, 68(2), 1994, pp. 184-191
Disturbances in hemostatic and hemorheological parameters have been in
vestigated in a group of 29 children with nephrotic syndrome: 23 child
ren classified as steroid-sensitive and 6 as steroid-resistant, Studie
s were performed before prednisone treatment and 3 weeks later, after
initiation of steroid therapy. Before treatment, the alterations in he
mostatic system involved moderate thrombocytosis with spontaneous aggr
egation in 19 patients. High levels of fibrinogen, factor VIII, Willeb
rand factor, protein C, protein S and alpha(2)-macroglobulin (alpha(2)
M) were observed. Factor XII and alpha(1)-antitrypsin (alpha(1)AT) wer
e lower than normal. Antithrombin III (ATIII) level was normal in the
majority of patients. A plasma and blood hyper-viscosity syndrome was
also observed as well as an increase in erythrocyte aggregation. Durin
g treatment, an improvement in the hemostatic parameters was observed
in the patients who responded to prednisone. The expected increase in
factor VIII (frequently described in the literature) was not observed,
while there was a significant increase in protein C. In the steroid-r
esistant patients, the only significant changes observed were decrease
d fibrinogen and increased protein C. The hemorheological parameters s
howed a tendency Hemorheology towards normality regardless of whether
or not the treatment provided remission Blood viscosity of NS. The rel
ationship between hemorheological and hemostatic factors Corticosteroi
ds changes are discussed.