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Journal Article
The Coagulopathy of Chronic Liver Disease
2011
Overview
Conventional wisdom is that chronic liver disease is an acquired bleeding disorder. However, the imbalance between procoagulant and anticoagulant activities can also lead to thrombosis. Studies are needed to assess the value of anticoagulants.
Chronic liver disease, particularly in the end stage, is characterized by clinical bleeding and decreased levels of most procoagulant factors, with the notable exceptions of factor VIII and von Willebrand factor, which are elevated.
1
Decreased levels of the procoagulants are, however, accompanied by decreases in levels of such naturally occurring anticoagulants as antithrombin and protein C.
1
In physiologic conditions, the coagulation system is balanced by these two opposing drivers (Figure 1), but the mechanistic significance of the parallel decrease of both procoagulants and anticoagulants in patients with chronic liver disease escaped attention for many years. As a consequence, chronic liver . . .
Publisher
Massachusetts Medical Society
Subject
/ Biological and medical sciences
/ Blood Coagulation Disorders - diagnosis
/ Blood Coagulation Disorders - etiology
/ Hematologic and hematopoietic diseases
/ Humans
/ Liver Cirrhosis - physiopathology
/ Liver Diseases - complications
/ Liver Diseases - physiopathology
/ Platelet diseases and coagulopathies
/ Proteins
