Publication Date
9-15-2020
Journal
Carbohydrate Polymers
DOI
10.1016/j.carbpol.2020.116443
PMID
32536393
PMCID
PMC7337982
PubMedCentral® Posted Date
9-15-2021
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Anticoagulants, Child, Female, Hemorrhage, Heparitin Sulfate, Humans, Liver Failure, heparin-like substance, heparan sulfate, bleeding, liver failure
Abstract
Heparin-like substances (HLS) have been described in various clinical situations, including in settings of liver disease associated with infection, transplant, and metastasis. HLS are generally attributed to circulating glycosaminoglycans. Initial results for this patient showed coagulopathy due to liver disease without HLS. Two weeks after liver transplantation, a 10 year-old female with liver failure patient began to bleed from catheter insertion sites, mouth, and nares and HLS was suspected. The patient subsequently died and these clinical samples resulted in the isolation of a single heparan sulfate (HS) present at high concentrations in the plasma. Analysis of this HS showed it had an intermediate between heparin and HS with low antithrombin-mediated anticoagulant activity. We speculate that this 10-year old patient might have a platelet function defect influenced by this unusual HS. Endothelial defects not measurable by our methods might have also contributed to the observed bleeding complications.
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Cardiology Commons, Cardiovascular Diseases Commons, Digestive System Diseases Commons, Hepatology Commons, Medical Sciences Commons
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