Full Text
Abstract
Summary. Background. Bleeding complaints and bleeding in children of various ages are quite common and cause anxiety for both the children themselves and their parents. It is important for specialists to understand the causes of bleeding and the possible impact of undifferentiated connective tissue dysplasia (UCTD) on bleeding manifestations, hemostasis changes and blood homocysteine levels as a factor provoking bleeding. Objective: to define the clinical and laboratory manifestations of hemostasis pathology and blood homocysteine level in children with UCTD. Patients/Methods. The study included 210 children aged 1 to 17 years with bleeding complaints. Two groups were formed: group I — 58 children with clinical manifestations of UCTD (12 or more points for external signs and 20 for visceral signs); group II (control) — 152 children without clinical signs of UCTD. Hemostasis parameters were studied: activated partial thromboplastin time (APTT), von Willebrand factor (vWF) activity, platelet aggregation with adrenaline, collagen, ADP, ristomycin, blood homocysteine level. Results. Bleeding complaints are presented by children mainly aged 7 to 17 years; boys have more bleeding complaints aged 1 to 6 years. The microcirculatory type of bleeding is most common in children. The presence of UCTD in children with increased bleeding is accompanied by hypocoagulation according to APTT, decreased platelet aggregation with adrenaline and ADP. An increase in homocysteine was noted in 46.2% in both groups with a strong direct relationship with the level of vWF activity in children with UCTD. Increased homocysteine level was observed in 46.2% cases in both groups with a strong direct relationship with the level of vWF activity in children with UCTD. Conclusions. UCTD in children with hemostasis pathology can affect the bleeding clinic, which should be taken into account in predicting the severity of hemorrhagic syndrome. Hyperhomocysteinemia as a factor influencing bleeding should be further investigated and taken into account in correcting the patient’s condition.
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