Hemostatic changes in Rocky Mountain spotted fever and Mediterranean spotted fever

M. Tarek Elghetany, David Walker

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Rocky Mountain spotted fever and Mediterranean spotted fever are rickettsial infections primarily of endothelial cells that normally have a potent anticoagulant function. As a result of endothelial cell infection and injury, the hemostatic system is perturbed and shows changes that vary widely from a minor reduction in the platelet count (frequently) to severe coagulopathies, such as deep venous thrombosis and disseminated intravascular coagulation (rarely). Changes favoring a hypercoagulable state include endothelial injury and release of procoagulant components, activation of the coagulation cascade with thrombin generation, platelet activation, increased antifibrinolytic factors, consumption of natural anticoagulants, and possibly high levels of coagulation-promoting cytokines. Yet, most studies have been performed on endothelial cell cultures that provide nonphysiologic, reductionistic, experimental conditions. The lack of flow, platelets, and WBCs makes these experiments far from simulating the response of endothelial cells in the human body. Coagulopathies and thrombotic events should be considered as potential complications of severe Rocky Mountain spotted fever and Mediterranean spotted fever.

Original languageEnglish (US)
Pages (from-to)159-168
Number of pages10
JournalAmerican Journal of Clinical Pathology
Volume112
Issue number2
StatePublished - 1999

Fingerprint

Boutonneuse Fever
Rocky Mountain Spotted Fever
Hemostatics
Endothelial Cells
Anticoagulants
Antifibrinolytic Agents
Disseminated Intravascular Coagulation
Platelet Activation
Wounds and Injuries
Infection
Platelet Count
Human Body
Thrombin
Venous Thrombosis
Blood Platelets
Cell Culture Techniques
Cytokines

Keywords

  • Coagulation
  • Endothelium
  • Platelets
  • Rickettsiae
  • Spotted fevers

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Hemostatic changes in Rocky Mountain spotted fever and Mediterranean spotted fever. / Tarek Elghetany, M.; Walker, David.

In: American Journal of Clinical Pathology, Vol. 112, No. 2, 1999, p. 159-168.

Research output: Contribution to journalArticle

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