Renata Swiatkowska-Stodulska

Publications of Renata Swiatkowska-Stodulska

• Adrenal myelolipomas composed with adrenal nodular hyperplasia in the same gland.

  Authors: Anna Babinska, Adam Nałecz, Renata Swiatkowska-Stodulska, Krzysztof Sworczak

  Polish journal of pathology : official journal of the Polish Society of Pathologists. 01/2012; 63(1):45-8.

  Adrenal myelolipoma is a benign neoplasm composed of an admixture of hemopoietic elements and mature adipose tissue. The incidence of adrenal myelolipoma is reported as between 4% and 5% of adrenalAdrenal myelolipoma is a benign neoplasm composed of an admixture of hemopoietic elements and mature adipose tissue. The incidence of adrenal myelolipoma is reported as between 4% and 5% of adrenal incidentaloma. The association of an adrenal myelolipoma and adrenal nodular hyperplasia or adrenal adenoma is rare. Four cases of adrenal myelolipomas in the material of 702 incidentally discovered adrenal lesions treated in our center are presented in this paper (in a group of 294 operated patients). Two myelolipomas have been reported as isolated adrenal masses and two - in association with adrenocortical nodular hyperplasia.

• The estimation of selected endogenous anticoagulation system parameters in patients with subclinical Cushing's syndrome.

  Authors: Renata Swiatkowska-Stodulska, Sonia Kaniuka-Jakubowska, Piotr Wisniewski, Anna Skibowska-Bielinska, Krzysztof Sworczak

  European journal of endocrinology / European Federation of Endocrine Societies. 09/2011; 165(6):865-71.

  An increased tendency towards thromboembolic events is observed in patients with Cushing's syndrome. There are much fewer publications available about thromboembolic complications in patients withAn increased tendency towards thromboembolic events is observed in patients with Cushing's syndrome. There are much fewer publications available about thromboembolic complications in patients with subclinical Cushing's syndrome (SCS). Therefore, a question arises whether hemostatic disturbances appear in this particular disease phase. Estimation of protein C (PC), free protein S (FPS), antithrombin (AT) activity, thrombomodulin (TM) concentration and activated PC resistance (APCR) in patients with SCS. We studied 35 patients with SCS. The control group consisted of 33 healthy volunteers. The activity of PC, AT, FPS, APCR and the concentration of TM was estimated in all representatives. The comparison of the examined coagulation parameters between the patients with SCS and the healthy individuals revealed significantly higher mean PC activity and mean FPS activity in the SCS group. Mean TM concentration was significantly lower in patients with SCS compared with the control group. The differences in APCR and AT activity were not significant. We did not prove any statistically significant correlations between the examined coagulation parameters and hormonal parameters. We did not find any correlation between the concentration of cortisol and basic coagulation parameters such as international normalized ratio, activated partial thromboplastin time or fibrinogen in the group with SCS either. The patients with SCS present disturbances in endogenous anticoagulation system defined as PC, FPS activity and TM concentration. This finding suggests an impact of mild autonomic cortisol overproduction on coagulation system.

• [Clear cell carcinoma of the kidney and Conn's syndrome in a patient with arterial hypertension--a case report].

  Authors: Renata Swiatkowska-Stodulska, Ewa Swierblewska, Joanna Zielonko, Krzysztof Sworczak

  Wiadomości lekarskie (Warsaw, Poland : 1960). 01/2011; 64(2):104-8.

  Recognition of secondary arterial hypertension is one of the main purposes of diagnosis in patients with arterial hypertension. Secondary hyperaldosteronism is one of the most frequentRecognition of secondary arterial hypertension is one of the main purposes of diagnosis in patients with arterial hypertension. Secondary hyperaldosteronism is one of the most frequent endocrinological causes of arterial hypertension. Because of the increased risk of cardiovascular diseases in these patients, the early diagnosis and proper treatment of primary hyperaldosteronism play a crucial role. The aim of the study was presentation of a patient with secondary arterial hypertension. During the diagnosis of the hypertension cause, a renal tumor was found and then primary hyperaldosteronism due to aldosterone producing adrenal adenoma. The presented case proves the necessity of a thorough diagnosis of etiology of arterial hypertension, as it exists a possibility of coexistence of two independent causes, what can delay the diagnosis and make it more complicated.

• [Hypercortisolism and hemostasis]

  Authors: Renata Swiatkowska-Stodulska, Anna Babińska, Krzysztof Sworczak

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 03/2009; 26(152):142-4.

  Endocrinopathies can cause various changes in coagulation and fibrinolytic mechanisms. Glucocorticoids show particulary important influence on hemostasis. Increased tendency to thromboembolicEndocrinopathies can cause various changes in coagulation and fibrinolytic mechanisms. Glucocorticoids show particulary important influence on hemostasis. Increased tendency to thromboembolic incidents is observed in either endogenous hypercortisolism or glucocorticoids administration. The aim of this paper was to present the hemostatic disturbances in patients with hypercortisolism, with particular emphasis in their development on metabolic changes, endothelium damage, influence of pro-inflammatory cytokines and hiperhomocysteinemia. The problem of anticoagulant prophylaxis in this group of patients is also discussed.

• Assessment of alpha1-antitrypsin and alpha2-macroglobulin levels in obese patients.

  Authors: Renata Swiatkowska-Stodulska, Anna Babińska, Anna Skibowska-Bielińska, Krzysztof Sworczak

  01/2009; 118(12):713-8.

  INTRODUCTION: Epidemiologic data show a higher frequency of thromboembolic incidents in obese individuals compared with normal weight subjects. Pro-inflammatory factors seem to play an important roleINTRODUCTION: Epidemiologic data show a higher frequency of thromboembolic incidents in obese individuals compared with normal weight subjects. Pro-inflammatory factors seem to play an important role in their development. It has not been fully explained so far how alpha1-antitrypsin (alpha1ATp) and alpha2-macroglobulin (alpha2MG) act in obese subjects. Both proteins participate directly and indirectly in regulation of inflammation, coagulation and fibrinolysis. Thus alterations in serum levels of these protease inhibitors may play an important role in the development of vascular incidents in obesity. OBJECTIVES: To assess serum alpha1ATp and alpha2MG levels in obese patients. PATIENTS AND METHODS: The study involved 16 subjects with obesity and metabolic syndrome and 14 obese subjects with no disturbances of glucose and lipid profile or arterial hypertension. 20 healthy volunteers served as the control group. Levels of alpha1ATp and alpha2MG were determined in all subjects using immunonephelometry. RESULTS: No significant differences in alpha1ATp and alpha2MG levels between the patients and the control group were observed. Comparison of the tested parameters in the obese with metabolic syndrome and those without metabolic disturbances showed higher values of alpha1ATp levels in the former group. In this group positive correlations between alpha1ATp levels and fasting insulin levels were found. CONCLUSIONS: Metabolic disturbances in obesity are associated with an elevated level of alpha1ATp, which might confirm its important role in the development of vascular incidents in obese patients. An increased risk of vascular pathological lesions in obesity is probably not associated with alpha2MG levels.

• Myocardial infarction in a 30-year-old patient with pheochromocytoma and type 1 neurofibromatosis.

  Authors: Anna Babińska, Alicja Gnacińska, Renata Swiatkowska-Stodulska, Krzysztof Sworczak

  Polskie archiwum medycyny wewnȩtrznej. 10/2008; 118(9):517-23.

  Chromaffinoma of the adrenal medulla (pheochromocytoma--PHEO) is a rare cause of arterial hypertension which is diagnosed incidentally or run in a family as a component of disease syndromes of theChromaffinoma of the adrenal medulla (pheochromocytoma--PHEO) is a rare cause of arterial hypertension which is diagnosed incidentally or run in a family as a component of disease syndromes of the genetic origin. PHEO is diagnosed in about 5-10% of patients with type 1 neurofibromatosis (NF1). In a patient group with diagnosed arterial hypertension and NF1, PHEO is diagnosed with a much higher frequency, i.e. 20-56%. Myocardial injury in a patient without coronary risk factors is very rare. Increased circulating levels of catecholamines in patients with chromaffinoma may cause damage to myocardium without any atherosclerotic lesions in the coronary arteries. A correct diagnosis of PHEO allows the right treatment to be administered. The present paper discusses the case of a patient with NF1 and periodic arterial hypertension in the course of unidentified chromaffinoma, which was complicated with myocardial infarction. The evaluation of the secondary arterial hypertension led to the detection of the adrenal tumor. Based on the clinical presentation and the tumor characteristics, on computed tomography, PHEO was suspected. The level of methoxycatecholamines in a 24-hour urine sample significantly exceeded the reference values. The patient underwent laparoscopic, right-sided adrenalectomy, and the histopathological examination definitely concurred with the diagnosis of PHEO. During the post-surgical period, the arterial hypertension normalized without the administration of hypotensive drugs. The patient is still cared for by the clinic. The diagnosis toward PHEO is recommended if the patient with NF1 shows arterial hypertension. Proper diagnosis and treatment protects the patient against life-threatening cardiovascular complications.

• Serum selenium concentration in patients with Wilson's disease.

  Authors: Renata Swiatkowska-Stodulska, Wojciech Dejneka, Irena Jabłońska-Kaszewska, Jerzy Lukasiak, Hanna Kiszkis, Piotr Wiśniewski, Monika Lubińska, Krzysztof Sworczak

  Hepato-gastroenterology. 10/2007; 54(78):1788-90.

  BACKGROUND/AIMS: Wilson's disease is a genetically determined disorder of copper metabolism in the liver. Due to the toxic accumulation of this trace element, body organs are damaged by free radicalBACKGROUND/AIMS: Wilson's disease is a genetically determined disorder of copper metabolism in the liver. Due to the toxic accumulation of this trace element, body organs are damaged by free radical generation, lipid peroxidase and inhibition of synthesis of some proteins. Behavior of anti-oxidative factors in Wilson's disease has not been completely evaluated yet. The aim of the study was to assess blood serum concentrations of selenium in patients with Wilson's disease. METHODOLOGY: Twenty-five patients with Wilson's disease and 30 healthy volunteers, constituting a control group were included in the study. The patients were in good clinical condition. In all the subjects blood serum concentrations of selenium were tested using the atomic absorption spectroscopy, hydride generation method. RESULTS: Selenium concentrations in the blood serum of the patients and healthy controls did not show statistical differences between both groups. Correlations between selenium concentrations and biochemical parameters: activity of alanine and aspartate aminotransferase, alkaline phosphatase, gamma-glutamyltranspeptidase, concentration of bilirubin, albumin and gamma globulin, international normalized prothrombin index as well as serum copper, ceruloplasmine and 24-h urine copper excretion were assessed. Statistically significant correlation was found only between selenium concentration and aspartate aminotransferase activity. No statistically significant differences between selenium concentrations in the serum of patients with different forms of Wilson's disease were found. CONCLUSIONS: On the basis of the results obtained in the study it can be assumed that in treated patients with Wilson's disease the antioxidant status measured as serum selenium concentration is comparable to healthy controls.

• [Effect of selected hormones on particular parameters of hemostasis]

  Authors: Renata Swiatkowska-Stodulska, Anna Babińska, Krzysztof Sworczak

  Wiadomości lekarskie (Warsaw, Poland : 1960). 02/2007; 60(7-8):390-3.

  Endocrinopathies belong to the group of heterogenic diseases in course of which hemostatic disturbances can occur at any stage of the disease. On one hand they could include an increased riskEndocrinopathies belong to the group of heterogenic diseases in course of which hemostatic disturbances can occur at any stage of the disease. On one hand they could include an increased risk ofthromboembolic events, on the other hand an increased tendency to development of bleeding complications. The aim of this paper was to examine the influence of different hormones on hemostasis and fibrinolysis with particular emphasis on blood clotting factors, platelets' function and parameters of fibrinolysis.

• [Hemostatic disturbances in obesity]

  Authors: Renata Swiatkowska-Stodulska, Ewa Kazimierska, Krzysztof Sworczak, Eugenia Czestochowska

  Wiadomości lekarskie (Warsaw, Poland : 1960). 02/2007; 60(3-4):185-8.

  Overweight and obesity belong to the group of chronic diseases in which there is a substantially increased risk of thromboembolic incidents. The changes involve both arterial and venous system. TheOverweight and obesity belong to the group of chronic diseases in which there is a substantially increased risk of thromboembolic incidents. The changes involve both arterial and venous system. The decisive role in their development seems to have disorders ofhemostasis including both excessive activation of coagulation system and/or inhibition of fibrinolysis. Coagulation changes in obese persons are complex. They include, among others, increase in concentration and activity of blood clotting factors, hyperfibrynogenemia and overeactivity ofplatelets. On the other hand, inhibition of normal fibrinolysis occurs in obese persons. The goal of this study was to examine disorders of coagulation and fibrinolysis developing in obese persons, taking also into account hormonal and metabolic changes, endothelium damage and the influence of adipocytokines on the hemostasis mechanisms.

• Interleukin-8 in the blood serum of patients with alcoholic liver disease.

  Authors: Renata Swiatkowska-Stodulska, Alicja Bakowska, Anna Drobińska-Jurowiecka

  Medical science monitor : international medical journal of experimental and clinical research. 06/2006; 12(5):CR215-20.

  BACKGROUND: The influence of the immune system on the development of alcoholic liver disease has recently been the object of attention. However, the connection between alcohol consumption, alteredBACKGROUND: The influence of the immune system on the development of alcoholic liver disease has recently been the object of attention. However, the connection between alcohol consumption, altered immune response, and development of changes in the liver has not been fully explained. The aim of the present study was to evaluate serum IL-8 concentration in patients with chronic alcoholic liver disease. MATERIAL/METHODS: 85 patients with different types of ALD and 35 healthy subjects were enrolled in the study. Serum IL-8 concentration was evaluated with the ELISA immunoenzymatic method. IL-8 in liver tissue was measured by the indirect immunofluorescence method. RESULTS: There was a significant correlation between IL-8 concentration and AST, ALP, GGT, total bilirubin and albumin levels in blood serum. A significantly higher concentration of IL-8 was seen in all the groups of ALD patients. The highest values were found in patients with chronic alcoholic hepatitis, and the lowest in those with fatty liver. Significantly higher values were found in patients with ascites or encephalopathy in comparison to those without any features of portal hypertension and/or insufficiency of the liver cells. A high concentration of the tested cytokine is a disadvantageous prognostic factor in patients with ALD. CONCLUSIONS: IL-8 appears to be an important factor in liver pathology in patients with ALD, especially in the development of the inflammatory process.

• [Negative D-dimers and exclusion of venous thromboembolism--own experience]

  Authors: Dorota Dworakowska, Ewa Kazimierska, Jolanta Weyer-Hepka, Anna Skibowska-Bielińska, Renata Swiatkowska-Stodulska, Monika Lubińska, Eugenia Czestochowska

  Polskie archiwum medycyny wewnȩtrznej. 01/2006; 114(6):1200-3.

  The assessment of D-dimer concentration has become essential step during diagnostic algorithm of venous thromboembolism (VTE). This test characterizes high sensitivity but limited specificity.The assessment of D-dimer concentration has become essential step during diagnostic algorithm of venous thromboembolism (VTE). This test characterizes high sensitivity but limited specificity. Negative D-dimer with high probability excludes VTE. The aim of this study was to assess the percentage of patients treated in Department of Internal Medicine, Endocrinology and Haemostatic Disorders, Medical University of Gdańisk, who in spite of clinical signs of VTE showed normal D-dimer level. Between 2000 and 2004 in our department 57 cases with recent deep vein thrombosis (DVT) were diagnosed, in 2 cases with co-existence of pulmonary embolism (PE). The D-dimer concentration was assessed in patients' plasma with the use of immunoturbidometry. Between 57 cases with VTE, 7 patients (12%) showed normal D-dimer level (<500 microg/ml). This group consisted of 4 men and 3 women, aged from 40 to 82 years (the mean age of 58 years). In all 7 cases DVT was diagnosed, in 2 patients with concomitent PE. The final diagnosis was confirmed by compression ultrasonography and pulmonary scintigraphy. Our analysis underlines the observation that occurrence of VTE and negative d-dimer concentration is possible and may probably be related to methodological limitations. However, the lack of increase of D-dimer could also be caused by fibrinolysis alteration.

• [Portal vein thrombosis in patients with thrombophilia--own observations]

  Authors: Renata Swiatkowska-Stodulska, Ewa Kazimierska, Jolanta Weyer-Hepka, Dorota Dworakowska, Monika Lubińska, Maria Gnacińska, Alicja Bakowska, Eugenia Czestochowska

  Polskie archiwum medycyny wewnȩtrznej. 05/2005; 113(4):346-51.

  Portal vein thrombosis is one of the main prehepatic causes of portal hypertension. The most frequent causes of thrombosis in this localization, apart from hepatic cirrhosis, are the following: acutePortal vein thrombosis is one of the main prehepatic causes of portal hypertension. The most frequent causes of thrombosis in this localization, apart from hepatic cirrhosis, are the following: acute inflammatory diseases and abdominal cancers, traumas, proliferative diseases of the hematopoietic system. In recent years attention was given to disorders in hemostasis, such as thrombophilia, in the course of which thrombosis development is particularly common. The authors present 10 patients after an incident of portal vein thrombosis, in which primary hepatic pathology was excluded and tests directed at thrombophilia were performed. In seven patients abnormalities in the examined parameters were found, and what is more, in two cases they had a complex character and involved more than one parameter. In five patients hyperhomocysteinemia was found. Among them, in two patients there was also a decreased protein S activity and in one of them there was also APC-resistance. In the next two patients there were abnormalities in one of the examined parameters - APC-resistance. Hyperhomocysteinemia was found in all patients with idiopathic thrombosis, and in one of them there were concurrent changes in protein S activity and APC-resistance. In patients with the history of portal vein thrombosis diagnostics of thrombophilia should be performed.

• [Prophylaxis of venous thromboembolism in otolaryngology--head and neck surgery]

  Authors: Dominik Stodulski, Renata Swiatkowska-Stodulska, Czesław Stankiewicz, Eugenia Czestochowska

  Otolaryngologia polska. The Polish otolaryngology. 02/2005; 59(2):239-44.

  Venous thromboembolic disease (deep vein thrombosis and pulmonary embolism) is a frequent and dangerous complication of surgical procedures. Guidelines considering prophylaxis in patients who have aVenous thromboembolic disease (deep vein thrombosis and pulmonary embolism) is a frequent and dangerous complication of surgical procedures. Guidelines considering prophylaxis in patients who have a risk of this complication exist in most surgical specialties. In otolaryngology it is a rare illness but a lack of Polish literature and quite few world publications on this subject made the authors check through the literature referring to venous thromboembolic disease in otolaryngology and maxillofacial surgery and indexed in the EMBASE and MEDLINE data bases up till 2003. Incidence of the disease, risk factors with regard to the kind of surgery and prophylaxis methods were presented, all with the aim of creating a kind of a guide useful in clinical practice in ENT.

• [Serum interleukin-6 concentrations in patients with alcoholic liver disease]

  Authors: Renata Swiatkowska-Stodulska, Alicja Bakowska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 10/2004; 17(99):255-9.

  Serum interleukin-6 concentrations in patients with alcoholic liver disease Pathogenesis of alcoholic liver disease (ALD) is not well defined, but immune mediated hepatic injury is thought to beSerum interleukin-6 concentrations in patients with alcoholic liver disease Pathogenesis of alcoholic liver disease (ALD) is not well defined, but immune mediated hepatic injury is thought to be important. The main aim of this study was estimation of serum concentrations of IL-6 in patients with chronic alcoholic liver disease and determination of correlations between IL-6 serum concentration and occurrence of clinical manifestations, biochemical parameters and a stage of ALD. 85 patients with the diagnosis of chronic ALD and 35 healthy subjects (mached for age and sex) were enrolled into the study. Serum concentration of IL-6 was measured with ELISA. Serum IL-6 concentrations were markedly elevated in the all analyzed groups of patients with ALD when compared with healthy controls. When compared in groups, patients with alcoholic cirrhosis and chronic alcoholic hepatitis had the highest and patients with fatty liver had the lowest serum IL-6 concentrations. In addition, IL-6 concentrations were higher in patients with hepatic encephalopathy than in those without liver failure. Furthermore, we found statistically significant correlation between serum IL-6 and albumin concentrations. High IL-6 concentrations were associated with high mortality in patients with ALD. These findings suggest that IL-6 is an important immunological factor associated with alcoholic liver disease.

• Serum selenium levels in alcoholic liver disease.

  Authors: Irena Jabłońska-Kaszewska, Renata Swiatkowska-Stodulska, Jerzy Łukasiak, Wojclech Dejneka, Agnleszka Dorosz, Ewa Dabrowska, Bogdan Falkiewicz

  Medical science monitor : international medical journal of experimental and clinical research. 09/2003; 9 Suppl 3:15-8.

  BACKGROUND: The pathomechanism of liver damage in chronic alcoholic liver disease has not been fully elucidated yet. It seems undoubted that one of the mechanisms of alcohol-induced liver damageBACKGROUND: The pathomechanism of liver damage in chronic alcoholic liver disease has not been fully elucidated yet. It seems undoubted that one of the mechanisms of alcohol-induced liver damage involves free radical reactions leading to peroxidation of proteins and lipids. The most important defense mechanisms are associated with the activity of antioxidative enzymes, among which glutathione peroxidase (GSH-Px), belonging to so-called 'free radical scavengers' should be mentioned. Selenium, regarded as a bioelement, is present in GSH-Px. Involved in numerous redox reactions, it belongs to the factors protecting the organism from oxidative shock. The aim of the study was to determine the selenium levels in blood serum of chronic alcohol abusers and to find potential correlations with the parameters of liver damage. MATERIAL/METHODS: The study was carried out in a group of 25 subjects (21 males, 4 females), treated in the Clinic or Outpatient Department of Hepatology for chronic alcoholic liver disease. At the time of the study, the patients had abstained from drinking for a period from one month to a year. Selenium was determined with atomic absorption spectroscopy method, using the hydride generation technique. The control group consisted of 11 males and 7 females. RESULTS: Statistical analyses of the control group indicated a significantly higher blood serum selenium level in males than in females. The patients demonstrated elevated aminotransferase activity, normal Falk, markedly increased GGTP. Mean INR was 1.4 and albumin concentration 3.3 g/l. Blood serum selenium levels in male patients were significantly lower in comparison with normal values. The analysis of correlations between some liver function parameters and selenium levels demonstrated a positive correlation between the levels of albumin and selenium. Serum selenium level was inversely proportional to ALAT activity. No correlations between selenium levels and INR levels, or GGTP activity were found. CONCLUSIONS: 1. Serum selenium levels differ in male and female populations. In healthy men, the level of Se in the serum is higher. 2. Antioxidative activity measured by serum Se level is low in men with chronic alcoholic liver disease (during the abstinence period). 3. Increased selenium level in the hair may indicate the presence of certain antioxidative reserve, which requires further studies.

• [Cyclosporine in the treatment of atypical celiac sprue. A case report]

  Authors: Hanna Suchanek, Renata Swiatkowska-Stodulska, Andrzej Kryszewski, Kazimierz Jaśkiewicz

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 03/2003; 14(80):130-2.

  We present a 45-year-old woman with atypical celiac sprue who was unresponsive to gluten-free diet. Cyclosporine therapy was applied (5 mg/kg body weight daily for 2 months). The patient demonstratedWe present a 45-year-old woman with atypical celiac sprue who was unresponsive to gluten-free diet. Cyclosporine therapy was applied (5 mg/kg body weight daily for 2 months). The patient demonstrated a remarkable clinical and histological response to this drug.

• [Acquired von Willebrand's disease in the course of severe primary hypothyroidism in a patient with autoimmune polyglandular syndrome type 3]

  Authors: Monika Lubińska, Renata Swiatkowska-Stodulska, Ewa Kazimierska, Krzysztof Sworczak

  Endokrynologia Polska. 59(1):34-7.

  The case of a 20-year old female, who had been followed because of von Willebrand disease (vWD) was presented in this paper . She had a past history of menorrhagia and bleeding after dentalThe case of a 20-year old female, who had been followed because of von Willebrand disease (vWD) was presented in this paper . She had a past history of menorrhagia and bleeding after dental procedures and the activity of von Willebrand factor (vWF) was decreased. Because of suggestive clinical features, the workup for hypothyroidism was performed and the patient was found to have severe hypothyroidism due to Hashimoto thyroiditis. After the institution of replacement therapy with levothyroxine, von Willebrand factor activity returned to normal range and symptoms of von Willebrand disease disappeared. Based on these findings, the diagnosis of acquired von Willebrand syndrome (AvWS) due to hypothyroidism was made. The development of myasthenia led to the final diagnosis of autoimmune polyglandular syndrome type 3 (APS) with myasthenia gravis and vitiligo.

• [Assessment of selected haemostatic parameters in obese patients]

  Authors: Renata Swiatkowska-Stodulska, Anna Skibowska-Bielińska, Alicja Bakowska, Piotr Wiśniewski, Krzysztof Sworczak

  Endokrynologia Polska. 58(6):505-9.

  BACKGROUND: Epidemiologic data show significantly higher frequency of thromboembolic incidents in obesity than in normal weight persons. Disorders of haemostasis seem to play a crucial role in theirBACKGROUND: Epidemiologic data show significantly higher frequency of thromboembolic incidents in obesity than in normal weight persons. Disorders of haemostasis seem to play a crucial role in their development. In the literature there are only few papers assessing coagulation and fibrynolitic parameters in obese subjects. AIM OF THE STUDY: Assessment of protein C (PC), antithrombin (AT) and alpha2 antiplasmin (alpha2AP) activity and thrombomodulin (TM) concentration in the blood plasma of obese person (BMI > 30 kg/m(2)). MATERIALS AND METHODS: The study involved 32 patients (22 women and 10 men, mean age 39.7 +/- 15.3 years) and 20 healthy volunteers matched correctly according to sex and age who constituted a control group. In the examined subjects activity of PC, AT, alpha2 AP were assessed by means of the colorimetric methods and TM concentration in the blood plasma using ELISA method. RESULTS: No statistically significant differences in activities of PC, AT, alpha2 AP and TM concentrations between the patients and the control group were found. However the tendency to higher activities of PC and concentrations of TM were noticed in the obese patients. Assessing tested parameters according to sex, statistically significant differences were found in AT activity between the male patients and healthy men. Statistically lower values, but still in the normal range, were found in the obese men. Comparing the groups of women, significantly lower concentrations of TM were found in the obese ones. CONCLUSIONS: It seems that changed values of PC, AT, alpha2 AP activities are not responsible for increased risk of thromboembolic events in obese persons. Increased TM concentration in obese, may indirectly indicate endothelium damage.