Trousseau’s syndrome: The forgotten past or actual present?
Objective. To carry out a systematic analysis of the data available in the current literature on the modern view on Trousseau’s syndromeVorobyev A.V., Makatsaria A.D., Brenner B.
Material and methods. The review included the data of foreign and Russian articles published in the past 10 years and found in e-Library and PubMed on this topic.
Results. This paper provides a pathogenetic explanation for the increased thrombotic potential in cancer patients, which underlies tumor growth and metastasis. In addition to direct thrombotic events, the paper also describes hemorrhagic complications resulting from systemic coagulopathy, including disseminated intravascular coagulation, hemolytic thrombotic microangiopathy, and excessive fibrinolysis.
Conclusion. At present, any manifestation of thrombohemorrhagic complications in patients with malignant tumors can be classified as a paraneoplastic syndrome (Trousseau’s syndrome). In addition to Virchow’s classic triad, hyperproduction of tissue factor (TF), the main initiator of the extrinsic coagulation pathway, underlies the pathophysiology of Trousseau’s syndrome. At the same time, the substantial release of microparticles from TF-bearing tumor cells is critical not only for clot formation, but also for the progression of tumor growth.
Keywords
Trousseau’s syndrome
malignant neoplasms of female genital organs and breast
thrombotic events
hemostatic system
tumor metastasis
disseminated intravascular coagulation syndrome
thrombophilia
pathogenesis of thrombotic events
cancer patients
prevention of thrombosis
hemostatic disorders
Supplementary Materials
- Table 1. Markers of the hemostasis system activation
- Table 2. The role of hemostasis system in the process of growth and progression of malignant neoplasm
- Figure 1. Modification of the Virchow’s triad
- Figure 2. Common pathogenesis of tumor growth and thrombotic complications
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Received 18.04.2017
Accepted 28.04.2017
About the Authors
Vorobyov Alexander Viktorovich, Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics and Gynecology of the Facultyof Medical Prevention, I.M. Sechenov First Moscow State Medical University.
109004, Russia, Moscow, Zemlyanoi Val str. 62, bld. 1. Tel.: +79031056365. E-mail: alvorobev@gmail.com
Makatsariya Alexander Davidovich, Corresponding Member of the Russian Academy of Sciences, Professor, Doctor of Medical Sciences,
Head of the Department of Obstetrics and Gynecology of the Faculty of Medical Prevention, I.M. Sechenov First Moscow State Medical University.
109004, Russia, Moscow, Zemlyanoi Val str. 62, bld. 1. Tel.: +79037280897. E-mail: gemostasis@mail.ru
Brenner Benjamin, Professor, Director, Institute of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa,
Israel. E-mail: gemostasis@mail.ru
For citations: Vorobyev A.V., Makatsaria A.D., Brenner B. Trousseau’s syndrome: The forgotten past or actual present? Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (2): 27-34. (in Russian)
https://dx.doi.org/10.18565/aig.2018.2.27-34
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