Coagulation Status in Women With Endometriosis
Paola Viganò, PhD1, Jessica Ottolina, MD2, Veronica Sarais, MD2, Giorgia Rebonato, PhD2, Edgardo Somigliana, MD3, and Massimo Candiani, MD2
Reproductive Sciences 2018, Vol. 25(4) 559-565
Subtle alterations in coagulation and fibrinolysis have been recently reported in patients with endometriosis supporting a potential hypercoagulable status associated with the disease. This cross-sectional study aimed at evaluating some variables of coagulation status and inflammatory markers in women with endometriosis. A total of 314 women who underwent surgery were considered.
The case group (n ¼ 169) included patients with a surgical diagnosis of endometriosis, at any stage of disease. The control group (n ¼ 145) included women with a surgical diagnosis of benign gynecologic pathology. No difference was found for thrombin time, International Normalized Ratio (INR), platelet count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (PLR) between women with endometriosis and controls. Conversely, patients with endometriosis had significantly shortened activated partial thromboplastin time (APTT) when compared to controls (1.08 + 0.06 and 1.12 + 0.19, respectively; P < .01). In the subgroup analysis, women with ovarian endometriosis had significantly shortened APTT values in comparison to women without this form and women with stage I to II endometriosis had significantly shorter APTT values and higher PLR than those with stage III to IV disease. In multivariate logistic regression analysis, after controlling for potential confounders, a shortened APTT remained associated with the disease. Activated partial thromboplastin time is shorter in women with endometriosis but still in the normal range. The evidence is insufficient to foresee a possible use of APTT as a diagnostic marker and to claim a crucial role of a systemic hypercoagulable state in the origin of the disease. A role of the local coagulation
system in the pathogenesis of the disease cannot be excluded.
coagulation, endometriosis, activated partial thromboplastin time, platelet, platelet–lymphocyte ratio, thrombin time, INR
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