Vichai AtichartakarnPantep AngchaisuksiriKatcharin AryurachaiSupornchai OnpunSuporn ChuncharuneeAmmarin ThakkinstianKanlayanee AtamasirikulMahidol UniversityFaculty of Medicine, Ramathibodi Hospital, Mahidol University2018-07-242018-07-242002-09-23British Journal of Haematology. Vol.118, No.3 (2002), 893-898000710482-s2.0-0036039730https://repository.li.mahidol.ac.th/handle/20.500.14594/20354Small pulmonary arterial thromboses can occur following splenectomy of patients with haemoglobin E/β-thalassaemia (Hb E/β-thal). We compared plasma markers of coagulation activation in vivo and red blood cell (RBC) markers of procoagulant activity in 15 Hb E/β-thal patients who were not splenectomized (NS), 15 who had been splenectomized (S), and 15 normal controls (NC). Levels of plasma thrombin-antithrombin III complex (TAT) were significantly higher in the S group than in either the NS or the NC groups, and levels of prothrombin fragment 1.2 (F 1.2) were significantly higher in the S than in the NC group. Diluted Russell's viper venom clotting times were significantly shorter when RBCs from group S patients were added to the assay compared with RBCs from the NC group. Phosphatidylserine (PS) expression (% of annexin V-positive RBCs) on the outer leaflet of RBC membrane of both 'larger'-and 'smaller'-sized RBCs was significantly higher for the S than the NC group. The RBC PS expression of the S and the NS groups, respectively, accounted for 25.3% (P = 0.174) and 6.3% (P = 0.675) of the variation in plasma TAT levels. Our findings indicated that, when compared with NC, splenectomized patients with Hb E/β-thal were in a chronic low-grade hypercoagulable state associated with increased numbers of circulating PS exposed RBCs. This condition may have a role in the risk of these patients for pulmonary arterial thromboses.Mahidol UniversityMedicineArticleSCOPUS10.1046/j.1365-2141.2002.03711.x