{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:24:57Z","timestamp":1783488297395,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,6,12]],"date-time":"2014-06-12T00:00:00Z","timestamp":1402531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Rotation thromboelastometry (ROTEM<jats:sup>\u00ae<\/jats:sup>) can be used for hypercoagulability evaluation. Cushing's syndrome (CS) is associated with hypercoagulability; however, ROTEM<jats:sup>\u00ae<\/jats:sup> has never been evaluated in this setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate hypercoagulability in CS using ROTEM<jats:sup>\u00ae<\/jats:sup> and to correlate these parameters with coagulation markers and with the presence of deep vein thrombosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and methods<\/jats:title><jats:p>Thirty patients with active CS (26 women) and 30 controls matched for age, sex, body mass index, diabetes mellitus, arterial hypertension, ABO blood group and smoking were included. We measured levels of activated partial thromboplastin time (aPTT), platelets, fibrinogen, D\u2010dimer, factor VIII (FVIII), von Willebrand factor (vWF) and C\u2010reactive protein. ROTEM<jats:sup>\u00ae<\/jats:sup> was used to evaluate the intrinsic (INTEM), extrinsic (EXTEM) and fibrinogen (FIBTEM) pathways. Doppler ultrasonography was performed to search for lower limbs deep vein thrombosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>INTEM clotting time using ROTEM<jats:sup>\u00ae<\/jats:sup> was shorter in patients than in controls (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b704). Other ROTEM<jats:sup>\u00ae<\/jats:sup> parameters were not different. Mean aPTT was shorter in patients than in controls (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7001). The FVIII, vWF and D\u2010dimer levels were higher in patients than in controls (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7001, 0\u00b7001 and 0\u00b702, respectively). Obese CS patients presented higher levels of platelets and alterations in maximum clot formation (MCF), alpha angle and maximum speed of clot formation of INTEM (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b703, 0\u00b702 and 0\u00b702, respectively) and an increase in the MCF of FIBTEM (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b702). No deep vein thrombosis was found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although FVIII and vWF were abnormal in CS patients, only the initiation clot formation was different in the ROTEM<jats:sup>\u00ae<\/jats:sup> methodology and no deep vein thrombosis was found.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12491","type":"journal-article","created":{"date-parts":[[2014,5,10]],"date-time":"2014-05-10T15:48:45Z","timestamp":1399736925000},"page":"657-664","source":"Crossref","is-referenced-by-count":22,"title":["Rotation thromboelastometry and the hypercoagulable state in <scp>C<\/scp>ushing's syndrome"],"prefix":"10.1111","volume":"81","author":[{"given":"Maria Caroline","family":"Alves Coelho","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Endocrine Unit Medical School and Clementino Fraga Filho University Hospital Federal University of Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Vieira Neto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Endocrine Unit Medical School and Clementino Fraga Filho University Hospital Federal University of Rio de Janeiro Rio de Janeiro Brazil"},{"name":"Endocrinology Section Federal Hospital of Lagoa Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leandro","family":"Kasuki","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Endocrine Unit Medical School and Clementino Fraga Filho University Hospital Federal University of Rio de Janeiro Rio de Janeiro Brazil"},{"name":"Endocrinology Unit Bonsucesso Federal Hospital  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Eduardo","family":"Wildemberg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Endocrine Unit Medical School and Clementino Fraga Filho University Hospital Federal University of Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila Vicente","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Endocrine Unit Medical School and Clementino Fraga Filho University Hospital Federal University of Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gizele","family":"Castro","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Hematology Unit Medical School and Clementino Fraga Filho University Hospital Federal University of Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glauber","family":"Gouv\u00eaa","sequence":"additional","affiliation":[{"name":"Anesthesiology Unit Clementino Fraga Filho University Hospital Federal University of Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlando Carlos Gloria","family":"Veloso","sequence":"additional","affiliation":[{"name":"State Center of Imaging Diagnosis Rio de Janeiro State Health Secretary  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Telma","family":"Gadelha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Hematology Unit Medical School and Clementino Fraga Filho University Hospital Federal University of Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f4nica R.","family":"Gadelha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Endocrine Unit Medical School and Clementino Fraga Filho University Hospital Federal University of Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,6,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1994.tb02486.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-10-0583"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.87.8.3662"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001721-199904000-00006"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-0290"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1055\/s-0038-1657887","article-title":"Further studies on the hypercoagulable state of patients with Cushing's syndrome","volume":"54","author":"Patrassi G.M.","year":"1985","journal-title":"Thrombosis and Haemostasis"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03343697"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-009-9186-y"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-03-1042"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0b013e328309044b"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2009.02082.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.12.006"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc7765"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000153938.77777.26"},{"key":"e_1_2_7_16_1","first-page":"111","article-title":"Thromboelastographic profiles as a tool for thrombotic risk in digestive tract cancer","volume":"29","author":"Papa M.L.","year":"2007","journal-title":"Experimental Oncology"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182652a33"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(02)00777-2"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0125"},{"issue":"1","key":"e_1_2_7_20_1","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.2337\/dc13-S011","article-title":"Standards of medical care in diabetes\u20132013","volume":"36","author":"American Diabetes A.","year":"2013","journal-title":"Diabetes Care"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1617-9625-10-9"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1575-0922(09)70191-3"},{"key":"e_1_2_7_23_1","first-page":"461","article-title":"Cushing s syndrome: twenty\u2010five years of clinical experience in Navarre","volume":"35","author":"Perez Garcia L.","year":"2012","journal-title":"Anales del Sistema Sanitario de Navarra"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2006.07.006"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000314315"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2753"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03345709"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1159\/000323765"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3148.2001.00315.x"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.22.2706"},{"key":"e_1_2_7_31_1","first-page":"463","article-title":"Kaolin partial thromboplastin time: high levels of procoagulants producing short clotting times or masking deficiencies of other procoagulants or low concentrations of anticoagulants","volume":"70","author":"Edson J.R.","year":"1967","journal-title":"Journal of Laboratory and Clinical Medicine"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-012-0398-4"},{"key":"e_1_2_7_33_1","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1055\/s-0038-1642511","article-title":"Factor VII and fibrinogen levels as risk factors for venous thrombosis. A case\u2010control study of plasma levels and DNA polymorphisms\u2013the Leiden Thrombophilia Study (LETS)","volume":"71","author":"Koster T.","year":"1994","journal-title":"Thrombosis and Haemostasis"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2002.01511.x"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-008-9129-0"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcen.12491","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.12491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T07:34:18Z","timestamp":1695540858000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.12491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6,12]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,11]]}},"alternative-id":["10.1111\/cen.12491"],"URL":"https:\/\/doi.org\/10.1111\/cen.12491","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,12]]}}}