Inferior Vena Cava Filters as a Potential Non-immune Cause of Low Serum HaptoglobinLaura Cooling*, Donald Giacherio and Matthew Elkins
Departments of Pathology, University of Michigan, Ann Arbor MI and SUNY Upstate Medical University, Syracuse, New York, USA
- *Corresponding Author:
- Laura Cooling, MD, MS
Associate Professor, Pathology Associate Director
Transfusion Medicine University of Michigan Hospitals 2F225 UH Blood Bank
Box 0054 1500 East Medical Center Drive Ann Arbor, MI 48109-0054,USA
Tel: (734) 936-0695
E-mail: [email protected]
Received date: March 28, 2017; Accepted date: April 29, 2017; Published date: May 05, 2017
Citation: Cooling L, Giacherio D, Elkins M (2017) Inferior Vena Cava Filters as a Potential Non-immune Cause of Low Serum Haptoglobin. J Blood Disord Transfus 8:382. doi:10.4172/2155-9864.1000382
Copyright: © 2017 Cooling L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: Serum haptoglobin level is commonly used as a marker of hemolysis. We hypothesized that inferior vena cava (IVC) filters may be a potential non-immune etiology for subclinical hemolysis and low haptoglobin in some patients, after encountering a patient with an IVC filter, mild macrocytic anemia and unexplained severe haptoglobinemia. IVC filters can be associated with pressure gradients and turbulent blood flow in the presence of trapped clots and thrombus formation.
Methods: Prospective study in patients undergoing IVC filter placement at our institution over a 3-month period in 2008. All patients had a haptoglobin level prior to filter placement, and then daily for a period of 3-14 days. The absolute and relative change in haptoglobin compared to pre-procedure levels was determined. Results were evaluated by t-test (paired, 2-tail). Statistics and graphics were performed with commercial software.
Results: A total of 22 patients underwent IVC filter placement. Four patients were excluded due to low preprocedure haptoglobin levels. At least one post-procedure haptoglobin values was available until day 3 in 18/18 eligible patients. Nine patients were followed for a period of 1-2 weeks. Although the majority of patients had an increase in haptoglobin after IVC filter placement, 3/9 (30%) had >50% decrease in haptoglobin by day 7, including one patient with severe haptoglobinemia by day 14. Patients with decreased haptoglobin levels also had decreases in platelet count over the same period.
Conclusion: These results suggest that IVC filters may be another non-immune, device-related cause of decreased haptoglobin in some patients.