Observational studyThe Journal of clinical endocrinology and metabolism2021
Procoagulant Imbalance in Klinefelter Syndrome Assessed by Thrombin Generation Assay and Whole-Blood Thromboelastometry.
Observational study in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Clinical features and prevalence of Klinefelter syndrome in transgender individuals: A systematic review.Clinical endocrinology · 2022Pooled it
- Platelet Reactivity and Sex Differences: Clinical Implications for Women.Circulation research · 2026Review
- Klinefelter Syndrome Identified by Next-generation Sequencing as a Risk Factor for Venous Thromboembolism: A Single-institution Study.Annals of laboratory medicine · 2026Article
- Update on Physical, Psychological, and Quality of Life Management in Klinefelter Syndrome.The Journal of clinical endocrinology and metabolism · 2025Review
- Mild liver dysfunction in Klinefelter syndrome is associated with abdominal obesity and elevated lipids but not testosterone treatment.Journal of endocrinological investigation · 2024Article
- Testosterone Therapy Does Not Affect Coagulation in Male Hypogonadism: A Longitudinal Study Based on Thrombin Generation.The Journal of clinical endocrinology and metabolism · 2024Observational
- Morbidity, mortality, and socioeconomics in Klinefelter syndrome and 47,XYY syndrome: a comparative review.Endocrine connections · 2023Review
- [Chronic venous leg ulcers in association with postthrombotic syndrome in an XYY patient with a history of estrogen therapy].Dermatologie (Heidelberg, Germany) · 2023Article
- The complications of male hypogonadism: is it just a matter of low testosterone?Frontiers in endocrinology · 2023Review
- Relationships between endogenous and exogenous testosterone and cardiovascular disease in men.Reviews in endocrine & metabolic disorders · 2022Review
Corrections and comments
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Authors and funding
19 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextKlinefelter syndrome (KS) is a condition at increased risk of thrombosis compared to 46,XY men.
objectiveThis work aimed to investigate the coagulation balance of KS patients by thrombin generation assay (TGA) and thromboelastometry.
methodsAn observational, cross-sectional study was conducted at 3 tertiary endocrinological centers in Milan, Italy. Fifty-eight KS patients and 58 age-matched healthy controls were included. Anticoagulant or antiplatelet therapy and known coagulation disorders were exclusion criteria. TGA was performed in platelet-poor plasma (PPP) and platelet-rich plasma (PRP). Whole-blood thromboelastometry and activities of coagulation factors were assessed. Endogenous thrombin potential (ETP), the area under the thrombin generation curve, assessed with and without thrombomodulin (ETP-TM+ and ETP-TM-), and their ratio (ETP ratio), were considered as indexes of procoagulant imbalance.
resultsPatients with KS displayed higher PPP-ETP-TM+ (mean 1528 vs 0.1315 nM × min; P < .001), PPP-ETP ratio (0.78 vs 0.0.70; P < .001), factor (F)VIII (135% vs 0.107%; P = .001), fibrinogen (283 vs 0.241 mg/dL; P < .001), and FVIII/protein C ratio (1.21 vs 0.1.06; P < .05) compared to controls. Protein C was comparable in the 2 groups. Similar results were observed in PRP. The ETP ratio was positively associated with FVIII (ρ = 0.538, P < .001) in KS. Thromboelastometry parameters confirmed evidence of hypercoagulability in KS.
conclusionPatients with KS display a procoagulant imbalance expressed by increased thrombin generation both in PPP and PRP, which is at least in part explained by increased FVIII levels. The procoagulant imbalance, which was confirmed by thromboelastometry, may be responsible for the thrombotic events observed in these patients. Further investigation on the benefit/risk ratio of antithrombotic prophylaxis is warranted.
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