Plasma Prekallikrein, Factor XII, Antithrombin III, C1−-Inhibitor and α2-Macroglobulin in Critically III Patients with Suspected Disseminated Intravascular Coagulation (DIC)

Abstract

In nine patients with suspected disseminated intravascular coagulation (DIC) and five controls, the following analyses were performed on admission and 7-29 hours later: Routine coagulation studies (fibrinogen, platelet count, fibrin(ogen) degradation products, ethanol gelation, reptilase time, Factor V) providing a semiquantitative DIC score, prekallikrein (PK), Factor XII, antithrombin III (AT-III), C1(-)-inhibitor and alpha 2-macroglobulin. Significant correlations were found: PK or AT III with the DIC-score, PK with AT-III and Factor XII, AT-III with Factor XII. The changes (expressed as a percentage of normal plasma) of PK and AT-III from the first to the second evaluation were nearly identical. The two patients with rapidly fatal irreversible shock showed the highest DIC score and a pronounced decrease of PK and AT-III, whereas in reversible shock stable or increasing PK and AT-III values were found. The other variables showed an overlap between reversible and irreversible shock. DIC in these shock patients, accompanied by a decrease in PK, probably was mediated via Factor XII activation. PK and AT-III might be of prognostic value in patients with (septic) shock.

Activation of the Plasma Kallikrein-Kinin System in Respiratory Distress Syndrome

“…It has been previously demonstrated that plasma prekallikrein is transformed to kallikrein in a series of other pathophysiologic conditions such as septicemia, multitraumatized patients with multiple organ failure, and the adult RDS (1)(2)(3)(4)(5)17). On the basis of the present data it may therefore be tempting to speculate that RDS has some features in common with "posttraumatic" diseases such as those listed above (1)(2)(3)(4)(5).…”

“…On the basis of the present data it may therefore be tempting to speculate that RDS has some features in common with "posttraumatic" diseases such as those listed above (1)(2)(3)(4)(5). It is known that RDS may be aggravated and precipitated by shock, hypothermia, and acidosis (26,27).…”

Elevated TFPI in malignant disease: relation to cancer type and hypercoagulation

“…In contrast, fulminant or acute DIC is characterized by both consumption coagulopathy and evidence of organ failure (Mü ller-Berghaus, 1989;Bick, 1995). Fulminant DIC is more frequent in ANLL than in solid tumour disease, and is relatively frequent in septicaemia (Lammle et al, 1984).…”

Effect of Heparin, Hirudin, and a Synthetic Thrombin Inhibitor on Antithrombin III in Thrombin-Induced Disseminated Intravascular Coagulation in Rats

“…The importance of AT III for the haemostatic balance is elucidated by the clinical observation that AT III plasma levels of less than 70-80% of normal are indicative of a thrombotic risk [3]. On the other hand, AT III may be reduced in the course of disseminated intravascular coagu lation [4][5][6], This would result in a reduced effectiveness of heparin treatment.…”