The possible relationship between epistaxis and protein Z plasma levels

Abstract

Epistaxis represents a very common emergency in any ear, nose, and throat (ENT) department around the world. Frequently seen in the systemic vascular patients, nasal anatomy the lack of vessels muscular structure, the absence of vasoconstriction ability, the clot formed in the bleeding area further increases the amount of bleeding supports the importance of vascular causes in the etiology. The purpose of our research is to evaluate the relationship between epistaxis and plasma protein Z levels. 18 patients with epistaxis and 30 healthy subjects were investigated. 8 of patients gruop (44.4%) participating the research were women, 10 of them (55.6%) were men, in total 18 people. Control group consisted of 16 women (53.3%), 14 men (46.7%), 30 people in total. Both groups were measured about protein C (PC), protein S (PS), and protein Z (PZ). PC and PS concentrations were determined in plasma by using cholorimetric and the formation clotting methods, respectively. Sandwich enzyme immunoassay method was used for the determination of PZ plasma concentrations. While statistically there were no significant differences detected comparing Protein S and Protein C levels data of control group, (p=0.27 ve p=0.29 respectively). Protein Z levels of patient group was found significantly lower than Protein Z levels of control group and this was found to be statistically significant (p<0.001). Vascular causes are known to take part in the etiology of epistaxis. Defects of Protein Z function and/or secretion, are associated also with bleeding, venous thrombosis and arterial thromboembolism as well as including especially epistaxis.