Thrombin generation in patients with thrombotic thrombocytopenic purpura.
Thrombotic thrombocytopenic purpura (TTP) is thought to be caused primarily by endothelial cell injury or primary platelet agglutination. A coagulation screen usually shows normal or minimal changes, but a modest elevation of fibrinogen/fibrin degradation products (FDP) is observed in many patients with TTP. To assess the thrombin generation in vivo in TTP, plasma levels of thrombin-antithrombin III complex (TAT) were measured together with plasmin-alpha 2-antiplasmin complex (PAP) in ten patients with acute TTP. Plasma TAT [mean 6.7 +/- (SD) 3.7 micrograms/liter] as well as PAP (2.1 +/- 1.2 mg/liter) were elevated in patients with TTP as compared with healthy subjects (TAT of 1.7 +/- 0.3 microgram/liter and PAP of 0.2 +/- 0.1 mg/liter; n = 10). These findings indicate that considerable amounts of thrombin and plasmin are actually generated in TTP, although the majority of patients do not show signs of consumption coagulopathy.
Takahashi
H
H
First Department of Internal Medicine, Niigata University School of Medicine, Japan.
Tatewaki
W
W
Wada
K
K
Shibata
A
A
D000328:Adult; D000933:Antifibrinolytic Agents; D000990:Antithrombin III / Q000378:metabolism; D005260:Female; D005341:Fibrinolysin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000378:metabolism; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood*; D013917:Thrombin / Q000378:metabolism*; D000979:alpha-2-Antiplasmin / Q000378:metabolism
D000933:Antifibrinolytic Agents; D000979:alpha-2-Antiplasmin; C046193:antithrombin III-protease complex; C037742:plasmin-plasmin inhibitor complex; D000990:Antithrombin III; D010447:Peptide Hydrolases; D013917:Thrombin; D005341:Fibrinolysin